Cover Story

MSF saves over 35,000 lives in Agok through its Community Malaria Agent Projects

MSF volunteer taking the blood sample from Mary Atoch. This is one of the community malaria testing sites in Manhawan village in Agok-Abyei Administrative Area (Photo: Morris Dogga/Juba Monitor)

By Morris Dogga

It was at 10:30AM on a bright Tuesday morning when 39 year old Mary Atoch walked to one of the Medecins Sans Frontieres (MSF/Doctors without Borders) testing site-just a few meters away from her home in Manhawwan village-Agok Abyei Administrative Area.

She was experiencing fever and headache. In just about five minutes later she was diagnosed with Malaria. Atoch had simple Malaria but was immediately given treatment by a trained volunteer working at the centre.

“This malaria treatment programme has been very important for me and my children. Instead of us moving from here up to Agok hospital where sometimes children suffering from Malaria die on the way, but since this programme (CMAP) was established, we are no longer walking for too long.  I am very grateful for that,” says Atoch.

Malaria remains one of the leading diseases in African countries. As of 2016, the World Health Organisation (WHO) estimates that at least 407,000 deaths were claimed by Malaria on the African continent.

With the rainy season at its peak, many villages face difficulty in accessing health care due to the poor road conditions.

First started in 2015, the Medical Charity (MSF) developed a Malaria response project dubbed Community Malaria Agent Project (CMAP) which takes health care closer to the people.

The CMAP is a strategy whereby non-medical personnel in the villages are trained using approved materials previously used by community-based materials projects.

It involves sensitization of the community for malaria, recognition of danger signs for Malaria, performing rapid test for Malaria as well as referral of severe cases to the MSF hospital in Agok.

The CMAP consists of about 50 volunteers working in 23 villages in Agok-Abyei Special Administrative Area.

In the last three months, a total 0f 42,985 people were tested for Malaria. Out of these, 35,637 were treated for simple Malaria in the 23 CMAP sites. A total of 115 Malaria cases were also referred to the MSF hospital from the CMAP sites.

For many citizens of Agok where accessing the health care centres is very difficult due to poor road conditions, the project has helped reduce Malaria related deaths and many more others treated.

Kat Deng Deng the Chief of Manhawan Village, nine kilometres from the MSF hospital says the project has lessened the time they waste in going to the main hospital which sometimes takes up to two hours by foot.

“We access the drugs whenever there is an emergency. This programme has also helped to prevent severe cases of Malaria because we get early treatment,” Kat says.

“We used to carry people with severe Malaria cases up to the hospital using beds. Some of them used to die on the way before reaching the hospital. Now no more carrying of people with beds. Only if the case becomes severe that is when we take the person to the hospital,” he explains.

The MSF vehicle cruising through a muddy road leading to Maibong Village-where one of the testing sites is stationed in Agok (Photo by Morris Dogga/Juba Monitor Newspaper; 10thOctober 2018)

The CMAP sites are supervised by six Community Health workers who reach the communities via motor bikes, boats and by foot if a village cannot be accessed by motorbikes.

Despite the challenging situations of poor roads, MSF says it will continue to take the medical services closer to the communities in Agok.

Yoruba Mitchell, the CMAP Activity Manager says the goal was to see Malaria eradicated.

“Pregnant women and children under the age of five are referred to the MSF hospital. Specifically women who are pregnant; we often refer them to the hospital because those cases for Malaria can be more complicated than what will be treated by the volunteers,” she says.

“During the rainy season in this area, the roads are soggy and impassable. The community health workers access the sites on motorbikes. Sometimes they have to take a boat to cross the river, sometimes they may have to walk several hours on foot. So I think poor road condition is the main challenge for us,” she reveals.

“We get stuck in the mud all the time because the roads are really bad. It can be very hard to get to some of these communities but that is also why it is so important that we have some sort of service available for them in their villages because it is hard for us to get to them but it is just as hard for them to get to us here in the hospital,” Yoruba adds.

Bulbeck Dumbek, a chief of Maibong village just13 kilometres away from the MSF hospital says it was very difficult for people to be treated for simple Malaria.

“There was no car to take sick people to the health centres. It takes 3 hours to reach the Agok or Anet Health centre. People were suffering. We have the young children who have suffered a lot,” Dumbek says.

“I am happy to see that people in my village can get treatment for simple Malaria near them,” he says.

Volunteering to saving life


The MSF Volunteer and the community health worker testing a child for Malnutrition in Manhawan Village in Agok on the 9thOctober 2018 (Photo by Morris Dogga/Juba Monitor)

The CMAP project operates in a total of 23 sites with 50 volunteers. Each centre has at least two volunteers who are available 24 hours.

“We provide ongoing training for our volunteers. Doing capacity building for our volunteers helps the community but it helps keep people out of the hospital,” says Yoruba.

Through the CMAP programme, Yoruba says they have been able to identify severely malnourished children who were not able to access the MSF health centre or any other nearby health care centre.

“To access some villages, the community health workers have to walk a lot of kilometres get some villages. You have to walk for two hours to the village and also walk for another two hours to come back to the main road and they do that every week,” she explains.

“Hopefully in five years, we will have eradicated Malaria,” she says.

45 year old Mary Akuol Nyuol has been volunteering in one of the centres working in Miogok centre. Akuol says she always wanted to serve her community.

“I decided to volunteer to help the people because I have seen the suffering of my people. Where they are is very from far the hospital. During the rainy season, there is water everywhere and if there are sick patients, they cannot be able to take sick person to the hospital,” she says.

Blood Donation campaign

Arek Adhel takes care of her eight year old Lou Bol in the MSF Hospital in Agok. Lou suffered from severe Malaria. (Photo by Morris Dogga/Juba Monitor)

The charity organization had also embarked on mobilizing local communities to donate blood to save the severely acute Malaria patients.

Noon Makor, the health promotion officer explained how important it was for the local community to donate blood to save the lives of those suffering from severe Malaria.

Makor hinted that some people were very sceptical about who was going to receive the blood but they were willing to donate to their loved ones.

Through the campaign however, Makor says voluntary donors accepted to donate their blood.

“Before it was less but now we got about 60 voluntary donors. We hope that the number will increase. This donation really helps because we have some cases of acute Malaria which are brought to the hospital and need urgent blood. If our blood bank has blood, we are able to donate immediately to patients who need it,” he reveals.

“We conducted this campaign such that we have blood on standby. We don’t want to lose anyone due lack of blood,” he says adding that it was very hard for some people to accept to donate blood.

Ajak Atem Diing has been donating blood since 2015 when he had seen some people die due lack of blood.

“In 2015, there were a lot of deaths from the hospital due to lack of blood. When these people of MSF told us that we should donate blood, I decided to give my blood to save the lives of other people,” Atem explains.

“If you have blood and leave your brother or sister to die, it is useless,” he adds.

Arek Adhel, a mother of 8 year old Lou Bol who suffered severe Malaria and Anaemia explains how this blood donation saved her little boy.

“My child complained of headache. When he went to urinate he collapsed. It took us four hours to reach the MSF hospital. My child convulsed twice on the way and he was unconscious.  I was just touching his eyes to see whether he still sees or not. I did not have hope that my child would alive,” she narrates.

After reaching the hospital, she says the doctors told her Lou had not enough blood and needed a blood donation.

“I am very happy that the health of my child stabilized after he was given the blood,” Adhel says.

Saniton Anei Akol walked for an hour from Miogok village before reaching the MSF hospital. Anei says he had first visited one of the health centres but he was told to pay some money, a bill he said he could not afford.

“I decided to bring her to the MSF hospital. The doctors told me she has severe Malaria and anaemia,” says Anei.

“I was told to donate blood but the blood group was not matching. My child was given blood from the MSF hospital….I am seeing some improvement in my child’s health. I am very happy that the health of my child has improved,” Anei narrates.

From June to September, a total of 11,203 patients were treated for Malaria at the MSF hospital. Out of the 11,972 outpatients’ consultations, 10,096 people were treated for simple Malaria including 2,745 children under the age of five and 7,351 others above the age of five including pregnant women.

The hospital also treated 1,107 people for severe Malaria out of 2,694 who were admitted. 540 were children under the age of five and 206 pregnant women.

The Medical reference Veronica Holmiere talking to one of the volunteers in Maibong village. This centre serves up to 4,000 people (Photo: Morris Dogga/Juba Monitor)

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