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Young warriors no match for insects bearing malaria

Declan Walsh,Kenya
Monday 16 December 2002 01:00 GMT
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The Masai are a match for Africa's greatest predators. Young warriors in tartan-red shawls stand guard over their cattle, spears in hand and eyes scanning the horizon for lion or leopard. By night, their homes – clusters of mud and dung huts – are protected by a ring of thorn and stick.

But the ancient wiles cannot keep out one adversary. As evening falls, mosquitoes fly through the lines of defence and into the dark, smoky huts. As families drift off to sleep, the insects set to work – biting into exposed skin, and killing more people than any wild animal.

Pashaka ole Sisi was slumped across her mother's lap, the five-year-old girl's forehead burning with fever. Her eyes were shut tight to keeping a ringing headache out. Her mother, Mosomba, a woman with a fine-boned face and wearing seven bead necklaces, stroked the girl's head.

The malaria had started three days earlier, she explained. "The first signs were the fever and coughing. I tried to use a sponge to cool her down, but it was no use." Her husband, clad in a red Masai shawl and battered sandals, hovered with a worried look under a nearby acacia tree.

The malaria season has returned with a vengeance here in Entasopia, a Masai town in southern Kenya. Every morning, mothers line up for treatment outside the smart health clinic, opened with help from Amref, one of the three charities that Independent readers are helping in this year's Christmas appeal for Africa.

The scourge of 19th century Victorian explorers remains among the continent's deadliest diseases. There are over 100 million cases a year, causing about half a million deaths, making malaria Africa's second greatest killer after Aids.

Every 40 seconds a child aged under five dies. That's about two since you started reading this story. It is entirely preventable. While HIV/Aids needs complex social and medical intervention, malaria can be fought with a little money and imagination. The simple solutions are the best. The drugs are cheap. And sleeping under a nylon net halves the chances of infection while odds are halved again if the net is treated with insecticide.

But in Masailand simple solutions can be expensive. Pashaka's mother said they had mosquito nets at home, but the insecticide has long run out. The repellent costs 40p per dose.

Training is also important. "We have to train the mothers a lot," said a district nurse, Albert Munyere, himself a Masai. "Before, they would stay home and try traditional cures first, like inducing vomiting or mixing herbs with water. Change is coming, but it is slow."

Until a few years ago, the Masai way of protecting against malaria was to stitch together sugar sacks and hang them around the cow-skin beds. It didn't work. "Those sacks were very hot, and not very comfortable," said Magdalene Toroge. "Many people died".

Then, with help from Amref, a group of mothers took matters into their hands. Amref trainers showed them how to stitch and treat their nets. Since then, the group has made more than 200, for their families and for sale in town. The impact has been dramatic, with local malaria rates plummeting.

The nomadic lifestyle also exposes the Masai to another health risk – the eye infection called trachoma. Amref-trained health workers – mostly volunteer mothers – are leading the fight against the disease. Children and adults needing treatment are given an antibiotic cream or referred to an Amref clinic for an operation.

Is the Masai lifestyle incompatible with the fight against malaria and trachoma? Not so, says Amref's programme manager, Francis Dikir. "You can live normally in a traditional village like anywhere else. The problem is marginalisation – they need basic services like a dispensary and schools. This is just the start of changing all that."

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