On Okello’s trail: a day in the life of a malaria health worker
It’s 6:30 AM. Leon Okello, a health worker in the Oyam district of Northern Uganda, starts the engine of his motorbike, ready to take on another day in the field.
He works with the Community Access to Rectal Artesunate for MALaria (CARAMAL) Project, a Unitaid-funded initiative to facilitate access to artesunate rectal capsules as an emergency intervention for severe malaria. The project is led by the Clinton Health Access Initiative, with support from the Swiss Tropical and Public Health Institute, UNICEF and Medicines for Malaria Venture. The observational study under the CARAMAL Project ended in 2020 and data analysis is currently ongoing.
“My day begins early in the morning. I meet my fellow health workers at the office where we are assigned locations for our daily visits. Each health worker is expected to visit between six and seven households per day,” explains Okello.
The current household visit campaign in Oyam district is aimed at ensuring that all families are tested for malaria and those found sick are treated immediately. Every child’s haemoglobin levels are tested and temperature taken.
Additionally, Okello and his colleagues sensitize parents and caregivers on how to protect children against malaria.
Okello begins by paying a follow-up visit to his former patient, Aboli Patricia, a young girl who recently suffered and recovered from severe malaria. Aboli was referred to the health centre by the Yamiyoro Village health worker, Ogweng Samuel, when she was in a critical condition.
Following pre-referral intervention with artesunate rectal capsules and consequently treatment with injectable artesunate and 3 days of an oral artemisinin-based combination therapy, Aboli’s condition improved.
Wanting to make sure that Aboli is malaria-free, Okello does some quick tests for any symptoms and shares malaria prevention tips with her mother.
It is now 2:00 PM. Okello makes his way to Inyer Village, to visit some families with young children. As a routine, he tests the children’s temperature, haemoglobin count and if necessary, does a rapid malaria test.
During his visit, two of the children in the village test positive for malaria. Fortunately, Okello is well-equipped to treat them. He prescribes a child-friendly, dispersible version of artemether-lumefantrine (A-L). The first child-friendly dispersible version of A-L was co-developed by MMV and Novartis to treat acute uncomplicated malaria in children.
Okello is grateful to have medicines like A-L Dispersible that have been developed specifically for children. Child-friendly medicines ensure accurate dosing, better compliance, and easy administration.
Okello was one of the many health workers who continued testing, treating, and tracking patients through several waves of the COVID-19 pandemic. When asked about the impact of COVID-19 on his work, Okello admits that, initially, it was not easy to access his patients.
“Transport was restricted, and people feared that we would infect them. On the other hand, we were also terrified to interact with the people whose COVID status was unknown. However, we persevered.”
He notes that on average, he treats between eight and nine children daily. As the first point of contact for malaria patients in these remote regions of Uganda, Okello believes that a secure supply of effective and affordable antimalarials distributed through community health workers is crucial for the health of the community.
According to WHO’s World Malaria Report 2020, children accounted for 67% of all malaria deaths. Thus, it is vital that they receive timely and effective treatment.
As Okello heads back home after a long day, he admits that his desire to help people drew him to this field of work. This is easily attested by the excitement his former patients express when they see him.
As dusk falls, Okello makes his way back to his motorbike, ready to spend the evening in the company of his family and friends.
Community health workers like Okello are the backbone of the fight to end malaria. They test, treat and track malaria at the community level, helping avert death as a result of severe disease.
As we mark the International Year of Health and Care Workers, we express our deepest gratitude to health workers like Okello on the frontlines of malaria and COVID-19.
Photos by Emmanuel Museruka
14 November 2012