In the thick of our malaria epidemic, we saw up to 25 patients a day with severe malaria at the hospital. Most of those patients required blood transfusions as they had developed anemia related to the severe form of malaria. Most patients were also in a coma. For a period, we were doing up to 10 blood transfusions a day! On our worst day, we had 25 patients in 11 beds in the Intensive Care unit. All of this was in addition to the 800-1200 cases a week of “simple” malaria that we were seeing at the health centres that MSF supports.
Everyone worked hard to set up extra beds, increase blood donations, and treat malaria cases as early as possible. This included setting up specific mobile malaria clinics that ran 5 days a week in the areas with the highest concentration of cases. We also successfully lobbied the local Ministry of Health leaders to change treatment policy in the area to more effective therapies. This meant the difference between one quick injection a day versus several hours-long infusions a day for severe malaria. We were able to make this treatment available in our supported health care centres, thereby decreasing time to treatment. Despite the heavy caseload and severity of cases, this treatment change helped us to keep mortality very low throughout the epidemic.
Each year, around eight million simple malaria cases progress to severe malaria, where patients show clinical signs of organ damage, which may involve the brain, lungs, kidneys, or blood vessels. It is therefore critical for people to be able to access health care more easily. Severe malaria cases often stay in the hospital for over a week. This can be much longer, especially in children with malnutrition who are prone to other infections. If caught early, however, simple malaria can be treated with a 3-day course of pills.