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7 years after World Bank’s Malaria Project, Rivers state residents still looking for help



By Elfredah Kevin-Alerechi

Mercy Gilbert’s 2-year-old son typically fell sick and therefore the doctor, on varied occasions,  diagnosed the upset as malaria. At first, she and her husband never thought the constant unwellness of their son were the results of the multiple mosquitoes bites till a doctor and pharmacist called their attention to it. 

Fortunately for her, the World Bank in collaboration with the Rivers State government in 2008 started sharing mosquito nets across her community in the Ogbobo compound in Okrika Local Government Area.

Mercy Gilbert.  Photo credit: Elfredah Kevin-Alerechi

“That year, they brought plenty nets to Okrika town and started sharing to everyone. I was given 3 nets; one for me, my son, and my husband. But, some persons took more than three,” Ms. Gilbert recalls.

She said during that period, her family used only one of the World bank’s gifted mosquito nets for a very long period, and the other two were gifted to her relatives who were absent at the time of sharing.

“Since we took the net, my son stopped suffering from these mosquitoes that they said cause malaria. See him now, he is 16years,” she told the reporter in her native dialect, Okrika, pointing to her son who was playing with his peers. 

Though Ms Gilbert’s son is lucky to survive malaria, not all children survive the life-threatening disease. Globally, Malaria is known as a life-threatening disease caused by parasites, female Anopheles mosquitoes, and transmitted to people through bites.

State Governor Nyesom Wike during the 2018 World Malaria at Government House in Port Harcourt.

Data from the United Nations Inter-agency Group for Child Mortality Estimation estimated that 732,751 children under five died in Nigeria in 2016. 

About the Program

World Bank in the year 2007 launched a project titled, “Malaria Control Booster Project with project Identification, “P097921″ in Nigeria’s Rivers State”. The Project was also implemented in 9 states in Nigeria including Rivers State with a total fund of $260 million.

The objectives of the Malaria Control Booster Project include ensuring that the target population had improved access to, and utilization of, a well-defined set of Malaria Plus Package interventions (MPP); and strengthening Federal and States ability to manage and oversee the delivery of malaria plus interventions.

Doctor Mina Jaja, Rivers State malaria program officer said the malaria booster project was in collaboration with the Rivers state government which started on May 27, 2007, and ended on  March 15 2015. She said the project recorded milestones across the 23 Local Government Areas of the state

According to Jaja, the objective of the project is to provide key preventive and curative intervention against malaria and other diseases associated with maternal and child mortality; and improve access to malaria intervention.

Dr. Mina Jaja during World Malaria Day… Photo Credit: Mina Jaja

The fight against Malaria

Jaja explained that the government did a lot of sensitization during the malaria booster projects which include training of health workers in different categories.

According to Jaja, “there was State level training of trainers of community development initiatives approaches, about 46 people were trained.

“There were also training of indoor residual spray operators and supervisors. About 1, 000 people were trained and there was a cascade training of faith leaders in 23 LGAs. 256 people were trained,’’ she added.

Explaining further, Jaja recalls that faith community health mobilizers were also trained, approximately 3,000 people were trained, and the training cut across health workers and advocacy communication and social mobilization workers.

Dr Jaja said, “Health workers were trained across the 23 local government areas to handle malaria cases and community leaders were trained on how to take the message to the grassroots on prevention of malaria and the importance of the mosquito net.

“We had a lot of jingles which informed the public about malaria and its prevention,” she said, adding that “information and communication materials about malaria and its prevention were produced and circulated across the entire local government.’

Governor Nyesom Wike with state Stakeholders on 2018 World Malaria Day.

“We did a lot of campaigns about malaria in churches, mosques, communities’ gatherings market places,” Jaja said, narrating that the state government dwelled on the fact that religious leaders are well respected and whatever they say is what the people believe.

According to her, several people across Rivers State received the mosquitoes net and health workers who visited these communities were excited because of the response they received from residents who were happy receiving the net 

However, she said the state government usually distributes treated mosquito nets every five years, stating that the last mass distribution spilled over to 2015.

“And, household benefited from vector control and mass replacement of long-lasting insecticide-treated net that spilled over from 2014 to 2015,’’ and, “I think a lot of households benefitted,’’ she added, attributing distribution of mosquitoes net to the low prevalence of malaria in 2015.

“That is responsible for the prevalence of malaria being 7.3 per cent in 2015.

“The long-lasting insecticide-treated net household coverage was 98 per cent in 2014  and that’s the end process evaluation and then 7.6 per cent in 2010,’ Jaja said in an interview.

Governor Wike on 2018 World Malaria Day was made Grand Ambassador for Malaria Elimination.

Post Malaria Booster Project

Since after the Malaria Booster project, the state governor, Nyesom Wike has continued to make effort to reduce malaria, Jaja said.

According to her, the State governor has gone all the way to make the health facilities of standard and even above standard to provide facilities where people suffering from malaria will be treated “all these are part of the malaria program,’ she added.

In 2018, Governor Wike announced a plan to eliminate malaria in the State.

He said, “we must all join the fight to eliminate malaria. The deaths flowing from malaria are unacceptable. We must execute it as a communal-based action plan. The fight against malaria goes beyond providing bed nets or ensuring access to effective treatment. These are important measures, but certainly not enough. We must move from this sense of complacency that malaria is preventable and completely treatable and focus on the need to end malaria for good within the shortest period,” Wike said during his investiture as the Grand Ambassador for Malaria Elimination at the State House in Port Harcourt.

Demand for more

It is 13 years after the World Bank malaria control project; Rivers State residents want to get another free mosquito net to prevent mothers and babies from life-threatening diseases. There has been a big hole after the World Bank project ended.

All the sources who spoke to the reporter on the benefits of the mosquito net suggested that a fresh program should be initiated where mosquito nets would be distributed to people.

In the Dic-Fiberesima community, Mba George, a mother of 8 children also received the free mosquito net shared by the World Bank in collaboration with the state government.  George’s children often fall ill sometimes once or twice a month, and she also travelled to the city, Port Harcourt to treat her children due to lack of hospital in her community.

George recalls that it’s been over 10 years since she received the mosquito nets from the world bank. “They brought it inside “Ghana-must-go-bag.” They gave me two because I have eight children”.

The 60-year-old woman now uses mosquito insecticide locally called “cull” since she could not afford to buy a single mosquito net, which according to her cost five thousand naira in the neighbouring market.

“The net really helped us. All these places were bush when they (World Bank) brought the net. And, it was what we used but now, the net caught fire when our community caught fire a few years back,” she lamented, calling for help.

Mrs Iniegibe sitting in front of the Mosquitoes net given by Wolrd Bank. Image credit: Elfredah Kevin-Alerechi

Mr Samuel Iniegibe, one of the community elders in the Dic-Fiberesima community lamented that although he was absent when the net was shared his family got only a net.

“We used to share ourselves to sleep inside the net. We sleep outside our house. We need more nets to satisfy us”. 

But, the wife of Mr Ineigbe, who preferred to be identified as Mrs Samuel while describing the impact of the given net, noted that her children were between 15 to 4years when the net was given to her.

Mrs Samuel said, “I hate when mosquitoes touched me and it pained me, so, when they shared it, I had a relief.”

“Since they gave us a net, till now, we haven’t gotten any net. And, mosquitoes have been biting us especially when there is no generator to get light. The net really helped us.

“Before they give us the net, mosquitoes were too much, and we go to the market to buy net before they brought net. 

“Even the net that they brought for us was not enough,’ she added

Findings from the 2015 National Malaria Indicator survey shows malaria prevalence across the country in 2015. According to the survey, 27 per cent of children age 6-59 months tested positive for malaria by microscopy egh.

Residents no longer sleep under mosquito nets despite several bites except a few.

Nathaniel Samuel’s one-year-old son has been sick with a high fever. According to him, the doctor blamed the high fever on malaria due to several bites from mosquitoes.

He said, “We have one mosquito net we bought for me and my son, and now that we are using the net, it is no longer biting us’’

Research carried out between March – July 2017 in Obio/Akpo Local Government Area in  Rivers State revealed that malaria infection had a prevalence of 109 (44.86%). According to the research, a total of 243 blood and stool samples each were obtained from randomly selected students of the three schools in Obio Akpor Local Government Area in Rivers State. Of the 243 blood and stool samples, malaria infection had a prevalence of 109 (44.86%) and the intestinal helminths had 4 (1.65%).

Health workers at the Orogbum primary health centre in Port Harcourt local government who pleaded anonymity said the mosquito nets given to distribute to residents were insufficient.

Although the staff who spoke separately has long been transferred to another health care centre, they told the reporter that during the time of sharing the net in 2014, there were a lot of rush and demand in the community they visited.

Oluwamehinola Kehinde Festus, regional institutional manager of Elbe, producer and distributor of Almateem malaria drug urged the government to do more than distributing nets every five years. 

He suggested that nets should be given quarterly to reduce malaria burden.

“Even if the net is distributed every five years, it still won’t go round to all families. 

“Five years is a long term but if it is quarterly, it will reduce malaria and economically help reduce burden patients spend on drugs,” Pharmacist Festus said.

This report is supported by Maternal Figures

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