Malaria must not be a forgotten disease

Today (April 25) is World Malaria Day and we are privileged to offer our readers a most thought-provoking and informative article written by Emeritus Professor Kamini Mendis of the Colombo University who has contributed enormously to fight this once deadly disease not only here in Sri Lanka but also in the wider world through her work at the World Health Organization (WHO). Today’s generation, though bothered by the mosquito menace and at risk of other mosquito-borne diseases, are barely aware of what this scourge did to this country in the earlier part of the last century when swathes of the Kelani Valley and many parts of the dry zone were wracked by what was then a deadly disease. The lives it claimed and the misery it caused is now history.

Older readers would know that the founding leaders of the Lanka Sama Samaja Party (LSSP) won the affection of tens of thousands people, particularly in the Kelani Valley, for the succour they extended to families afflicted by the disease. That was very much a factor in the blossoming of the LSSP during its early years and the popularity of its leaders. In fact, as Prime Minister Dudley Senanayake used to say at political meetings in the dry zone during his day, opponents of the colonization schemes launched in the pre and post-Independence period would say that there were mosquitoes “as big as crows” in those areas! Nevertheless, people who left overcrowded wet zone villages to pioneer, with massive government support, irrigated agriculture in the relatively unpopulated dry zone prospered. Sadly many of their descendants are today victims of the human – elephant conflict triggered by mindless deforestation of more recent years.

Prof. Mendis makes the point that while today we may be beleaguered by many health problems, not least by the covid epidemic raging globally, malaria is no more. She says that the year 2012 saw the last case of malaria transmitted by a mosquito in this country. This, as she says, is a colossal achievement by any standard and despite anxieties and worries that the disease may return, the country has been kept clear of malaria transmission for nearly nine years now. But given the fact that we thought we had defeated malaria forever when we nearly eliminated the disease as far back as 1963, “it returned with a vengeance to devastate the country for the next 50 year.” That’s a clear indication of what can happen if the guard is let down as happened in the case of leprosy. In the context of the fact that a new and highly efficient vector mosquito transmitting malaria in urban areas in India has found its way here, there’s an ever present danger of the recurrence of the disease in Sri Lanka.

It is our good fortune that this country is blessed with specialists like Professor Mendis, with both the expertise and commitment to fight the disease, as well as communication skills to effectively convey the message of the ever-present danger of a recurrence. Alongside, she has presented simple and effective ways of meeting the threat. She says in her article that if physicians seeing fever cases, probes the patient’s history and finds that he/she had recently traveled abroad, then there is good reason to test for malaria using the tools readily available today. Business travelers, pilgrims, Lankans working abroad and even returning members of the armed forces and police posted for UN Peace Keeping duties in malarious countries may well carry the infection back home, she has said. Most ‘imported’ malaria infections are acquired in neighboring India and African countries, the article says. Thus a state-of-the-art surveillance scheme must be maintained to treat infected persons without delay to ensure they would not infect the mosquitoes that are a continuing stinging and buzzing menace in this country.

Out of sight out of mind is a well-worn cliché that nevertheless retains its validity. Given mankind’s current preoccupation with the covid pandemic, other dangers that continue to lurk around us can be easily forgotten as they too often are. This country took a lot of pride in the achievement of eradicating malaria using insecticides like DDT and later malathion. Yet we permitted the disease to return largely as a result of our own negligence and lack of civic consciousness among our people who uncaringly allowed mosquito breeding places to exist without let or hindrance. Apart from abandoned gem pits in the countryside and numerous other stagnant water bodies, urban dwellers with clogged gutters and drains, carelessly strewn containers, coconut shells etc. collecting water have seemingly forever allowed the mosquito problem to grow. This is despite the many dengue scares and near epidemics that have plagued us in the recent past. But malaria, in the words of Prof. Mendis, “is a rare and forgotten disease in the country today.” Such a situation obviously must not be allowed to persist and the Anti Malaria Campaign that has done yeoman service to this country in the past must be supported as best as we can.