Weekly Awesome Madagascar: Personal Tales of Pecadom+; A Difficult Reality

Written By: Alicia Adler

Photo credit: Alicia Adler. Community Health Worker administering an RDT during a Pecadom + sweep.

Photo credit: Alicia Adler. Community Health Worker administering an RDT during a Pecadom + sweep.

The room was eerily quiet – so quiet I could hear the slow drip from the medicine bag hanging by the hospital bed. Men, women, and children sat solemnly around the head of a young boy, stuck in a coma caused by malaria. Not a word was said as they all silently hoped the child, only six years old, would soon wake up. Tragically he did not. And a few hours later, in a room just down the hall, a little girl died. Also from malaria. Two deaths in one day. Two deaths that were completely preventable.

This time of year malaria cases increase significantly across Madagascar, especially in the coastal regions (where I live). But with the closest medical clinic located up to four hours from many villages, people wait until the situation is grave before seeking help. Coupled with a lack of education about malaria, this means people often arrive at the hospital when they are dangerously ill. And in the case of the little boy and little girl, it’s too late for treatment.

I find myself both heartbroken and frustrated by this. With a disease that is both preventable and treatable, there doesn’t seem to be any reason for children to be dying. And yet this is the difficult reality we see every day here in Madagascar and countries across Africa.

In an effort to confront some of these barriers to treatment, Peace Corps Madagascar recently introduced Pecadom +. Pecadom +, a pilot program I am participating in, works with the Community Health Workers in rural villages to provide active detection for malaria during the rainy season. This means that we go into the village and visit every household, every week for 6 months. If someone has a fever we take their temperature, administer an RDT (Rapid Diagnostic Test for malaria) and provide the medicine if they test positive. And all of this is free- giving people a chance to be tested and treated without any financial or distance barriers. We are only piloting this in one of my 12 fokontanys (cluster of villages), but we can already see the results proving its success – if you call dozens of positive malaria cases in 3 weeks a success… With our local clinic currently overflowing with cases of malaria, I only wish we had the resources to provide active detection in every village.

I never expected death to be such a common theme of my Peace Corps service. And with almost 1 ½ years left in my service, I sadly know I will see many more lives lost. I can only hope that programs like Pecadom + and my constant pestering about bed nets will give only little boy or girl the chance at a future.