Update: This case study was updated in November 2012
Milu Jani lives in Labangi, a small village in a remote area of Western Odisha - one of the poorest states in India. The village is around 3 hours from the nearest district town of Angul and part of the journey needs to be done on foot. There is no health centre, no electricity and no school in the village. Milu works as a forest guard at the Satakosia wildlife reserve, earning a mere 90 rupees (£1.20) a day.
Like most villagers, Milu has lost a loved one to malaria. His eyes tear up as he recalls his father’s death last winter. Milu’s father fell ill with a high fever and was tragically diagnosed with malaria only a day before his death, leaving no time for proper treatment. Malaria can be treated effectively with drugs, but treatment is most effective when administered within 24 hours of the onset of fever. Odisha accounts for a quarter of India’s malaria cases amd 16% of its malaria deaths.
Milu knew mosquito bites can cause malaria but didn’t know the deadly mosquitos were breeding in the water pools around the village. After his father passed away, Milu met a local health worker who explained the risks of malaria and how to prevent his family from becoming ill with this deadly disease.
Getting healthcare to rural communities
The DFID supported state health programme in Odisha trains health workers to help raise awareness of malaria prevention and treatment among vulnerable tribal communities like Milu’s. Health workers like Suhasini Behera in Milu’s village are trained in the use of diagnostic tests and how to administer appropriate medicines. They also distribute bednets and promote the proper use of nets to prevent malaria.
“It was not easy to convince people to use bed nets,” Suhasini says. “People feared the nets were poisonous as there had been reports of rashes and itching from the insecticide” - misconceptions that she sought to dispel while visiting their homes.
By working with the community to raise awareness of malaria, Suhasini and her fellow health workers help to prevent people from contracting malaria and help the villagers to understand how to access treatment.
Bednets - a simple prevention tool
DFID’s support to the Odisha state health programme has helped Milu and his family purchase bednets that will prevent them from contracting malaria in the future. By subsidising the cost of the nets, DFID enabled poor families like Milu’s to purchase two bednets for only 20 rupees (25p). The nets are treated with insecticide and last up to five years.
Milu’s mother is content with her new net. “I always had disturbed sleep due to the mosquitoes. This new net has brought me a lot of comfort and I also use it for my afternoon nap”.
Milu is equally satisfied. “Malaria was a huge problem in our area. Now everyone in the village is using a net. I have lost my father but now I can keep my family safe from malaria”.
The DFID supported Odisha state health programme distributed 4.3 million bed nets to villages between 2009 and 2012, integrated with education and awareness activities of health workers. The programme has trained nearly 39,000 health workers to use diagnostic tests, give medicines and distribute bed nets.
DFID support has helped provide an extra 240,000 bed nets to young expectant mothers and tribal children to prevent anaemia and malaria-related deaths between 2010 and 2012. The fact that most women sleep with their newborn under the treated bednet has helped reduce deaths in children due to Malaria. DFID’s technical support has also helped the state government establish evidence required for assessing and up-scaling malaria initiatives.
Odisha has recorded a 24% decline in malaria cases and 60% decline in reported deaths in 2011 compared to 2010. The total number of reported malaria deaths declined from 247 to 100 between 2010 and 2011.