Emergency Response Mission: Fighting Malaria in Chad

Postcard from the field

Pieter Smit is a microbiologist by training, with a specialisation in international public health. He completed his PhD at the London School of Hygiene and Tropical Medicine before joining the EUPHEM programme. He is currently a 2012 EUPHEM fellow at the National Institute for Health and Welfare in Finland. Pieter shares his experiences from his recent mission to Chad.

What was the mission about? 
During the autumn of 2013, malaria became a major public health concern in Chad. The disease used to be present in Chad at very low levels (i.e. endemic) but a ten-fold increase in malaria cases was noted by the medical team of Médecins sans Frontières (MSF) in the Salamat region in Chad.  The main hospital and other smaller clinics in the area were extremely busy.  Extra tents had to be placed in the courtyard of the hospital to provide enough space for all the malaria cases. An emergency malaria response team was created by MSF to provide all the care that was desperately needed and to be able to take suitable preventive measures.

What did the team do? 
The responsibilities of the team were to provide epidemiological intelligence and extend the medical care to very remote regions. Additionally, MSF needed information to decide which preventive actions could be taken, for the time being but also for the future.  One of the main tools to prevent malaria are bed nets.  Therefore a Knowledge, Attitudes, and Practises (KAP) study to evaluate the availability, quality and use of bed nets was planned in the region. MSF requested the epidemiological support of ECDC. So, after completing the course I was attending in Sweden at the time, I packed my bags, got the necessary vaccinations and flew to Chad. 

What was your experience? 
Chad is a former French colony located in Central Africa.  I was a little worried to go, given that my French is anything but perfect and there was very little time for preparation. But I am really happy that I went, it was a very memorable experience and if I had the chance, I would go again! I felt privileged to be part of a team that was so dedicated to providing medical care and fighting malaria in a country where basic resources are scarce. Witnessing the joint attempt to relieve the region from the disastrous impact of malaria was extremely motivating.  

What have you learned?
A lot! Besides implementing some of the technical aspects a response mission involves (i.e. performing a KAP study, providing a two-day training to twelve local interviewers, setting up mobile malaria clinics, preparing and undertaking exploration missions, working with data from the regional surveillance system, and writing weekly malaria updates for MSF), the Chad mission also meant living on a compound with colleagues of ten different nationalities, amazing dusty long drives through the countryside and learning about the local cultures and beliefs.