by Sean Conners

Responsible for over 600,000 deaths each year, malaria is the number 1 killer worldwide. Having learned about the disease in almost every public health lecture at Cal, I came to Tanzania with an abundant supply of malaria prophylaxis, bug spray, and long-sleeve shirts and pants. I’ve diligently slept with my mosquito net at night and dutifully fumigated my apartment weekly. Along the way, however, living in Tanzania for a long period of time has dramatically shaped my view of malaria from that of distant fear to one of intimate understanding.

For Westerners like myself who have lived in malaria-free zones their entire lives, entering a malaria zone should not be taken lightly. As many of my students have explained, without any sort of immunity to malaria built up, infection can result in serious complications and often times become fatal if not treated with urgency. However, for local residents who have dealt with malaria their entire lives, there’s less of a fear, and more of a practical understanding of how to manage the disease in their everyday lives.

You sneezed two times today? You must be coming down with malaria.
Stuffy nose in the morning? Better get tested for malaria.
Feeling a little tired lately? You probably have a touch of malaria.

Even the slightest signs of sickness put my students on high alert. Part of it may be that I work with some of the most diligent health professionals in the country, but it also reveals a lot about the culture of vigilance that comes with living alongside malaria every day.

While a great amount of effort is spent on prevention, most people live with the expectation that they will become infected with malaria at some point (or multiple points) in their lives. Thus, the culture shifts from fervent prevention (as is the case for me and my fellow westerners) to due diligence in regards to case management.

According to one of my students who is also a medical officer here in Tanzania, almost every doctor in Tanzania knows how to treat malaria. If someone tests positive for malaria, they are certain to receive proper treatment and walk away without any major complications. Unfortunately, those who wait to go to the doctor, either from ignorance or a lack of financial means, end up with serious cases that can potentially become life threatening. Anti-malarial medication works, but accessing it is a significant challenge all on its own.

And so, the issue returns to a pervasive, ongoing struggle across all aspects of public health: access to adequate care. Rolling back malaria abroad can be achieved through comprehensive prevention efforts, but treatment should not get lost in the process.

Working to improve access to healthcare in developing countries will not only help bringdown the malaria mortality rate, but it will also improve outcomes for other diseases and strengthen countries as they grow and develop in today’s globalized economy.

Sean graduated from Berkeley in December of 2013 with a major in public health and a minor in public policy. For the past couple of months, he has been working as an English Language Mentor to a class of Master’s of Health Monitoring & Evaluation Students at Mzumbe University in Tanzania.