By Indrias Getachew

SHEBEDINO, Ethiopia, 5 August 2008 – The rainy season is well underway in much of Ethiopia, but while the rains bring hope to rural communities, they also create ideal breeding conditions for malaria-carrying mosquitoes.

Over twenty million insecticide-treated nets (ITNs) have been distributed to more than ten million households in malaria-prone areas of Ethiopia since 2005. The nets have only a three-year lifespan, however, so those that were distributed early in the campaign now need replacement.

Mulunesh Musse shares one such treated bednet with her four children in Shebedino District. The bednet is now ripped along one side and has a gaping hole in front, so it no longer fully protects her and her family from malaria.

Female health workers

Medhanit Tilahun and Bezunesh Bekele are two of more than 24,000 female Health Extension Workers deployed at the village level to bring preventative health care to rural communities.

© UNICEF Ethiopia/2008/Tibebu

Villagers from outlying parts of Sedeka Village in Shebedino District, line up to receive insecticide-treated nets at the village health post.

They are part of a major pillar in Ethiopia’s strategy to control and eradicate malaria. The workers go door-to-door, inspecting protective bed-nets and educating the community.

Ms. Tilahun and Ms. Bekele help Ms. Musse take down the ragged net hanging over the bed she shares with her four children. They replace it with a brand new one.

“When I started working, a lot of people in this community were sick with malaria,” said Ms. Tilahun. “You would find two or three members of the same family sick at the same time. There were times when we buried two or three persons who had died from malaria in one day.”

The female health workers form the core of the ambitious Health Extension Programme launched in 2005 by the Federal Ministry of Health and supported by UNICEF.

“I am very happy with what we have accomplished,” said Ms. Tilahun. “First, I have protected myself from getting sick. I use myself as an example to teach others to transform their lives.”

Preventing a lethal combination

Drought-related malnutrition can leave a weak immune system open to attack from malaria. It can also worsen the effects of existing malnutrition through diarrhoea and anaemia.

“If a malnourished child catches malaria it is prone to complications and has a higher risk of dying,” says UNICEF Ehtiopia's Health Project Officer Dr. Tersit Assefa. “We are distributing insecticide-treated bednets there because there are a large number of children who are malnourished.”

To prevent the lethal combination of malaria and malnutrition,140,000 ITNs, purchased with funds donated to UNICEF by the Government of Japan, are being distributed in drought-affected districts. There have been no major outbreaks of epidemic malaria since the campaign began.

The campaign is supported by UNICEF, the Global Fund, World Bank, donors like CIDA and the Government of Japan.

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