Magazine article New Internationalist

Killer Sting

Magazine article New Internationalist

Killer Sting

Article excerpt

The thick forests and natural wealth of Gomia in Northern India conceal an appalling poverty and a variety of illness. Malaria is one of these illnesses.

Men and women survive by selling coal extracted from abandoned coal mines, or working for daily wages in brick kilns and stone quarries, or as agricultural labourers. Most live in mud huts, often along with their livestock.

The hospital in Gomia receives 20 to 30 malaria patients a month. But it has no facilities for routine pathology tests and it takes one month to get the results of blood smears - far too late to be relevant for treatment. In this area malaria is on the rise - especially in its deadly falciparum form.

Some 70 million Indians get the disease every year, according to a WHO estimate. Hundreds of thousands die of what can be described as the country's single biggest public health problem - bigger even than tuberculosis.

But official Government figures record 'only' two million cases a year - with 1,000 deaths. And the World Bank hails the malaria control programme it has funded in India as a 'success' which resulted in a 45 per cent decline in cases.

What is going on?

Deception, some would say, with the World Bank peddling false data to claim false victories.

Let's take a look at their star project. Called the Enhanced Malaria Control Project it ran in eight Indian states between 1997 and 2005. Transparency does not seem to have been a key feature - even the amount loaned by the World Bank is variously reported as $86 million, $119 million and $165 million.

The Bank claims that as a result of its programme, malaria in the states of Maharashtra, Gujarat, and Rajasthan declined by 93 per cent, 80 per cent and 40 per cent respectively from 1997 to 2002.

And it attributes this success to a fundamental change in approach to malaria control.

However, a study by a group of public health researchers holds the Bank's claim to be a pack of lies. Writing in the 15 July 2006 issue of The Lancet, Amir Attaran and his colleagues quote government documents indicating a much smaller drop in malaria in the states where the programme was conducted. In some states it actually went up, they note. The Bank's statistics for the states of Maharashtra, Gujarat and Rajasthan did not correspond to Indian government data between 1997 and 2002; in fact in 2004, there was more malaria in Gujarat than there had been in 1997.

Tellingly, the Bank refused researchers access to data needed to examine its claim that the programme has been a success.

Health professionals working in malaria-infested areas are unimpressed: 'The Bank's programme has made no difference in Orissa,' says Johnny Oommen, a medical doctor working in Bishamcuttack for more than 13 years. 'The Government's figures are a fraction of the total number of cases. The ground situation is much, much worse. Malaria is our single biggest public health problem.'

Ravi Dsouza, who trains health workers to treat malaria and tuberculosis, reports: 'I have seen villages where three out of four people have a swollen, palpable spleen - the effect of repeated, untreated malaria.'

Even when it doesn't kill, untreated malaria leaves people with severe anaemia because it destroys the red blood cells. Children's growth is stunted. 'In tribal areas, where it is the most common, it is an important cause of infant and maternal mortality,' says Dsouza.

And while the number of cases officially recorded is not increasing, the proportion of people with the deadly falciparum strain of malaria is up from a little under one-third of all cases to about half today. …

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