Child health gets major boost in Togo

Published: 13 December 2004 0:00 CET

Marko Kokic in Lomé

The paediatrics ward in l`hôpital de Bé is filled to capacity, and most of the children here suffer from a single illness: malaria.

Six-year-old Marco Togbe is one of the more serious cases, having contracted cerebral malaria. He has just recently woken from a month-long coma. Once a normal vibrant child, Marco now suffers from severe brain damage. His prognosis is grim.

The statistics for malarial infection in Togo are staggering. There are 345,000 reported cases of malaria in Togo annually. Malaria is the leading cause of morbidity and mortality in the country, accounting for 43 per cent of consultations in health centres and 66 percent of hospital admissions for children under five.

However, malaria is easily preventable by simply sleeping under insecticide treated bed nets (ITNs), yet only 13 per cent of children under five slept under one in 2003. Only 17 per cent of pregnant women, another vulnerable group, slept under an ITN the same year.

With malaria representing a major burden both on the country’s health system and on the disposable income of families, the obvious question is: why do people not use ITNs?

“Many people in Togo lack education regarding malaria. They do not associate the disease with mosquito bites but attribute it to other factors such as fatigue,” explains Blaise Sedoh, Public Health Consultant for the Togo Red Cross Society. “What they need is to be informed on the causes of malaria and how to prevent it.”

He continues, “Another major factor is the price of ITNs. They cost about US$ 5 each in the market. For a subsistence farmer whose surplus crop may yield US$ 15, an ITN represents a major investment that few are willing to take on, especially if they have reservations about the effectiveness of ITNs in preventing malaria.”

This week, all that is about to change. Malaria and other deadly diseases affecting Togo’s children are being addressed on a country-wide scale. During a week-long campaign, more than 900,000 children under the age of five will be vaccinated against measles and polio and 600,000 between ages two and five will be given the de-worming medication mebendazole. In addition, every household with children under five will be given an ITN for free.

Addressing several health issues during the same campaign will serve to keep costs down, but a great deal of preparation is also needed. For the past few months the Togo Red Cross Society, through its 7,400 community-based volunteers, has been preparing the ground for this unprecedented integrated health campaign, which starts today.

The Togo Red Cross Society has been contributing to the social mobilization component of the campaign. Volunteers have been registering children and informing parents about the dates of the campaign and the location where vaccinations will take place.

Because the number of ITNs to be distributed is unprecedented, much of the focus has been placed on convincing community leaders and residents how using ITNs helps prevent malaria.

In a poor Lomé suburb called Katanga, 36 volunteers have spent a lot of time, especially in the last month, going door-to-door to talk with residents about the campaign.

“Most of the people in this suburb are originally from Ghana. Many do not speak French nor any of the traditional languages of Togo,” explains Togo Red Cross Coach for Katanga, Kinvi Ayi. “But amongst our volunteers we have residents from Katanga who know English or some of the traditional languages of Ghana, so communication has not been a problem. Residents are looking forward to getting their own ITNs.”

In the village of Momo, about 60 km from Lomé, Red Cross volunteer Marguerite Kpeyaka and volunteers from the village have got the village on board for the integrated health campaign.

“Although some people were at first hesitant to let us into their homes to register their children, we have gradually changed all that, especially with the support of the village chief. We have organized several information sessions that included music and singing and we were able to get our message through to villagers while entertaining them. Now the whole village of 12,000 is excited about the campaign,” says Marguerite.

The Togo initiative is the first time an integrated campaign has targeted an entire country. Previous pilot projects in Ghana and Zambia have demonstrated the vital role Red Cross volunteers play in ensuring their success.

“As in previous campaigns it has been the commitment of Red Cross volunteers that has resulted in their success,” says the International Federation’s Public Health Advisor, Jean Roy.

“It is no different in Togo where that commitment is expressed through the volunteers going door-to-door to identify and register vulnerable children, volunteers convincing community leaders and individual families of the health benefits the campaign offers their children and finally volunteers` commitment to following up long after the campaign is over,” he adds.