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Leading a Successful Malaria Programme

Overview

At many remote mining and drilling sites in addition to the employees and contractors living and working onsite, there may be several communities living nearby. This case study shows how effective malaria control for a work site accounts for the broader population around the project through vector control and health promotion programmes. It addresses the employer’s corporate and social responsibility obligations while helping meet productivity targets. 

Service: Public health consulting
Location: Democratic Republic Congo (DRC)

Problem

Malaria is a leading cause of mortality in the DRC. So establishing an effective malaria control programme is a chief occupational and public health concern for any organisation wishing to operate in the country.

A mining company beginning the construction phase for a remote site in the DRC’s Katanga Province contacted International SOS for our malaria expertise and advice. The client faced a unique set of challenges for its 9,000+ employees and contractors. Nearly 70% of the onsite workforce were Congolese nationals—many of whom had moved to the site with their families greatly increasing the local population around the site.

The remaining workers were expatriates from India, Pakistan, Bangladesh, and the Philippines. The vast majority of these Asian expatriates had little or no acquired immunity to malaria and knew little about its prevention.

This was a real challenge. International SOS devised an integrated plan for malaria including: Comprehensive vector control management and health awareness programmes for each population group.


Tackling malaria

Solution

We began by examining the biology and ecology of local disease-carrying mosquito species, the disease transmission dynamics, and the malaria morbidity statistics at the site. An International SOS consultant undertook epidemiological and entomological field studies to determine baseline infection rates, primary mosquito vectors and resistance patterns to insecticides. We surveyed the workforce and local community to get a better picture of the knowledge, attitudes and practice toward malaria and its prevention.

From these initial findings, it was clear we needed to treat each group individually. Separate health awareness agendas were developed for employee and contractor sub-population as well as the greater community including mothers, children, and local leaders.

For the on-site employees, we conducted indoor residual insecticide spraying, supplied long-lasting insecticide-treated bednets (LLIN), provided an anti-malaria chemoprophylaxis programmes, and delivered ongoing awareness and education programmes. At the International SOS onsite clinic, prompt and accurate malaria diagnosis and treatment were made available to all workers and their families.

For the community, we provided each family with one or more LLIN, trained local heath staff on early malaria identification, and ran awareness and prevention programmes for different community groups. Lastly, we monitored the prevalence of infection and made operational changes to programmes as necessary. 
 

Impact

In the two-years that the malaria programme was implemented, malaria was reduced by 60% in the communities compared to the 2007 baseline infection rate.  We saw similar dramatic reduction in malaria risk in both the national and expatriate workforce during the same period.

By taking an integrated approach to vector control and adapting health awareness programmes to suit each population, the programme was effective.  The client showed strong corporate citizenship in developing a malaria programme for the community, and also lowered the morbidity rate and reduced sick time.