ON World Malaria Day, Armando Valdez, who has fought the disease for almost 20 years in the Philippines, says success is bittersweet. Every day, Valdez, who lives in Palawan province, walks 200 meters from his home to his office.
It is a tiny microscopy clinic, barely big enough to fit four people comfortably.
There, the community volunteer pores over blood samples from sick villagers. Peering into a microscope, he looks for the tell-tale signs of the malaria parasite.
“It looks like a sunny side-up egg,’’ he says, referring to the signature dot in the center of an infected cell.
Palawan, known for its lush forests and powdery beaches, is also commonly called the country’s malaria capital. Eighty percent of the Philippines’s malaria cases occur there.
The World Health Organization estimates that there were 216 million cases of malaria and 445,000 related deaths in the world in 2016.
While most of the cases occurred in Sub-Saharan Africa, countries in Southeast Asia are also at risk. In the Philippines malaria is the ninth leading cause of death.
However, thanks to a program set up by Shell Philippines, the number of cases in Palawan has dropped dramatically.
In 1999 the Pilipinas Shell Foundation Inc. (PSFI), Shell’s social-development arm, started Kilusan Ligtas Malaria (KLM) or Movement Against Malaria, to tackle the disease at the community level.
That year there were 78,000 cases of malaria, and 100 people dying every year in Palawan.
Last year the province registered 2350 cases and one death.
In 2011, largely because of the success in Palawan, the Philippines achieved the United Nations’ Millennium Development Goal of halting and reversing malaria, ahead of its 2015 deadline.
Marvi Rebueno-Trudeau, PSFI’s program manager, says: “The World Health Organization called KLM the most sophisticated community-based malaria program because every village had a diagnosis facility. When people went to the microscopy centers, they immediately became part of the health system.’’
Early days
THINGS were very different in the early days. “There was no scientific approach to diagnosis then. People would take pills whenever they had a fever, assuming it was malaria. Some believed drinking coconut juice would protect them from the disease,’’ she recalls.
PSFI started small. Buenavista, a tiny barangay in Palawan, with a population of about 800, was one of 344 initial barangays selected for the KLM program, which PSFI operated together with the Palawan provincial government.
It placed villagers at the frontline in the battle against the disease. Clinics were set up, and villagers were trained and empowered to dispense medicines, distribute insecticide-treated mosquito nets and conduct education and outreach programs.
Valdez signed up as a volunteer in 2001, after he contracted malaria and was treated by KLM. Because he had a high-school degree, he was trained to be a microscopist.
KLM also sent volunteers into remote and forested areas to check for malaria cases. Previously, the sick there would suffer in silence or travel for days to reach a city hospital for proper treatment.
Valdez, who is paid P3,300 ($64) a month, contracted malaria again, in 2014, during one of these visits to an isolated village. “I had forgotten to bring my mosquito net. I fell asleep after a few drinks, and that was that,” he recalls.
Signs of success
By 2006 malaria cases in Palawan had dropped to about 12,000, with 21 deaths.
Impressed, the Swiss-based Global Fund to Fight AIDS, Tuberculosis and Malaria decided to support the program, which was renamed Movement Against Malaria, or MAM.
It has since donated a total of $66,240, extending the program’s reach beyond Palawan to a total of 40 provinces. And the results have been remarkable.
Dr. Rhodora Cruz, who is in charge of National Dengue Prevention and Control in the Philippines Department of Health, says: “As of July last year, in the whole of the Philippines, there were 2,500 malaria cases and only two deaths.’’
While Palawan province will only be officially declared malaria-free when no new cases are reported for five consecutive years, there have been no cases this year in Valdez’s barangay of Buenavista.
These days, the hours pass slowly as fewer villagers come to his clinic for testing. Because of the success of the program, no more microscopists will be trained.
He is the last one in Buenavista.
This means he could soon be out of a job, one that has given his life meaning, the bachelor says.
“The people here are like my family. I am godfather to some of their children, and they even come to me with their marital problems,” he says in mock horror.
He adds he will likely leave Buenavista to work as a tour guide in the city.
Nellie Bayuge, 47, a carpenter in Buenavista, says the villagers will be sad to see him go.
“He has done a lot for the community. Even if you call him in the middle of the night, he will wake up and help you, with anything. We will miss him.”