Protecting Palawan

MANILA, Philippines - Mention Palawan and what comes to mind is the Underground River, or the beautiful island resorts of El Nido and Coron. But for many years, Palawan has also had to endure the tag of “malaria capital” – until Pilipinas Shell Foundation, Inc.’s (PSFI) Kilusan Ligtas Malaria (KLM) came along.

KLM is a community-based malaria control program that aims to help control and eliminate malaria in Palawan through early-case detection and prompt treatment, vector control, community organization, awareness campaigns, capability building, research, advocacy, and networking. KLM made significant headway in 1999 when PSFI co-implemented the program with the provincial government of Palawan.

“We have all bases covered in this program, including indicators, so that after we conclude KLM, it will continue to function among the people. We are helping them while at the same time empowering them to do something about malaria, the leading cause of morbidity in Palawan,” says PSFI program manager Marvi Trudeau.

Trudeau recalls that back in the 1990s, information about the disease in the province was seriously lacking.

“Everybody who had a fever simply assumed that they had malaria,” she explains. “It was a common practice that they would take malaria pills without finding out their real sickness.”

What made things worse was the lack of medical facilities. There was only one doctor serving 39,000 people. “At times, there was no doctor, only nurses,” Trudeau continues. “Nobody else was there to look into the matter. Sure, there were pockets of malaria-control programs, but those can only do so much. A province-wide malaria program was needed, and that was when KLM came about.”

The crucial step was to have the Palawenyos diagnosed. This is most accurately achieved through blood smearing, or microscopic analysis of blood samples from patients.

Through KLM, villages were supplied with microscopes, laboratory equipment, and microscopy training. The provisions continue to help people in far-flung areas, especially those who had to walk for miles and days just to get a diagnosis. It is a huge relief, therefore, to find trained microscopists overseeing the conditions in their respective areas.

Microscopist Deborah Arroz, who has been tending to her assigned village for years, happily reports that malaria cases have been going down.

Arroz also led the recycling of non-functional mosquito nets. “Instead of throwing the nets away and leaving them in the trash, I turned them into pot holders, rugs, and seat covers. Of course, these nets underwent a thorough cleaning process before being sold,” she says.

Training microscopists is just part of KLM’s extensive efforts. Since 1999, KLM has distributed almost a million conventional nets and long lasting insecticide nets in Palawan. Over 500,000 houses have also been covered by indoor residual spraying.

In another trip, this time to the rather remote sitio Tagnaya in barangay Concepcion, PSFI held a Malaria Awareness Day, where awareness lectures, distribution and retreatment of nets, and blood smearing to test for malaria was conducted for the members of the indigenous Tabak tribe.

Recognizing the program’s effectiveness, KLM was awarded $14.3 million in 2006 by the Global Fund to Fight AIDS, Tuberculosis & Malaria, to continue operations in Palawan, and to replicate the KLM project in Apayao, Quirino, Tawi-Tawi, and Sulu. The program was then renamed as the Movement Against Malaria.

In 2010, the Global Fund gave an additional $31.4 million in a Consolidated Malaria Grant to PSFI to increase the coverage to 40 more provinces.

Trudeau is quick to add, “The DOH welcomes support from the private sector. They gave us the protocol, the Center for Health and Development, the regional offices that support us in terms of technical assistance and manpower, among others.”

Working together, the program has achieved significant results. Based on figures, mortality has decreased by almost 97 percent in 2012, with cases decreasing by 92 percent. Despite the encouraging figures, PSFI continues to man the fort in taking the program further.

Trudeau adds, “In 2005, the World Health Organization said that ours is the most sophisticated community-based malaria program because we had the diagnosis in every village. People actually went to the microscopy center and when they were taking that service, they become part of the health system.”

Freedom from malaria is even more evident now, thanks to the collaborative efforts of PSFI, as well as the DOH, the local government units, and volunteers. The Millennium Development Goal to halt diseases such as malaria has a target date of 2015, and if all these results are any indication, the Movement Against Malaria is definitely on the way to reaching that goal.