Rural research institute leads way
BY WALLEN SIMWAKA
MACHA - Musapa Mulenga wakes up at midnight and trots to his laboratory to see if the mosquitoes he has colonised there are consuming their blood meals. If not, he gets little sleep and at 03:00 hours in the morning, he goes to check again. Mosquitoes can be moody, he told visitors to his “insectary” – the first laboratory mosquito colony in Zambia.
“They require a lot of tender loving care,” he explained.
His mosquitoes dine at their leisure on mice strapped to a board and mate in the romantic glow of an electric dimmer that mimics the 24-hour natural cycle of daylight and darkness.
While this level of care for insects that have caused untold misery to humanity might shock an ordinary mind, Mr Mulenga, who is the resident entomologist at the Macha Malaria Research Institute, has a longer perspective.
He is proud of his laboratory which is a good 6-hour drive from Lusaka and a two hour drive on rough road from the nearest town of Choma. It has surpassed the most sophisticated labs in the world in its achievements.
With his basic laboratory, entomologist Mulenga has been able to supply mosquito eggs to institutions like the National Malaria Control Centre in Lusaka and the John Hopkins Bloomberg School of Public Health.
His work is part of a battle strategy being waged by the Macha Malaria Research Institute, on the front lines in this remote rural community ravaged by the disease that has been the leading cause of death in Zambia, kills more children under five than any other, and contributes to a vicious circle of poverty and illness.
In addition to leading to Zambia’s first mosquito colony, and one of very few in the world, the institute’s approach has also demonstrated that malaria can be diagnosed through saliva and played a prominent role in proving the effectiveness of the Artemisinin combination therapies that Zambia was the first to adopt.
And Macha Hospital, where the institute began with one small room with a sign that said “Research, ” and where 1500 patients were admitted with malaria in 2003, had only 45 cases this year.
“If you’re going to attack a disease,” Institute founder and director Dr. Phil Thuma said during a recent visit, “go right to where the disease is.”
Malaria is endemic in the Zambezi Valley, explained scientific director Dr. Sungano Mharakurwa, because transmission increases with falling altitudes.
Until recently, he added, malaria killed as many as 50 children in a year in this community of about 180,000. The disease also filled the hospital’s beds by driving other problems: anemia, low birth weight, maternal mortality – and poverty.
“Effectively, a humble mission hospital decided to take the bull by the horns,” Dr. Mharakurwa said.
The mission hospital was started by Dr. Thuma’s father, who arrived in Macha in 1954. Dr. Thuma grew up here.
“This is my home village,” Dr. Thuma said.
He returned after completing his training as a pediatrician and started researching solutions to malaria, because, he said, “Malaria was killing my children.”
In 1984 the research room opened at the hospital.
“That was the year I felt we could no longer tolerate something that had been controlled in other countries.”
Today, the research facility occupies a sprawling campus in Macha, where everything from the bricks of the buildings to the painted trim on them is the product of local work.
“I think for anything to be sustainable it has to be locally owned,” Dr. Thuma said.
“Our real research is done in the villages,” he added.
Chief Macha, of the Tonga people, sits on the hospital’s board.
“There is no doubt that the institute has made tremendous progress in the fight against malaria. Before then, my subjects and children in particular were the victims of the disease that this time is under control,” the traditional leader told this author.
Dr Thuma is proud that in recent years, malaria cases in Macha chiefdom have dropped to the extent where it has become a challenge to find a community or family infected.
The goal, of course, Dr. Thuma says, is the elimination of malaria in the region. He and Dr. Mharakurwa agree that is possible.
The research centre‘s role, Dr. Thuma said, is to develop evidence so that policy makers can make decisions based on what has been proved.
One of the purposes of the mosquito colony, for example, is quality control: the mosquitoes are used to test the effectiveness of indoor residual spraying.
And while he emphasises that eliminating malaria will require collaborative effort, and comprehensive approaches beyond research, he is pleased with the unique role played by this remote rural institute, where work began in one room 25 years ago.
“In the bush,” he said, smiling, “why not?”
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