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"id": 190108,
"url": "https://info.mzalendo.com/api/v0.1/hansard/entries/190108/?format=api",
"text_counter": 183,
"type": "speech",
"speaker_name": "Dr. Eseli",
"speaker_title": "",
"speaker": {
"id": 141,
"legal_name": "David Eseli Simiyu",
"slug": "david-eseli"
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"content": "Mr. Temporary Deputy Speaker, Sir, the other problem that malaria causes, especially the women will tell you, is that it leads to a lot of suffering to women of child bearing age. A woman who is expecting can easily miscarry because of malaria. In fact, in the malaria endemic districts, malaria is the highest cause of spontaneous abortions. Women are really suffering because of this. Moreover, women who are expectant and contract malaria have a higher incidence of anaemia, namely, lack of iron in the body. That impacts negatively on the wellbeing of the mother and that of the unborn baby. While all this is going on, a lot of things have been done. For example, we have changed drugs. The WHO suggested that we change some drugs. The combination drug that we are using now is so expensive. We are talking of not less than Kshs600 per dose. This is being provided by the Government for free in our hospitals. That is not for free. The Government must be buying it from somewhere. Somebody, definitely, is footing that cost. The Kshs600 per dose is a rather high cost to pay. We all know that prevention is better than cure. Indeed, malaria can be prevented effectively if we adopt the correct methods. The cost we are incurring are recurrent and are impacting negatively on our financial situation. We have encouraged the use of mosquito nets. Everybody has been informed about the use of mosquito nets. Now we even have impregnated mosquito nets. It has been put in a such a way that a lot of people believe that if you sleep in a mosquito net, then you are preventing malaria. Just to give a bit of the information that I have, which I think should be public information, there is the July 9, 2008 PARLIAMENTARY DEBATES 1711 anopheles mosquito that transmits malaria. There are 400 sub-species of the anopheles mosquito that transmits malaria. Each one of them, behaves differently. There are those that bite at dawn and there are those that bite at dusk. There are those that bite indoors and sleep outdoors. I am sorry for putting you through all these entomological studies, but I think the hon. Members need to understand this. The mosquitoes that bite at dawn and at dusk are the majority of the anopheles mosquito. You go under a mosquito net at night well after dusk and if you wake up early, you leave your net well before dawn. So, you are bitten before you go under the mosquito net and after you have left your mosquito net. Those who advocate the use of mosquito nets give us statistics of how much malaria the mosquito net has prevented, but they fail to do one thing. They do not give us the statistics on how much malaria the mosquito net has failed to prevent. That is where the problem is. I am not saying that mosquito nets are bad. They are just an addition to the arsenal of fighting malaria. They should not be the mainstay. They should be just part of the arsenal to control malaria. In this case, if we really want to control malaria, we should not mislead the public to believe that when they have the mosquito net, they are safe from malaria. They are only safe from 30 per cent of the malaria causing mosquitoes. The other 70 per cent are still active and are biting. The mosquito net is not going to prevent it. When we have a situation like that, we need to find another way of controlling those mosquitoes. Mr. Temporary Deputy Speaker, Sir, if you look in the history of malaria, in the countries that malaria used to be, they had a way of eliminating it. They used DDT, which is a chemical that we no longer want to use. It is not advocated because it stays in the environment for very long. It degrades the environment and leads to a lot of damage. So, it is not something that we want to use although it was used to eliminate malaria in the Western countries. So, we have to find better ways of controlling malaria. Mosquito nets are not the only way and they are not the best. In fact, with mosquito nets, we are fighting a war Tank with pebbles and then we feel secure with that. We should not allow that. As I said before, mosquitoes do not exclusively reside in countries like Kenya. They are worldwide. It is just that there is a particular species that transmits malaria. You will find that as the weather changes, the mosquito population goes up. Like now, we have the global warming. With global warming, the mosquito population is going up. Certain events can occur that will make the mosquito population go up. For example, when there are floods, the mosquito population goes up. You will remember the American situation when they had the Hurricane Katrina and the Hurricane Floid, the mosquito population went up. What did they do? The Americans realised that mosquitoes, apart from transmitting malaria, might transmit other diseases. They feared that. So, they had to eliminate the mosquito menace and malaria in the United States of America after Hurricane Floid. They employed the military aircraft, Hercules C130, which is capable of spraying 77,000 acres of land per day. They employed three of them and sprayed through North Carolina. They sprayed for 21 days and eliminated 90 per cent of the mosquitoes using a chemical called dibron. Mr. Temporary Deputy Speaker, Sir, America, the great power of the world, knows that to control a vector borne disease, you eliminate the vector. Who are we not to follow suit? Why can we not follow suit? What is good for the gander is good for the goose! We follow many American things, some not so good and some quite good. Why can we not take some of their good examples? Now, we have a problem with that. Now, we do have a problem with that because, if we took that example and sprayed wide- scale, an issue will arise. Our horticultural crops will be rejected on the world market. They will say that we have sprayed them with chemicals. So, they cannot be accepted. In that case, we have 1712 PARLIAMENTARY DEBATES July 9, 2008 to find a way of cushioning farmers, so that we do not lose the horticulture market. There is a better way of doing it. It has been done in other countries. South Africa has done it and reduced the amount of malaria transmission by over 60 per cent. In fact, our own Ministry of Public Health has done it in 16 or 17 districts on pilot basis. Mr. Temporary Deputy Speaker, Sir, the districts where the Public Health Ministry did it are the districts which have what we call \"highland malaria\". Highland malaria does not come throughout the year. It comes at certain times of the year, when the mosquitoes invade those areas and transmit malaria. The Ministry sprayed in some districts. That is commendable, but very dangerous, indeed. I believe there are scientists in that Ministry, who know that mosquitoes develop resistance to chemicals. If you spray piecemeal, you are encouraging resistance by those mosquitoes to that chemical. When you decide to spray only 16 or 17 districts in this country, you are giving those mosquitoes a chance to develop resistance against the chemical. Next time you spray those chemicals, they will not work. So, what the Ministry is doing is very risky. Mr. Temporary Deputy Speaker, Sir, the way to do it is to spray the walls and the surfaces inside the house, and not outside. This should be done in all the districts that are endemic with malaria. It should not be done in some districts and not in the others. If you spray in selected districts and leave out others which are endemic to malaria, you risk the chance of creating resistance in the mosquitoes. So, you have to spray everywhere. While I commend the Ministry for having sprayed in the 17 districts, I wonder about that child in the district that was not part of those sprayed. Suppose that child dies of malaria? Are those children who are dying of malaria in the left out districts children of a lesser god? Do they not deserve protection from us? I believe that if we looked at this issue more fairly, we will realise that there is a very good way by which we can prevent malaria. That is to spray in the houses. The question is what chemicals we should use. Nobody should go away, thinking that I am talking of DDT. This is a chemical which we are not supposed to use. It has its own bad effects on the environment and the population. There are better chemicals now, which are based on pyrethrum, which is a natural product. I am talking about pyrethrin-based insecticides, which are environmentally friendly. They do not harm human beings or other animals, but they are highly toxic to the mosquito. These are products that are available on the market. Those are the sorts of products that the United States of America (USA) was using to spray in their country. Mr. Temporary Deputy Speaker, Sir, in fact, the Bill Gates Foundation and other bodies are going to give us money to buy expensive anti-malaria drugs. Maybe, they could just give us that chemical to spray, and we will be safe. We will not need the high cost drugs, because we will reduce malaria transmission by 60 per cent. What I would like to emphasise here is that there will be a lot of questions about what chemicals we are going to use, and what their long-term effect on human beings is. They are safe insecticides. We call them residual insecticides because when they are sprayed on a surface, they stay there and act for some time. So, we are able to control the mosquitoes for some time. Be rest assured that once we have been able to control mosquitoes for about seven months, the malaria transmission rate will drop drastically. This has happened in South Africa. It can also happen here if we do it correctly. When I talk about environment-friendly insecticides, I do not have in mind things like Doom or IT. Mosquitoes develop resistance very fast to Doom and IT insecticides. Most people must have realised that when they spray them, the mosquitoes do not even die. Some of the mosquitoes keep flying even faster after spraying that chemical. The chemicals I am talking about are well researched products, which can help us. Mr. Temporary Deputy Speaker, Sir, I do not know why we fear science. I do not know why we fear chemistry and yet, we can use chemistry to work for us. We have the knowledge. The Ministry has the knowledge and the means to do this kind of work. So, I am not asking them for July 9, 2008 PARLIAMENTARY DEBATES 1713 something they are not able to do. They have the human resources that can do this. When we decide to use this sort of method selectively and risk the mosquitoes developing resistance, then we are not doing a good job, and that should not be allowed to happen. So, I would, really, like us to wake up and use the resources and knowledge that we have and control this malaria menace once and for all. If we manage to control the malaria transmission rate by between 60-70 per cent, you can see the economic gain for this country through the amount of money saved in hospital treatment, cost of man-hours lost at work and the school hours lost by our children. We will be able to save a lot. I believe that the high transmission rate of malaria in this country contributes significantly to the poor performance of our economy, and yet, we have the means to reduce it. That is why I am asking this House to resolve that we adopt methods of controlling malaria. Apart from advocating for the use of mosquito nets and providing free treatment to victims of malaria, we should adopt a method of spraying inside all dwellings in malaria endemic areas, with residual insecticides that are environment-friendly, so that we can control this menace once and for all. Mr. Temporary Deputy Speaker, Sir, the reason is that the other malaria control measures seem to have broken down. Environmental sanitation has become very poor. You find that even the systems that existed before, where people used to go to our homesteads and tell us not to plant bananas too close to our homesteads because they carry water on which mosquitoes would breed, are not there. People now dump empty cans and plastic papers all over the place. If we adopt this method, mosquitoes will not get into our houses and transmit so much malaria. I believe that the Ministry is aware of this. That is why it decided to spray in just 17 districts. That is not good enough. In fact, it is risky, because mosquitoes will become very resistant to the chemical. When we use the chemicals again, they will not work. So, I urge the Ministry to, from now henceforth, make spraying the standard method of management and control of the spread of malaria. It should spray in all malaria endemic regions. Mr. Temporary Deputy Speaker, Sir, with those remarks, I beg to move the Motion and request Dr. Khalwale to second it."
}