World Vision Uganda empowering communities to fight malaria in Bugiri

Delilah survives malaria thanks to a community health worker

Children under five are one of the most vulnerable groups affected by malaria, and this was the case for three-year-old Delilah, who would have lost her life to this dangerous disease. 

Delilah is the youngest of five children and lives with her grandmother, the caretaker for the family of eight. Risper, Delilah's grandmother, recalls how her grandchild's health suddenly deteriorated one hot afternoon.

“Delilah had previously developed a high temperature, and I could feel it when I touched her forehead", Risper narrates. "But I reluctantly thought it was temporary and controllable by cooling with a damp cloth. On that same day, she lost her appetite for food and had difficulty breathing."

World Vision Uganda The Pfizer Foundation Expanded Project in Bugiri
Dorah, a Village Health Team (VHT) member takes measurement of Delilah's mid-upper arm circumference (MUAC).

Panicked by Delilah's situation and with no access to a nearby health centre, Risper decided to treat her granddaughter with paracetamol that she found in her stash. Soon after, however, she realised that this would not benefit the child's health.

"I got worried. Two days of my efforts, I didn’t see a change, so I opted to see a VHT worker, whom I was sure could help my grandchild", Risper says.

Dorah Nankya, one of the VHT members trained by World Vision with support from The Pfizer Foundation to bring health services closer to the community, visited various homes in her neighbourhood on recent occasions to register families supported with health interventions.

Risper's family participates in World Vision's Integrated Community Case Management (iCCM) Expanded Project in Kapyanga sub-county in Bugiri district, Eastern Uganda. The iCCM model utilises trained, supervised community volunteers linked to facility-based services to deliver curative interventions in the community.

"Risper brought Delilah to my home in severe condition shortly after 6pm", Dorah recalls. "It was already dark. I didn't have a thermometer, but she felt feverishly hot when I touched her skin."

Dorah then performed a rapid diagnostic test, which turned out positive –Delilah had severe malaria. 

"She didn't have any other underlying health conditions, so I immediately administered anti-malarial drugs. I also gave her grandmother directions on administering the remaining doses properly", Dorah says. 

Three days later, Dorah trekked a long distance to visit Risper. "I was so pleased she had greatly improved and could lift herself and walk without external support," says Dorah.

Her grandmother could not avoid smiling when Delilah regained appetite. "My granddaughter didn't want to eat anything for three days. But I was overjoyed when she asked for food. She loves porridge, so I prepared it for her very fast," says Risper. 

And to prevent malaria, Risper is adhering to the recommendation of everyone, including Delilah, to sleep under treated mosquito nets. "We used not to sleep under the [treated mosquito] nets, but we can't risk anymore," says the grandmother.

Malaria is a significant public health challenge associated with slow socio-economic development and poverty in Uganda. It has been the most frequently reported disease at both public and private health facilities for several years.


World Vision Uganda The Pfizer Foundation Expanded Project in Bugiri
The Health Ministry established VHTs to empower communities to take care of their health, create awareness on health services, and strengthen health services, including improving nutrition, sanitation, and hygiene practices at household level. World Vision works with the VHT structure to implement community models such as Integrated Community Case Management (iCCM).

Based on Delilah's story and many others, World Vision believes that working with the VHT structure to implement community models such as iCCM will help reduce the burden of common childhood illnesses such as malaria, diarrhoea, and pneumonia.

Story and photos by Clive Polycarp Inyhensico - Graphic Designer for World Vision in Uganda