Bo, Sierra Leone - April 18 2007

Sierra Leone has one of the world's highest child mortality rates (282 out of every 1,000 children die before their fifth birthday) and much of this is due to malaria. In the hospital and five clinics in the Bo area where MSF works, two out of five consultations are related to malaria.

Sierra Leone's decade-long conflict ended five years ago. The country, rich in resources and with significant international support, is recovering from its violent past. Yet, many thousands of its people continue to die from perfectly preventable and curable diseases. Today, malaria is Sierra Leone's leading cause of death.

Saidu Kamara, a six months old baby, arrived just before lunchtime. His right arm dangling freely in the air, as one of the nurses carried him into the intensive care unit. Eyelids more than halfway closed, head fallen backwards.

According to Saidu's mother, the boy's fever had started four days earlier. Around the same time, she said, Saidu had started to vomit and become unable to keep the breast milk she fed him.

During that first night, as she lay in their bed listening to his endless crying, Saidu's mother realised that her son needed medical treatment.

In the morning, she visited one of the drug peddlers in the village. In exchange for the money she had available, she was given two pills of paracetamol and two pills of chloroquine. The latter, said the peddler, would settle the matter if it was malaria. To compensate for the small number of pills, Saidu's mother also bought some of the herbs traditionally used for fevers.

She could afford more of the herbs than of the medicines.

The paracetamol first lowered Saidu's body temperature. But even though his fever was reduced, the parasites in his body kept on multiplying.

On the fourth morning, the six month old baby started to have convulsions. At that point, his visiting aunt managed to come up with enough money to take Saidu to the MSF clinic, located 110 kilometres from his home village Malar. The trip to get there cost his family 20 times as much the pills they bought from the peddler.

When they finally reached the MSF clinic in Godoma, Saidu was not only fighting the parasites in his blood. As a result of the malaria, he was suffering from severe anaemia and acute respiratory infections. In addition to that, Saidu was diagnosed with herbal intoxication.

Saidu Kamara's case of severe malaria might have been prevented, if his family only had a bed net available. If they had also had more knowledge about the disease, plus a health clinic closer to where they live, Saidu might not have had to be rushed to intensive care.

After an initial blood transfusion and treatment for the malaria, Saidu's condition stabilised. The doctors now hope that he will be able to leave the MSF clinic in Gondama soon.

He will leave together with his family's first bed net.