Voices from the field: In Papua, health workers and communities mobilize against malaria

26 February 2024

In Papua Region, eastern Indonesia, local health workers and communities are accelerating action to prevent, detect and treat malaria, in alignment with Indonesia’s updated National Action Plan on Acceleration of Malaria Elimination 2020–2024 and its 2025–2026 bridging plan. Based on a recent Ministry of Health report, as many as 81% of all malaria cases in Indonesia come from just nine districts and cities in Papua, highlighting the urgent need for accelerated, comprehensive and sustained action, with communities leading the way. From community clinics to remote islands, and from medicines and larval control to bed nets, each image in this story highlights the resilience, innovation and perseverance at the heart of Papua’s quest to become malaria-free, joining 389 malaria-free districts country-wide.


Written by Dr Herdiana Hasan Basri, National Professional Officer for Malaria, and Ina Rachmawati, Emergency Communication Officer; WHO Indonesia. 

 

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A health worker takes Alves’ blood sample at Harapan Primary Healthcare Centre.
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Health worker performs a malaria rapid diagnostic test

After experiencing malaria-like symptoms, Alves Doce visited Harapan Primary Healthcare Centre with his grandmother for a blood sample. After Alves’s diagnosis was confirmed as malaria, health workers accompanied Alves and his grandmother to their home to screen and possibly treat other family members.

 

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A laboratory worker examines malaria parasites in a patient’s blood samples at the Harapan Public Health Laboratory
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Microscopic analysis in malaria diagnosis and treatment

In the Harapan Public Health Laboratory (Labkesmas), a laboratory technician examines a microscope slide with blood smears from a malaria patient. Health workers use microscopy to examine blood samples, a method also used to ensure that the parasite plasmodium that causes malaria is no longer present following antimalarial drug therapy.   

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Alves and his grandmother obtain his malaria medication at the Harapan Primary Healthcare Centre
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Antimalarial drug therapy

Individuals who test positive for malaria require prompt treatment with antimalarial medication. After being diagnosed with malaria, Alves Doce receives antimalarial treatment from the Harapan Primary Healthcare Centre. Without effective treatment, malaria can progress to severe illness and spread within communities.

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Yustince and Anges discuss malaria.
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The impact of malaria on health and well-being

Yustince Tokoro is a pregnant woman living in a tiny village on Asei Besar Island. The impact of malaria on the health and the well-being of her and her child can be more severe during pregnancy. Yustince sits with Anges Pouw (second from the right), the village malaria worker, who emphasizes the importance of prevention, early screening and tailored treatment, addressing Yustince’s specific physiological needs and considerations.

 

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Priskila watches Yunus administer his daughter the antimalaria medicine, Jayapura District, Papua, Indonesia
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Leaving no one behind: Mass drug administration for all family members

Yunus Ansaka (right) took time out of his busy schedule to attend to his children and help them take their antimalarial medication. Priskila Ikari, a village malaria worker, is assisting during the second of three rounds of preventive antimalarial medication campaigns conducted in 2023 in Nendali village. WHO endorses mass drug administration campaigns as part of a comprehensive strategy to combat malaria in high-risk areas, mitigate drug-resistance and respond to malaria in complex emergency settings.

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Chorlina holds her daughter Cathalia as they walk in the backyard of their house in Keerom District.
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From anxiety to safety: Overcoming malaria

Chorlina Gadi carries her third child, Cathalia Alfra, as they walk in their home’s backyard in Keerom District, Papua Province. Reflecting on her first pregnancy, Chorlina recounts the daunting experience of being diagnosed with malaria at eight months, a situation that threatened her health and well-being and the safety of her unborn child. 

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Priskila, a village malaria worker, goes door-to-door, visiting a house in Nendali Village, Sentani Timur Subdistrict.
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Reduces malaria illness

Initially, Chorlina felt anxious when taking part in the pilot mass drug administration campaign in October-December 2023. However, she has since witnessed a notable improvement in her health. The frequent bouts of illness caused by malaria have dramatically reduced and she feels a renewed sense of safety for herself and her family.

 

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Junita Felle shows the bed nets inside her house in Asei Besar Island, Sentani Timur Subdistrict.
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Insecticide-treated bed nets save lives from malaria

On Asei Besar Island, villagers weave protective barriers against disease-carrying mosquitoes. Their homes are furnished with insecticide-treated bed nets, guarding against night-time bites. Junita Felle demonstrates how to properly install the bed net, a skill acquired through community education facilitated by local health workers.

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Health officer Muspri sprays larvicidal fluid into waterlogged areas at Arso Barat Subdistrict, Keerom District.
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Targeting the source: attacking larvae in mosquito breeding sites

In Keerom District, Muspri, a staff member of the district health office, is part of the team fighting malaria at its source. Muspri applies larvicide to breeding grounds, such as drainage channels, to eradicate mosquito larvae. This strategy is an effective way to reduce the adult mosquito population in the surrounding area.

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Asro, a recipient of mass drug administration, talks to Lerviana, head of the disease prevention and control division of the local district health office, in Keerom District.
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Communities coming together

Arso Barat is a small subdistrict located a few hours away from the Papua New Guinea border. People here know the threat of malaria. Having migrated to Papua in the 1980s, Asro (right) recounts the many occasions when family members, neighbours and friends were infected with malaria, requiring a long time to recover. He is glad that he and his community participate in the mass preventive drug campaign to be better protected against the disease.

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