Father sitting and holding his daughter in his lap.

Joseph Chebundet cradles his daughter, Rael, in his arms. Since Rael was stricken with cerebral malaria, she can no longer walk, feed herself, or communicate with her family.

Malaria can devastate families, but we’re giving them tools to beat this deceptively dangerous disease

The night three-year-old Rael Cheruto started calling out the names of her sisters and friends in her sleep, her family knew something was very wrong. Her skin was hot to the touch, and her family could not wake her.

By morning, Rael was unconscious. When she finally woke up after more than two weeks in the hospital, she could no longer walk, feed herself, or communicate. Doctors diagnosed her with cerebral malaria, which can cause the disease’s most severe neurological effects.

Malaria exacts a terrible toll on children and families in western Kenya, where Rael lives. It’s rare to meet a family here that has not been personally affected by malaria, this region’s number one health threat to children. PATH is reaching into villages across western Kenya through a network of community health workers and a broad-based health education effort to give families the tools to fight back against the disease.

Paying a heavy price

Before she became ill, Rael was full of energy, even helping her father, Joseph, carry water back to the family home from a nearby stream. “She was not left behind on anything,” Joseph recalls. Her older brothers and sisters had all had malaria at some point during childhood, but they had always bounced back. The family never knew the consequences of malaria could be so severe.

Now age six, Rael spends hours most days shut inside her family’s mud-brick house while the rest of the family is at school or work. Sometimes, she still calls out the names of her sisters and former playmates.

Her parents have taken her to local hospitals to see if anything can be done to straighten Rael’s thin legs, now drawn up tight under her body. Joseph and his wife struggle to support their family on the small income they earn from selling produce and working in a local shop. They haven’t been able to afford to return to the hospital for more therapy.

“When we are outside, we carry her with us. We love her and don’t want her to miss any company,” says Joseph, cradling Rael in his arms. She sits limply in his lap in a green polka-dot dress, staring vacantly around her. “What we are hoping and praying is that she will walk again.”

A neighbor-to-neighbor approach

In Rael’s village and across western Kenya, PATH is using simple, proven interventions to protect children, save lives, and prevent other families from facing the devastating consequences of malaria. At the heart of our strategy is an army of community health workers.

These local volunteers, selected by community members and village elders for their leadership and community standing, are equipped with training and tools from PATH and our partners to reach their neighbors with messages about malaria prevention. Many volunteers have nursed their own children through malaria—and sometimes lost them to the disease—giving them personal passion for their work and a shared experience with community members. 

They ensure that families have bednets and that the nets are being used consistently and correctly. They encourage their neighbors to drain standing pools of water and trim back vegetation to limit breeding areas for mosquitoes. They teach parents to recognize the signs of malaria and refer people with suspected malaria to health facilities.

In many communities, there’s a sense of resignation about malaria. The disease is so ubiquitous, local health officials say many people consider it unavoidable. Community health workers teach people to recognize malaria as an especially serious health threat to pregnant women and young children and to get them to a health facility at the first sign of fever.

“Mosquitoes outside, people inside”

Today, public health messages about malaria abound in western Kenya, part of a massive education and prevention effort supported by PATH and our partners that aims to reach more than 10 million people in Nyanza and Western provinces. The government has distributed millions of free bednets, and PATH is working to enhance bednet procurement and distribution methods to ensure a consistent supply.

Bednet ownership is rising, with about 60 percent of households in western Kenya owning at least one insecticide-treated bednet. Radio announcements remind people to sleep under bednets at night, using the Swahili slogan mbu nje, sisi ndani: “Mosquitoes outside, people inside.”

By empowering people to protect their own health—and by helping parents recognize their critical role in fighting malaria—we’re helping communities take charge of their response to malaria. Working together, we can reach our ultimate goal: to stamp out malaria for good and prevent families from losing children to the disease.

Photo: PATH/Eric Becker.