Malaria is one of the most ancient tropical infections known, dating back to the fifth century B.C. Although there is widespread knowledge that mosquitoes cause malaria, many African societies have traditional perceptions about the causes and management of the disease.
It is therefore not surprising that everybody in Africa can treat malaria. Of course, this depends on one’s perceptions about the cause of the condition. Right from the household level, where self-medication is common to witchdoctors and herbalists who prepare concoctions to treat the disease, there are various medications and preparations to treat malaria.
Some people in Ghana believe that they suffer from malaria because they exert themselves too much while working under the hot sun. According to a Gambian journalist, in Banjul, some people believe that if you drink lots of sour milk during the rainy season you would get malaria.
In some parts of Togo, it is also believed that one suffers from malaria from eating too much palm oil.
These beliefs, in addition to poor environmental sanitation and consumption of unripe fruits together with deep cultural belief in witchcraft has greatly impacted on the prevention and treatment of malaria across Africa.
There are various interventions therefore, to treat the condition depending on perceptions about the disease. These include drinking coconut juice, applying regular enema drinking liquid from boiled pineapple peels and boiled neem tree leaves.
Others believe that taking in large amounts of concoctions of herbs would treat malaria.
The truth about the cause, diagnosis and treatment of malaria across the continent is largely surrounded by myths and conceptions just like the hippopotamus, which lives largely submerged by water with only the ears sticking out.
Perceptions and myths, which have hindered the effective management of the disease, largely within the communities could be likened to the hippopotamus, which has a large part of its body submerged in water.
“Malaria is unique because its roots lie in human communities,” Dr. Margaret Gyapong, a malaria expert at the Dodowa Health Research Centre in the Eastern Region, said in a presentation at a workshop on malaria in Accra. Early work on malaria, she said, focused on vector control.
“Work done was without reference to human behaviour and belief system. Too often behavioural and socio-cultural aspects were an afterthought. Lack of attention to these aspects is a reason for the failure of early attempts at malaria control.”
As a result of such myths, decisions to seek treatment for malaria at health facilities are often the last resort. “The relatively few patients, who have any contact with the health services, represent the ears of the hippopotamus,” Dr Gyapong said, adding that “usually, victims of malaria seek medical examination and treatment from health facilities when the initial attempts have failed resulting in late presentation.
“Very often treatment of malaria in Ghana occurs at home with only a few of such home-based treatments being correct and complete. A medical sociologist at the Noguchi Memorial Institute for Medical Research (NMIMR), Dr Collins Ahorlu, said perception about a disease affect, prevention activities.
“If the perception within the communities is that malaria is not caused by mosquito but by witchcraft then drug intervention is not an option for people of that community,” he said.