Hidden Pacific: Pregnant mum's long trek for malaria shots

Daphne Norbert is 28 but looks much younger.

Suffering badly from malaria and heavily pregnant, she travelled alone for a full day to get from her village to the Bogia Medical Centre on Papua New Guinea's northern coast for treatment.

Malaria presents in many ways and symptoms include jaundice and anaemia with patients suffering fevers, aches, tiredness, nausea, vomiting and diarrhoea. If left untreated it can lead to organ failure and death.

Some 60 per cent of Papua New Guinea's population live in areas where malaria is endemic.

Just four types of parasite worldwide cause it, but PNG has all of them. It's transmitted mainly via mosquitoes, which infect in the same way as sharing a needle.

Only female mosquitoes bite, sucking in blood and malarial parasites called plasmodium from an infected person, then transmitting these through saliva when biting their next victim.

The injected parasites multiply in the liver before spreading to red blood cells. So if no one in a village has it, it is very difficult to catch.

Papua New Guinea's multiple failed attempts to eradicate malaria have included using insecticides such as DDT in the 1970s. In the years since, the number of cases has risen and fallen as various methods of control have been implemented and then withdrawn, usually through a lack of funding.

In more recent times they've had some success with long-lasting insecticidal nets.
On the morning I visit, just a week after her arrival, Daphne has an hours-old baby boy, her fourth child. He has congenital malaria.

"When I get the baby, they said, 'You are sick and the baby too'. The baby get sick with the mother."

The World Health Organisation (WHO) estimates that 18 per cent of deaths in children under 5 are attributed to malaria. Daphne is lucky that this clinic has some treatment available, although it's not the officially sanctioned medicine.

Papua New Guinea adopted WHO protocols in 2011 and now only approves and supplies the use of treatment that contains artemether-lumefantrine, which locals call Malawan.

But none of the rural clinics and aid posts I visit have any, with large hand-written notices in waiting rooms advising patients of this.

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At one clinic a patient comes forward to tell me the nurses have secret supplies kept hidden for family members. True or not, it hints at the desperate nature of the situation.

Daphne got here by local public transport, a PMV (Public Motor Vehicle).

They're converted trucks with tarpaulin covers stretched over corner posts for shelter, narrow hard bench seats lining the parcel tray.

Each one has big knobbly tyres to navigate roads frequently pock-marked with deep, muddy potholes. They are often overflowing with people and product, many stacked with sacks of betel nut destined for local markets. Second-class passengers ride on top.

Daphne has been injected daily since her arrival with a mix of amodiaquine and chloroquine, an older malarial treatment no longer approved by the government due to a surge in a drug-resistant strain.

But with no Malawan available, despite orders stretching back four months, staff have been forced to resort to what they know can offer relief.

Luckily for Daphne and her baby, her malaria isn't the drug-resistant strain and she is responding well. With support from her sister-in-law who has recently arrived, her situation has improved.

However it's not safe for them at the clinic with no lighting and no security, so as soon as her and her baby boy Michael have regained some strength they will leave to begin the bumpy day's ride back to her village.

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