The Links Between Malaria, Miscarriages, and Poverty in Liberia

By Syrulwa Somah, PhD (January 26th 2006)    

Glimpses of antiquity as far back as human ken can reach expose the womb of the woman as the axis of the universe, the nucleus of the world in which all deities and human beings, whatever their age, ability, background, physical or spiritual power take form. In other words, within the bosom of the woman resides the fructifying, life-giving power without which sustaining source for the continual existence of the human species is impossible. This is why generations throughout ages have celebrated the fertility of the woman. This is why pregnancy, the transition into motherhood in most African societies is climaxed with special mother-centered gatherings of friends and family to honor, support, nurture, and encourage the mother-to-be in her new role or continuing role. For the most part, pregnancy is a special time in life to honor this momentous rite of passage and infuse the epoch with love, spirit, caring, and support the mother-to-be. For example, in certain traditional society, not only was it uncommon to take all the best part of certain slaughter animals to be specially prepared to feed the mother-to-be but she was forbidden to eat certain meat, mushroom, and vegetables for the sake of the fetus. Equally important, the mother-to-be was the first to take her bathe, eat, and went to bed early as the goddess or a protectress of the “seed.” In essence, the mother has not only been the glue of the household and the flower in a garden but one who gives birth to the human race, the “sons of gods”, including Jesus Christ.

It is no wander why an early death of a child or the loss of the unborn to a miscarriage, “spontaneous abortion" is one of the most traumatic experiences no couple would ever want to go through. They are haunted for life with the frustrated feelings of motherhood. Musicians, poets, prophets, and sagas of all ages have ventured to send coded messages that the survival of any society was bleak where threat to the unborn and the mother was imminent. Sadly, this is the “sour pills” an estimated 30 million plus childbearing African women who become pregnant in malaria-endemic environment annually have to sallow, thereby dying from a malaria-induced miscarriage/stillbirth. The figure is vividly captured in the U.N. findings that 95 percent of the deaths worldwide, related to pregnancy and childbirth, occurs in Africa where a woman dies from complications in pregnancy every minute. The statistics is even frightening when compare to women living in the western world. For example, “African women are 175 times more likely to die in childbirth and pregnancy than Westerners, a UN report says (ww.news.bbc.co.uk/2/hi/health/).

Additionally, tens of thousands of African women who survive the ordeal would live with severe disabilities, maternal anemia, and would see their low birth weight babies so vulnerable to infection that death is likely to occur during their first year because malaria burns up energy of these weak children who must lose a lot of body fluids through sweating. As a result, 75% of all malaria deaths, which are children, happened in Black Africa (www.sahims.net) because of lack of treatment, including proper hydration due to economic depravity to buy appropriate valuable nutrients. Here is the true face of malaria but who will hear the cry of the women?

Role of Malaria Induced Miscarriage in Liberia
Miscarriage is a bleeding, cramping, or passing tissue or large clots that occurs before the 20 weeks gestational age or approximately up to the 5th month. In the case of malaria-related miscarriage, when the mosquito bites a mother-to-be, merozoites invade and destroy red blood cells in the human body. As the destruction of red blood cells spills wastes, toxins, and other debris into the blood, the human body responds by producing fever, an immune response that speeds up other immune defenses to fight the foreign invaders in the blood. The fever usually occurs in intermittent episodes, which begins with sudden, violent chills (or what we called in Liberian the person trembling), followed by an intense fever and then profuse sweating. Upon initial infection with the malaria parasite, the episodes of fever frequently last 12 hours and usually leave an individual exhausted and bedridden. Repeated infections with the malaria parasite can lead to severe anemia, a decrease in the concentration of red blood cells in the bloodstream because the malaria parasite usually consumes or renders unusable the proteins and other vital components of the infected person’s red blood cells www.ratsteachmicro.com/Malaria).

Untreated, the sporozoites divide repeatedly to form 30,000 to 40,000 merozoites in liver cells over the course of one to two weeks. The colony of merozoites departs the liver to enter the bloodstream, where they invade red blood cells. While in the blood cells, the merozoites multiply quickly thereby forcing the red cells to burst, while releasing into the bloodstream a new generation of merozoites that go on to infect other red blood cells (www.ratsteachmicro.com/Malaria).

How Malaria Destroys the Placentia and the Unborn of Liberian Mothers
When a pregnant woman develops malaria it enters the placenta. This is very dangerous during the first and second stages of the pregnancy at which time the pregnancy is more venerable to malaria than at a later stage. As stated early, the malaria parasites multiply and continue to burst the cells of the placenta, it damages placental integrity, thereby interfering with the ability of the placenta to transport nutrients and oxygen to the fetus. Infection of the placenta increases the risk of stillbirth and miscarriages because the placenta, which is soaked up serum iron for the mother's bone marrow and iron for the baby is not only responsible for creating the pregnant mother blood cells, but it is the lifeline of the fetus. In other words, infected placenta deteriorates in placental function, causing transient fetal hypoxia, meaning deprivation of enough oxygen supply to the unborn, so stillbirth or miscarriage occurs.

Malaria Destroys the Economy and Exacerbates Poverty in Liberia
Besides the emotional toll of a grieving mother and her family, the socio-economic penalties of malaria in our nation is a major impediment, meaning it is the number one cause of poverty because it uses up our resources (about $40 million annually) for its prevention and control. For example, malaria impacts on our national economy at a number of levels including but not limited to households and communities, the private sector, government and the macro economy. Throughout our 158th years of existence, poverty and inequalities have been exacerbated, government resources come under increasing pressure, and the private sector continue to face reduced investment, growth, profits and inflow of foreign currency. The direct economic costs of malaria comprise prevention and treatment costs at the household level is the main cause of poverty considering that an employee earns between $150 to $200 and has a spouse and two children who must buy mosquito stray or coils for 30 days and visit the doctor for treatment. Keep in mind that there are also indirect economic costs such as up to 10 days absenteeism from farm work, blue collar work, school, especially teachers and staff, domestic jobs, and reduced income. Simply put, malaria doesn’t only shrinks developing brain of malaria inflicted babies but children who are repeatedly inflicted with malaria become what we can “dull” (poor concentration in class and poor scholastic performance) to learn in Liberia. In addition to direct, indirect causes and impairment to the mental alertness of Liberian children, other social costs such as incurred debts, bereavement, sickness, and death (irreplaceable loss of our nation talented and wealth) harm our socio-economic and spiritual development.

Before the “Word” or “Spirit” was made flesh and went forth to live in the person of Jesus Christ, for thousands of years – from the Old Stone Age to the closing of the last goddess temples, around AD 500 – women have been at the forefront of all great civilizations. Women always bring love, peace, justice and equality to homes, communities and nations. Liberia and its people stand to gain nothing by sitting on the fence to see our wives, mothers and sisters who choose life die in drove from malaria. Deuteronomy 30:19 says "Choose life, says the Lord, that you and your descendants may live! But how do we in Liberia expect our nation to live on when we agree with misplaced priorities and let not the little fetus become children to come to us, and we let malaria stop them; knowing that it is to such as that the next Liberia belongs. As Liberians, we have a moral obligation to chart a new direction and change our malaria statistics for the better, by burying this national calamity once and for all. Remember, Liberian mothers are not only the source whence all blessings flow, but they are also the beginning and the end of all things. Luke 1:42 warns us, "Blessed is the fruit of thy womb".

In essence, God has allowed a new human being to come to life, His voice speaks to the woman's soul. Hence, it is a human rights violation to do nothing about eradicating malaria. Malaria only inspires the culture of death. No nation or people have the right to make malaria kill our children while they preach environmental protection and would not send their little children to spend a night in Africa without securing adequate protection against malaria. No one can claim to be caring for our welfare and democracy by violating our God’s given right to life. To continue to allow these fragile flies to decimate our future generation in the womb of the mother and the mother-to-be is a very serious crime and human rights violation. Until we as a people and nation collectively do something about malaria, our socio-economic, cultural, and poverty woes will not only continue, but will cause stillbirth to the growth and democratization of Liberia.

This is why all Liberians regardless of our differences and memberships of a particular organizations, must “cry out” and be architects and engineers to implement LIHEDE long-term (5-10 years) malaria eradication program in Liberia beginning with the December 14-19 National Conference in Liberia. Call or email LIHEDE today to let LIHEDE know that you want to help eradicate malaria in Liberia.

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About the author:

The author, Syrulwa Somah, Ph.D., is an Associate Tenured Professor of Environmental and Occupational Safety and Health at NC A&T State University in Greensboro, North Carolina. He is the author of several books, including, The Historical Resettlement of Liberia and It Environmental Impact, Christianity, Colonization and State of African Spirituality, and Nyanyan Gohn-Manan: History, Migration & Government of the Bassa (a book about traditional Bassa leadership and cultural norms published in 2003). Dr. Somah is also the Executive Director of the Liberian History, Education & Development, Inc. (LIHEDE), a nonprofit organization based in Greensboro, North Carolina. He can be reached at: somah@ncat.edu or infor@lihede.org