Problem

Malaria is a leading cause of mortality in the DRC. So establishing an effective malaria control program is a chief occupational and public health concern for any organization wishing to operate in the country.

A mining company beginning the construction phase for a remote site in the DRC’s Katanga Province contacted International SOS for our malaria expertise and advice. The client faced a unique set of challenges for its 9,000+ employees and contractors. Nearly 70% of the onsite workforce were Congolese nationals—many of whom had moved to the site with their families greatly increasing the local population around the site. The remaining workers were expatriates from India, Pakistan, Bangladesh, and the Philippines. The vast majority of these Asian expatriates had little or no acquired immunity to malaria and knew little about its prevention.

This was a real challenge. International SOS devised an integrated plan for malaria including: comprehensive vector control management and health awareness programs for each population group.

Solution

We began by examining the biology and ecology of local disease-carrying mosquito species, the disease transmission dynamics, and the malaria morbidity statistics at the site. An International SOS consultant undertook epidemiological and entomological field studies to determine baseline infection rates, primary mosquito vectors and resistance patterns to insecticides. We surveyed the workforce and local community to get a better picture of the knowledge, attitudes and practice toward malaria and its prevention.

From these initial findings, it was clear we needed to treat each group individually. Separate health awareness agendas were developed for employee and contractor subpopulation as well as the greater community including mothers, children, and local leaders.

For the onsite employees, we conducted indoor residual insecticide spraying, supplied long-lasting insecticide-treated bednets (LLIN), provided an anti-malaria chemoprophylaxis program, and delivered ongoing awareness and education programs. At the International SOS onsite clinic, prompt and accurate malaria diagnosis and treatment were made available to all workers and their families.

For the community, we provided each family with one or more LLIN, trained local heath staff on early malaria identification, and ran awareness and prevention programs for different community groups. Lastly, we monitored the prevalence of infection and made operational changes to programs as necessary. 

Impact

In the two-years that the malaria program was implemented, malaria was reduced by 60% in the communities compared to the 2007 baseline infection rate.  We saw similar dramatic reduction in malaria risk in both the national and expatriate workforce during the same period. By taking an integrated approach to vector control and adapting health awareness programs to suit each population, the program was effective.  The client showed strong corporate citizenship in developing a malaria program for the community, and also lowered the morbidity rate and reduced sick time.