Jackline is a Ugandan medical doctor and maternal health specialist. Malaria.com caught up with Jackline to ask her a few questions about her work, and specifically her observations on the impacts of malaria on pregnant women.
What is a typical day like for you when working in the field?
A typical day involves waking up at 6am, preparing for the day and by 8am I am in the ward. First I review the mothers in labor to identify any high risk mothers or those who may require C/S [Ed: Caesarian section], then do a ward round in the post natal/ post operative ward, then review those with other complications in pregnancy like malaria, UTI, and anemia, to mention but a few. After that I review children in the pediatric ward since we are only two doctors in the hospital so each handles at least two wards a day. Depending on when I finish the ward round, then I have lunch since I usually prefer seeing all patients before I go for lunch. After lunch, there are special doctors clinic in the OPD to review cases which the clinical officers may not be able to handle, then I wait for referrals from lower units in which 90% of cases are complications in pregnancy for C/S through the night.
Can you please provide a brief overview of the status of malaria control in Uganda?
Uganda has quite a number of interventions in the control of malaria. First we have the free distribution of insecticide treated mosquito nets by Ministry Of Health to all households, then we have indoor residual spraying of mosquitoes, and a lot of campaigns on the prevention of malaria infections, including provision of free antimalarials and intermittent preventive treatment for special cases like pregnant women and people with sickle cell disease.
What are the biggest challenges to controlling malaria in a country like Uganda?
I think the biggest challenges are illiteracy, poverty and ignorance. People are so dependent on the government that they cannot help themselves, people use nets for fishing, brewing alcohol and they resist indoor spraying!
In your work with pregnant women and newborns, do you see a lot of cases of malaria?
I see so many cases of malaria everyday! Literally speaking, so many especially among pregnant women and children! It is the commonest cause of admission in pediatric ward and maternity. As I write this, northern Uganda is battling with a serious outbreak since March!
Are there special control measures taken in Uganda to protect pregnant women from malaria? Can you please describe these briefly?
For pregnant women specifically, they are given free mosquito nets during the first antenatal visits, then we have intermittent preventive treatment (IPT) with Fansidar [Ed: This is a brand name for a combination of sulfadoxine and pyrimethamine] for all pregnant women both at around 12 weeks and 26 weeks.
Are there additional measures that you would like to see implemented to protect pregnant women from malaria?
I think the addition of insect repellents to the antenatal care package could help since most of the mothers get bitten just in the evening as they are preparing evening meals before going to bed and probably at sundown as they go to their gardens. Also educating them more on the effects of malaria in pregnancy and ensuring they take their IPT and actually use the mosquito nets as well.