Refugee Question in Modern World

Public Health scientists have been aware of the correlation between the proliferation of a disease and human mobility. Just the simple act of relocation or forced migration can put a person or family at a greater health risk. Malaria is considered to be the most wide-spread tropical diseases that is completely preventable. Malaria is the source of over one million annual deaths worldwide with 90% of it happening in the sub-Saharan Africa; two-thirds of refugees, IDPs affected by complex situations live in malaria endemic regions (Anderson, Doocy, Haskew, Spiegel, Moss, 2011).

In many of the refugee or IDP settings, women who are of reproductive age and children account for the majority of said population and unfortunately pregnant women and children are at a greater risk for severe malaria and death (Rowland & Nosten, 2001).

Although the parasites have little exposure to the environment, the environment which they thrive in plays a huge part. From the lifespan of the mosquito (which has a strong correlation to the availability of food sources), the temperature (high or low temperature can deter their lifespan) and humidity (increased humidity increases their lifespan). Hence the reason behind malaria thriving in tropical areas across the world especially where there are weak health programmes that prevents intervention (Connolly, Gayer, Spiegel, Ryan, Salama, 2004, p.1976).

Malaria is considered to have two regions, epidemic and endemic. Endemic regions are where the rate of malaria is fairly constant throughout the year. Areas of very high rate of malaria in endemic regions are called Stable endemic regions such as tropical parts of Africa and Papua New Guinea. While Epidemic regions those undergoing high but unequal prevalence rate due to high levels of fluctuations of the region's population. Epidemic regions that are unstable tend to be the most vulnerable due to its population having low immunity to the parasite which includes large parts of northwest Africa, South America, South East Asia, Indian subcontinent and the Middle East (O'Meara, Mangeni, Steketee & Greenwood, 2010, p.549).

There are four types of parasite that is commonly known to cause Malaria which are plasmodium falciparum (most dangerous), plasmodium vivax, plasmodium malariae and plasmodium ovale. The way most parasites infect humans are via a vector, in this case, a mosquito called Anopheles. Once the parasite enters the human bloodstream, typically the life cycle is as follows: The parasite travels to the liver where it multiplies asexually.

Following a two-week gestation period, the new daughter cell enters the blood stream and invades red blood cells. Then it multiplies to form a male and female gamete – at which point the first symptoms (within 10 days to 4 weeks after infection) of malaria starts to show in a person. The cycle is complete when this blood rich in parasitic gametocytes is sucked back by the mosquito and reintroduced into another person (Rowland & Nosten, 2001, p.548).

The main symptoms associated with malaria include fever, sweats, chills, muscle aches, diarrhea and vomiting. Patients suffering from malaria are treated with a variety of drugs sometimes in combination with other drugs to get the full effect. Drugs such as chloroquine, quinine, clindamycin. mefloquine and doxycycline (combined with quinine) help relieve the infected person of the parasite. Medication is usually given in a pill or tablet form unless the severity of malaria is high in which case it can be administered intravenously (Rowland & Nosten, 2001, p.550). The type of drug that needs to be administered largely depends on the type of parasite Unfortunately, older drugs such as cloroquine are mostly ineffective for malaria strains generating in sub-Saharan Africa.

In addition to the drugs mentioned above, primaquine is the only drug that can prevent relapse by actively eliminating dormant parasite forms, but pregnant women or people with a glucose-6-phosphate dehydrogenase deficiency are advised against taking it due to the lack of research on the effects of primaquine on a fetus (Baird & Hoffman, 2004, p.1338)

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