Let's cure malaria using Integrated Pest Management!!

Once upon a time there was a pretty green frog named Swati. Swati liked to eat so many things in her pond, but her favorite snack was mosquito larvae. Then one day, old farmer Chatterjee decided to use pesticides in his rice paddy. When Swati’s babies were born, the tadpoles each had 2 heads and died. Swati was so sad. Then she got a headache and died too.
Now who was there to eat the mosquito larvae?
Was it the mud fish?
Well, the mud fish would be happy to eat the mosquito larvae, but he’s not feeling very well. The pesticides make him sick too!
No one was left to eat the larvae and the mosquitoes increased too much.
Then old farmer Chatterjee’s granddaughter got a fever with great body pains. Suddenly she had a seizure was brought to hospital in Srikakulam. The doctors say she has cerebral malaria! This is too, too bad.


Oh the tangled web we weave. So, the frogs and this certain mudfish used to keep the malaria mosquitoes under control by eating the mosquito larvae. But then agricultural pesticides came into use, and destroyed many of these larvivorous species. Without these natural control mechanisms, malaria became rampant. So the government mounted a DDT spray campaign, which worked well… for a while. But what we see often in this situation is a rebound mosquito population even bigger than the original. We also see that mosquitoes develop resistance to the effects of DDT.

And DDT has effects on creatures besides mosquitoes. Birds and fish, for instance. It tends to kill them. Rachel Carson wrote about all this back in 1962, in her landmark book Silent Spring. Since then, evidence is accumulating that DDT has serious effects in humans, as well. DDT is one of the POP's (persistent organic pesticide) we hear about in the news. It is a fat-soluble organochlorine insecticide and it accumulates in fat tissue, such as the breast, and becomes concentrated in mother’s milk. It can have neurotoxic effects in children, and increases risk of breast cancer 5 fold, according to some studies.

Worldwide, malaria kills about 3 million people every year. The statistics alone are impressive, but there’s so much that they just don’t convey. A pretty common scenario is for somebody in a family to get sick with fever at least every couple of months. The fever may be malaria or not, but usually the doctor treats any fever lasting more than a few days because the odds are so high. The fever is incredibly painful to experience, and scary to witness. You feel so helpless. Children miss school, adults miss work. The financial burden of missed work and medical expenses is really significant. This is the kind of ongoing drain on the time and health and capacity of people here that’s difficult to quantify.

The proportions of the tragedy definitely warrant some risks, possibly even the use of toxins like DDT, but we get stuck in these arguments without seeing that entirely different approaches are possible. The other major intervention advocated by groups like the World Health Organization is pesticide-impregnated mosquito nets. They sound like a great idea, but here, you just suffocate inside them. It’s impossible to sleep under these nets (and breath at the same time), and so nobody would use them, even if they were supplied free of charge.
So what CAN we do?

Integrated pest management makes sense to me. This is a system based on the understanding that living systems are complicated and the fundamental principle of life is BALANCE. Generally, it doesn’t work to eliminate a species, even if it is a dastardly one like the mosquito. Instead we work with the natural systems that maintain a favorable equilibrium. This way, we’re less likely to mess up big and do something like feed DDT to babies.

There are lots of methods at our disposal -- natural predators and parasites, complementary crops that increase pest-resistance, physical techniques like mulch and compost, cultural practices, etc. All the principles of permaculture are relevant. We can shift our paradigm from the false binary thinking of good/evil, kill/be killed, and instead use our ecological wisdom to increase the strength of the whole system, and reduce or eliminate the use of chemical inputs.

I found an interesting article about a project in Karnataka where they actually eliminated Anopheles mosquitoes from the community within a year of introducing Poecilia reticulata fish into the wells and streams. Of course this needs to be done carefully because these are non-native species. I’ll be talking about these ideas when I give the infectious disease training module. Hopefully it will spark some enthusiasm in the field workers and we can start to develop a project of our own in this area.

Sometimes, the most powerful ways of affecting health don’t have much to do with medicine.

I’m going to Hyderabad soon for a visit, hopefully I’ll have some nice pictures for the next entry.