There are no bushes around Petua Elieu’s home in Amuria district, eastern Uganda. Before sitting down to un-shell groundnuts or sort the vegetables for the day, she and her family clear the compound and take away anything that places them at risk of malaria. They remove broken containers around their home and are sure to clear any bushes that might be growing. Only after they have ascertained that their environment is safe and clean do they sit down to take tea with lemon grass, a mosquito repellent they planted near the home. 

Elieu knows that preventing malaria is a matter of life and death. In 2017, she lost her six-month-old son to the disease.

“It was around June and it was raining,” she recalls. “I returned home from the market and I found he had no appetite. I took him to the health centre and they told me he had malaria. The nurse tried to find a vein to give him medicine, but she could not. She gave us coartem and we went home. He did not get better, and we went back to the health centre. This time they found a vein and gave him artesunate. They also told me he was anemic. He got worse and died.”

The Global Malaria report indicates that 94 percent of malaria deaths are in Africa, killing mostly children under five. In areas where malaria transmission is high, anemia is a common and serious consequence.  Malaria creates long term and fatal health complications while straining national health systems and families.

Elieu’s child died at a time when the family had no money to buy a net.

“When he died, I felt it. My heart was pierced. The pain was inside,” she says. The memory makes her eyes misty. “I got the little money I had and went and bought a mosquito net. I could only afford one mosquito net and we had to share it as a family even after I had my second and third child.”

Her two remaining children are now seven and three, and she is pregnant with another.

“I do not miss any antenatal visits. I got my first mosquito net when I started antenatal care in June last year. The VHT also gave us two more mosquito nets. Malaria no longer disturbs us like it used to. I do everything our Village Health Team tells us because we want to stay healthy. I want this child to live. This child will live. I want my remaining children to stay alive,” she says.

Investing in malaria ensures that essentials such as insecticide treated mosquito nets reach the people most vulnerable to malaria. RBM works with government and partners to implement successful distribution of insecticide treated nets, including enabling community driven surveillance, supporting procurement process, planning Social Behavior Change Campaigns that utilize VHTs as ambassadors, monitoring and evaluation.

“We work with the government to monitor the implementation of the national malaria strategic plan. We review information to see where the most needs are,” explains Mulumba Mathias Ssuuna, the National Coordinator, Uganda National Civil Society Alliance Against Malaria and CSO representative at the national malaria council. 

“Are there pregnant women in a particular community who are still not getting mosquito insecticide treated nets? Are there families that have not been given the nets that they are meant to receive? Are there other organizations providing mosquito nets so that we do not duplicate? These are some of the questions we ask to enable proper planning. We work with VHTs to provide information from the community,” Suuna says.

The countries that RBM supports utilize their network of government and local government institutions for pre-net distribution activities, giving people like Elieu the Big Push they need to end malaria in their homes.