Malaria

China prevents malaria from border entry

18 June 2019

Market traders wait to cross from China into Myanmar to sell their wares at the Meng Hai Daluo border post. With these crossings comes a risk of imported cases of malaria.
Market traders wait to cross from China into Myanmar to sell their wares at the Meng Hai Daluo border post. With these crossings comes a risk of imported cases of malaria.
WHO/C. McNab

It’s early morning and the light intensifies on the long line of tuk tuks laden with coloured bags of lettuce, green onions, sacks of rice and boxes of live chickens. The drivers – all market vendors – wait to advance and cross this remote border post joining China and Myanmar. It’s an orderly morning ritual.

And then a different kind of queue forms on the Myanmar side of the border gate. Children, about 30 of them, wait to be counted through the gate, one by one. They stride across the border area and up the road, tidy and smiling in their school track suits, sporting oversized backpacks branded with well-known cartoon characters.

Their pace quickens to a run as they spot the yellow school bus. As he does every morning, the headmaster, Mr Luo Jianging, greets each child as they board for a short ride to their school, just a few hundred metres away. These children from Myanmar are educated for free at the Friendship Primary School in Daluo township, China.

Children from Myanmar cross the border each day to attend the Friendship Primary School in Daluo township in Meng Hai county, China.
Children from Myanmar cross the border each day to attend the Friendship Primary School in Daluo township in Meng Hai County, China.
WHO/C. McNab

The daily border crossing in this remote corner of south-west Yunnan Province forges closer economic and social ties between China and Myanmar. But it also comes with a risk: anyone coming into China could be infected with the parasites that cause malaria.

Malaria, like most infectious diseases, knows no borders. Myanmar has made a lot of progress against the disease, but it continues to take a toll on the health and livelihood of its people. According to WHO’s latest World malaria report, the country had an estimated 117 000 cases of malaria in 2017 alone.

For neighbouring China, limiting the spread of malaria is now more important than ever. The world’s most populous country reported its last indigenous case of the disease in August 2016. Soon, it will be eligible to apply for membership in a small but growing club of nations officially certified malaria-free by WHO.

As China welcomes these school children, the country is also taking measures to help ensure they do not inadvertently bring malaria with them across the border. Though if they did, China is also preparing students to help stop the disease in its tracks.

Building awareness

By 8:30 am at the Daluo Friendship Primary School, the children are settled in their desks alongside their Chinese schoolmates.

Classrooms here are modern. The blackboards are giant smart tablets. Teachers write directly on them with their fingers and swipe through the screens from subject to subject.

The children are serious, alert and focused on their studies. When asked, they recite back phrases, and raise their hands to answer questions. In a previous generation, several children would have likely been absent from school due to malaria, or too tired or ill to learn.

Students at the Friendship Primary School focus on their teacher. When health risks like malaria are eliminated, children can attend school and get the most out of their education.
Students at the Friendship Primary School focus on their teacher. When health risks like malaria are eliminated, children can attend school and get the most out of their education.
WHO/C. McNab

Later in the morning the school headmaster explains how the students are made aware of a disease they have probably never seen.

“Before, when we were younger, we were very scared about malaria,” says Mr Luo. “But we haven’t heard of any cases in the community for several years.” Still, he says, many students from Myanmar board at the school, and he has a responsibility to prevent any infections they may bring with them from spreading to the local community. He also must keep them safe from illness should they be infected.

Mr Luo explains that health and customs officials visit the school once a semester to teach students about malaria. They bring leaflets and booklets. “This is great,” he says. “It raises people’s awareness about a disease they might not know otherwise.”

Preventing new malaria cases

Customs officials from the nearby border post also pass out hundreds of insecticide-treated nets (ITNs) at the school.

We’re invited to talk to 3 of the students in their dorm rooms about malaria. Nan Laodi and Yu Danban are both from Myanmar, and Huang Pei Pei is Chinese.

Huang Pei Pei, Nan Laodi and Yu Danban explain what they know about malaria, as they sit in their dorm room equipped with bed nets at the Friendship Primary School.
Huang Pei Pei, Nan Laodi and Yu Danban explain what they know about malaria, as they sit in their dorm room equipped with bed nets at the Friendship Primary School.
WHO/C. McNab

The girls demonstrate how they arrange the bed nets around their mattresses, careful to seal up any gaps where a mosquito could enter. WHO recommends the use of ITNs in all malaria-affected settings, even in those where transmission has been markedly reduced. In countries that have eliminated malaria, continued use of ITNs is recommended for all populations at risk of the disease.

“The bed nets help us to prevent mosquito-transmitted diseases like malaria,” explains 12-year old Huang Pei Pei.

She’s never seen malaria, but knows that “if I had malaria, I would have fever and chills.” She adds: “It’s not good to have malaria and it’s not good to transmit it to other people!”

Nan Laodi, from Myanmar, and Huang Pei Pei, a Chinese student, use bed nets every night in their dorm room at the Friendship Primary School.
Nan Laodi, from Myanmar, and Huang Pei Pei, a Chinese student, use bed nets every night in their dorm room at the Friendship Primary School.
WHO/C. McNab

As malaria cases continue to decrease in countries bordering Yunnan Province, the aim is for the students at this school to know how to describe malaria symptoms, but to never know the disease first-hand.

“Knowing about malaria, and protecting students from mosquito bites is really important,” explains Headmaster Luo. “Our school takes this very seriously.”