In remote communities, the impact of malaria is insidious. Prevention is difficult given the lack of

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1 Anthony and villagers Anthony Helou battles malaria personally and professionally in Senegal In many ways, Anthony Helou spent a lifetime preparing for his Global Health Fellow (GHF) assignment in Senegal. "I was born and raised in Côte d'ivoire, West Africa and I was personally exposed to the health problems in this region," says Anthony, a Clinical Research Project Manager. "A dream I have cherished from a very young age was to obtain a professional degree in a health-related field and help the many people in need in developing countries." Anthony was assigned to work with IntraHealth International, a Non-Governmental Organization (NGO) present in more than 50 countries. IntraHealth specializes in working with communities to develop effective health care and supports health care providers within the context of local needs and resources. In Senegal, Anthony worked with IntraHealth on a Pfizer-funded project called 'Mobilize Against Malaria' (MAM). According to the World Health Organization, malaria is the second highest cause of death for Senegalese of all ages and accounts for a quarter of deaths among children under five. On arriving in Senegal, Anthony brought his medical knowledge and extensive project management experience, as well as his knowledge of the region, to the project. He was faced with some daunting challenges, working in remote communities among some of the poorest people in the world. "My assignment was in the region of Tambacounda, about 460 km from Dakar," he says. "There was no access to electricity and little access to water, food and other essentials." Most of the time, Anthony was on the road with a driver and his co-worker from IntraHealth, travelling to small villages and returning to his base in Tambacounda only once a week. On an average day, the small team would set off by car at sunrise and travel four to six hours on bumpy roads to get to a village in temperatures sometimes reaching 50 degrees.

2 At the village, Anthony and his colleagues met with the village council, assessed health care needs, and provided health care training and materials. The team often ate no more than one meal a day (a small, communal plate of rice) and water was carefully rationed (one litre per day for drinking, cooking and washing). In remote communities, the impact of malaria is insidious. Prevention is difficult given the lack of Anthony and villagers information, the low level of education of the population, and the prevalence of mosquitoes. Anthony knows first-hand the impact of malaria. "I got malaria when I was young," says Anthony. "Anyplace where you have water, you have mosquitoes and they are very resistant. I knew it was going to be a big fight." In fact, during the assignment, Anthony was once again stricken with malaria and was bedridden for a week. Once infected with the disease, most villagers have no choice but to travel to the closest healthcare facility, a journey which can take a week by donkey for the fortunate ones - while untreated malaria can kill within two days. As a result, people were regularly dying en route to seek treatment. "Part of our intervention was actually to bring healthcare services and treatment closer to the population, by equipping villages with furniture, health management tools, instruments, medication, and training villagers on how to prevent, diagnose, and treat simple malaria," says Anthony. With this objective in mind, Anthony and his IntraHealth colleagues identified 24 villages for intervention and then began setting up a primary health care system in each village. The focal point for care was a health hut where Community Health Workers were trained to promptly diagnose and treat children and adults with simple malaria. So far, 10 health huts have been set up and next year all 24 health huts will be functional.

3 The impact was dramatic. More than 17,000 people can now be promptly diagnosed and treated for simple malaria at the community level. In year two of the program (2008/2009), more than 76,000 people will have access to primary care at the community level. Anthony saw the population change its health care habits. They now stay in the villages to receive appropriate treatment from a Community Health Worker rather than risk travelling to a hospital. The successful implementation of the Pfizer MAM program in Senegal will now be used as a model for other malaria programs in Africa. In addition, Anthony and his colleagues were first to introduce rapid diagnosis tests at the community level in Senegal, in alignment with the country's National Malaria Control Program strategy plan. Due to the success of the Senegal project, Pfizer Global Corporate Philanthropy has donated an additional $50,000 USD in 2008 to IntraHealth International. Along the way Anthony has learned invaluable lessons and best demonstrated practices which have had a powerful impact on his life. "As a Program Advisor, I had to think out of the box, learn how to survive and run a project in a very difficult area with limited resources," he says. "It's made me a more flexible manager, more willing to accept change. Participating in this program gave me a sense of pride and satisfaction for having made a significant contribution to society and for 'working together for a healthier world'." "This experience has changed my life," he says. Anthony helps treat a patient Additional Pictures:

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