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VN Struggles With Malaria

Ho Chi Minh City (AP) - Despite severe shortages of money and health care workers,

Vietnam is finally making a dent in controlling malaria, one its most enduring public

health problems.

The number of recorded deaths from malaria dropped to 2,632 last year from 4,446

in 1991, according to the Ministry of Public Health.

But 40 percent of Vietnam's 70 million people live in malarial areas, and over one

million are infected each year, said Le Dinh Long, director of the National Institute

for Malaria and Parasites.

Most fatalities are children, he said.

British researcher Dr. Nicholas White, working at the center for tropical diseases

in Ho Chi Minh City, said the mosquito-borne disease still approaches epidemic proportions

in some remote regions.

One such area lies much closer to Ho Chi Minh City, he said- just across the river

from its luxury Saigon Floating Hotel.

Fever, chills and severe headaches are the initial symptoms of malaria.

If the disease isn't treated in time, fatal complications can set in, including anemia,

liver dysfunction, and kidney failure.

Malaria afflicts more than 2,5 million people every year, White said.

Between 70 and 80 percent of the malaria in Vietnam is the deadly Falciparum strain,

which has built up a 90 percent resistance to Chloroquine and many other common anti-malarial

drugs.

In addition to children, malaria commonly strikes at those young men and women who,

migrating to make a living, have moved to undeveloped malaria-infested regions.

At the disease center, one 28-year-old woodcutter lay nearly comatose in a small

ward. Beside him was his 26-year-old wife, who was also stricken with malaria.

Like many other patients, they came from Dong Nai province.

Many people go to cut timber or work in rubber plantations in the forests of Dong

Nai, just outside of Ho Chi Minh city.

Others flocked there in 1991 to hunt for gold.

Late last year, the son of Vice Premier Pham Van Khai was rushed off to the center

after getting infected while hunting in Dong Nai.

For many years, even during prolonged war, Vietnam had the upper hand against malaria.

A program started in the north in 1958 reduced malaria cases there by 95 percent.

When the campaign was extended to the south of the country in 1976 after Vietnam's

post-war unification, cases dropped by two-thirds, said Long.

But as Vietnam's postwar economy sputtered in the early 1980's, hundreds of thousands

of people migrated back and forth to frontier areas in search of work. They included

gold and gemstone prospectors. Malaria cases began multiplying.

The big joke in malaria wards, said White, was that the prospectors "go out

looking for gold rings, and come back with tiny rings,"-the shape of the malaria

parasites in the blood.

The disease also multiplied because of changes in the natural environment, including

tree-cutting that left uncovered stretches of water and encouraged mosquito breeding.

There were also shortages of doctors and nurses, especially in areas most heavily

affected, and of medicine and insecticides.

In 1992, Vietnam needed 77 million dong (U.S. $7.2 million) to cope with the problem

but health authorities got half that much, said Long.

Spraying and distribution of free medicines reportedly are working.

According to the Vietnam state radio, the northern mountain province of Lai Chau

cut its malaria death rate by 30 percent by spraying mosquito repellent in all of

the province's communes, distributing medicine to more than 35,000 people, and impregnating

mosquito nets with insecticide.

Research on longer term solutions is going on at the center for tropical diseases.

The Wellcome Trust of Britain is paying for a project with Oxford University to study

the Chinese herbal drug artemizanin, which has been effective against Falciparum

malaria.

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