Deep in rural Zimbabwe, where healthcare facilities are less accessible and information is limited, community health workers are waging a quiet war against malaria.
Armed with a backpack full of medical supplies, a smart phone and unwavering dedication, these unsung heroes are changing the face of malaria prevention in their communities.
At the regional commemoration of SADC Malaria Day in Murehwa in Mashonaland East Province last week, Zimbabwe launched the new annual campaign to fight against malaria, thrusting community health workers into the spotlight.
The campaign is part of a broader initiative to address the disproportionate burden of malaria in Africa, where 94 percent of global cases and 95 percent of deaths occur.
Zimbabwe becomes the 25th country to launch the campaign of "Zero Malaria Starts with Me".
This recognises the critical role of communities in the fight against this deadly disease. The plan is built around the recognition that if no one has malaria then it does not matter who mosquitoes bite, there is no malaria to transmit.
This is how malaria was wiped out in southern Europe and North America.
In the meantime, and for many years in the future, reducing mosquito bites remains one of the core parts, along with as near instant diagnosis and treatment as possible, of the anti-malarial strategy.
As part of SADC's broader effort to eliminate malaria by 2030, Zimbabwe aims to harness the power of community engagement to achieve a malaria-free future.
And what better way than through these community heroes.
One such hero is Mrs Esnath Chimbwanda, a community health worker from Nyadire resettlement, Chimurenga Clinic, who walks more than 15km every day to reach all the villages she serves.
Her mission is to educate, test and treat, a simple yet effective strategy that has dramatically reduced malaria cases in her community.
"I visit households and teach people how to protect themselves against malaria. I tell them about the importance of using treated mosquito nets and how to use them," said Mrs Chimbwanda.
"I also test for malaria using rapid diagnostic kits and provide treatment to those infected."
Mrs Chimbwanda's work extends beyond medical interventions.
She mobilises community members to take ownership of malaria prevention, encouraging them to keep their environment clear of pools of water and long grass.
Through these interventions, there has been a marked decline in the number of positive cases in her area.
Between January and October, she has only reported three positive cases.
Community health workers like Mrs Chimbwanda face numerous challenges like limited resources and cultural misconceptions about malaria.
But working together with the malaria community action groups (CARGS), they are making an impact.
These groups were mobilised from the local communities to link people with the local clinics and hospitals.
Mutoko district CARG vice chairperson Mr Anthony Mapara said they are there to raise awareness in the communities about malaria and their work was making an impact.
"We engage with traditional leaders who mobilise people so that we can disseminate information on malaria.
"Through these sessions, we have seen a change in the way our communities perceive malaria and also people are going to the health facility early.
"This has been good in reducing malaria deaths," he said.
Malaria is a life-threatening disease and currently the third largest killer of children after pneumonia and diarrhoea, globally.
Children under five and pregnant women are more at risk of contracting the disease.
When children contract malaria, their growth is affected and significant numbers die.
Relatedly, malaria in pregnancy contributes significantly to deaths of mothers and their unborn children.
An estimated 11 million pregnant women living in 38 African countries were infected with malaria in 2018, as a result, nearly 900 000 babies were born with a low birth weight - a major risk factor for infant mortality.
Over the past two decades, Zimbabwe has made significant progress in the fight against malaria, which has resulted in a decrease in the malaria incidence from 136 per 1 000 population in 2000 to 16 per 1 000 population in 2023.
Malaria deaths were slashed by two thirds from 950 to 317 during the same period.
Health and Child Care Minister Dr Douglas Mombeshora said a high percentage of malaria mortality trends in the country was still attributed to late presentation to health care centres.
"To combat this, the Ministry of Health and Child Care has stepped up community malaria activities. We have 29 districts with trained community health workers offering malaria testing and treatment.
"We have provided treatment services inclusive of the hard-to-reach areas to improve access to care. Regular outreach radio community sensitisation meetings are also ongoing," he said.
Through these interventions, seven of the targeted 29 districts had managed to report zero malaria cases in 2023.
These included Chirumhanzu, Zvishavane, Bulawayo, Shurugwi, Umguza, Umzingwane, and Insiza.
Zvishavane and Chirumanzu have, however, maintained zero local malaria cases in three years, earning them recognition during the SADC Malaria Day commemorations.
Vice President Dr Constantino Chiwenga maintains that community participation is vital in the prevention and control of malaria.
"It is pertinent that we engage our communities, as they are key in ensuring that our efforts are sustainable and resilient.
"Communities living along borders often face unique challenges, including frequent movement between countries and inconsistent healthcare services, making them more vulnerable to malaria. In that regard, community participation and ownership of malaria prevention control, and elimination initiatives must be at the core of our strategy," he said.
This must be reinforced by joint malaria prevention and education initiatives, drawing lessons on interventions that worked, so that prevention strategies are synchronised in-country and on both sides of the borders to ensure coverage across the entire region.
Roll-back Malaria chief executive officer Dr Michael Adekunle Charles acknowledged the work being done by community health workers in the fight against malaria.
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"Let me acknowledge the vast amount of community health workers that are working day and night to protect our children, to protect our pregnant women, and to protect the most vulnerable people. Thank you so much for your hard work. I know sometimes we don't give you enough recognition, but on behalf of the RBM partnership, we thank you," he said.
He said countries needed to deploy commodities in a timely manner to ensure that children, who are disproportionately affected by the disease, are protected against malaria.
He implored SADC member states to continue collaborating to fight against malaria.
Southern Africa bears a huge burden of malaria cases and deaths and to combat this, the SADC Malaria Elimination E8 Initiative was established in 2009.
It sought to coordinate and promote collaboration towards malaria elimination between eight SADC Member States: Angola, Botswana, Eswatini, Mozambique, Namibia, South Africa, Zambia, and Zimbabwe.
It serves as a platform for sharing best practices, coordinating cross-border initiatives, and advocating for increased political commitment and investment in malaria elimination.
SADC deputy executive secretary for regional integration Ms Angele Makombo N'tumba reiterated the importance of cross border collaboration towards elimination of malaria. She called on member states to prioritise investments towards these interventions.
As southern Africa strives to eliminate malaria, communities remain a pivotal anchor towards the realisation of these goals. With committed community health workers like Mrs Chimbwanda, communities can become more aware of the disease and contribute towards its elimination by 2030.
