New Malaria Alarm

It is a matter of concern that high number of malaria infections has been found among the Nepalis who have returned from India. There is always a risk of such infected people transmitting the disease locally. Such a development poses a public health threat at a time when Nepal is working to bring down the malaria cases to zero with the ultimate goal of eliminating it by 2025. In a scenario where Nepalis get infected across the border and come back with risks of potentially aiding in local transmissions, it is hard to achieve the malaria eradication goal. According to the Epidemiology and Disease Control Division, 359 malaria cases out of total 391 detected in a year were imported. And out of 359 imported cases, 336 were detected in India returnees. Most of the malaria cases have been found in Mugu district of Karnali Province and Dadeldhura and Baitadi districts of Sudurpaschim Province. 

These are the districts from where a large number of people make seasonal migration to India to work as menial labourers. In the past, malaria was found only along the Terai belt. Its prevalence in the hills and mountains now sends new public health alarm. Having open border with southern immediate neighbour, India, is both - boon and bane - depending on the differing context of things. On the positive side, people on both sides of the border have the benefit of easy cultural inter-mingling that has continued for ages. Such a bond is rare between two bordering countries. Similarly, there is also an open environment for trade activities across the border that benefits the suppliers and consumers from the two countries alike. There are cultural and festive activities that have intimate cultural connection across the border. Cultural events related to Lord Ram, his consort Sita and King Janak have close affinity between Nepal’s Janakpur and Ayodhya in India. 

Pilgrims from Nepal visit holy religious sites in India such as Varanasi, Gaya, Badrinath, Kedarnath and Haridwar. Likewise, Hindu devotees from India visit Pashupatinath with all reverence and devotion. Every day people of both the neighbouring countries cross border to and fro with the purpose of trade and work. Both skilled and semi-skilled workers exchange their visits across the border in large number. The daily visits, cultural bond and economic inter-dependence are so close that any measures to control the trans-border mobility have wider consequences at the people’s level. On the negative side, the open border poses a lot of risks to the public health when it comes to the spread of the transmissible diseases. 

Regarding the coronavirus pandemic, the disease first spread across India and then came to Nepal through the thousands of people crossing the border every day. Thousands of Nepalis who went to India to seek job returned home in hordes after the disease spread to critical level causing massive infections and fatalities in India. Three consequent waves of COVID-19 were mainly transmitted to Nepal via the border with India. This shows that the open border between the two nations is both advantageous and risky. Communicable diseases carry a glaring risk and control measures are not easy to apply because screening is very difficult. It spreads not only through the check points where crossings are limited but there are many porous points where movements take place unchecked. This is where risks of disease transmission remain.