Background: This article discusses the link between disability and malaria in a poor rural setting. Global malaria
programmes and rehabilitation programmes are organized as vertical and separate programmes, and as such they
focus on prevention, cure and control, and disability respectively. When looking at specific conditions and illnesses,
the impairing long-term consequences of illness incidents during childhood are not questioned.
Methods: The study design was ethnographic with an open, exploratory approach. Data were collected in
Mangochi District in Malawi through qualitative in-depth interviews and participant observation.
Results: Despite a local-based health service system, people living in poor rural areas are confronted with a
multitude of barriers when accessing malaria prevention and treatment. Lack of skilled health personnel and
equipment add to the general burden of poverty: insufficient knowledge about health care, problems connected
to accessing the health facility in time, insufficient initiatives to prevent malaria attacks, and a general lack of
attention to the long term disabling effects of a malaria attack.
Conclusions: This study points to the importance of building malaria programmes, research and statistics that take
into consideration the consequences of permanent impairment after a malaria attack, as well as the context of
poverty in which they often occur. In order to do so, one needs to develop methods for detecting people whose
disabilities are a direct result of not having received health services after a malaria episode. This may be done
through qualitative approaches in local communities and should also be supplemented by suitable surveys in
order to estimate the problem on a larger scale.