Behold

Putting a Face on Malaria

Nambassa Miriyamge, mother, Uganda: “It was my aunt who died of malaria. I was very young and in the room. It was a very sad time. It still is. I do not think we have ever truly recovered from the loss.” 

Adam Nadel

There are a few devastating facts about malaria, photographer Adam Nadel notes on his website: It’s easily preventable and treatable, it’s a disease of the poor, and it will kill at least 500,000 children this year.

Nadel learned much more about malaria when Peter Newton of the Malaria Consortium approached him about working on a project about the disease. The resulting series, “Malaria: Blood, Sweat, and Tears,” explores malaria’s history, its science, and the people affected by its devastation told primarily through photographs. Since 2010 the exhibition has been shown around the world to gain international support to combat the disease. Nadel said the exhibition isn’t about fundraising but instead is a “traveling educational exhibit.”

Mohammed Umar Amadu, right, Aminu Ali IsaTwo children recover at a clinic after receiving anti-malarials.NigeriaTwo children recover after receiving emergence medical intervention for malaria. Ten minutes earlier they were being held-down by their parents due to violent spasms.  They are covered in wet cloths to cool their bodies down. Last year an estimated 800,000 children died from malaria. All the deaths are easily preventable.  Children under five are the hardest hit by the disease, their immune systems are not strong enough to fight off the malaria infection.  Poor diet also contributes as it weakens the body’s ability to fight off disease.“They were very sick; they both had convulsions.  We had to hold them down while they were getting the medication to reduce the fevers. It’s not that we are not concerned… it is just normal.” - Aminu Ali Isa father
Mohammed Umar Amadu (right) and Aminu Ali Isa, Nigeria. Two children recover after receiving emergence medical intervention for malaria. Ten minutes earlier they were being held down by their parents due to violent spasms. They are covered in wet cloths to cool their bodies down.“They were very sick; they both had convulsions. … It’s not that we are not concerned—it is just normal,” said Aminu Ali Isa’s father.

Adam Nadel

Malaria: blood, sweat and tears  Mosquitoes kill more humans then any other insect or animal. They transmit malaria from human to human and are responsible for between 800,000 and 2 million deaths a year. Nearly half the worldÕs population lives under the threat of contracting malaria. The parasite prays upon the most vulnerable of society, at least 700,000 children under 5 years of age will die this year, while leaving millions of it's survivors either physically or mentally impaired. The disease is also economically devastating, sucking an estimated 12 billion dollars out of Africa a year.  These mosquitos are being used to create a trial vaccine. The vaccine is the "Holy Grail" of malaria control.
Mosquitoes kill more humans then any other insect or animal. They transmit malaria from human to human and are responsible for between 800,000 and 2 million deaths a year. Nearly half the world’s population lives under the threat of contracting malaria. The parasite prays upon the most vulnerable of society, at least 700,000 children under 5 years of age will die this year, while leaving millions of survivors either physically or mentally impaired. 

Adam Nadel

Control of malaria means keeping mosquitoes away from people. The best way to do this is with nets or spraying. These men spray insecticides in homes. It is an effective, but labor intensive thus expensive.It has been over 20 years since a new class of insecticide was last introduced for use in public health. The reality is that all insecticides used in public health sectors were initially developed for the agriculture market. The appearance of mosquito resistance to insecticides is sometimes a consequence of their use - and abuse - in the agriculture sector. Without monetary incentives it is unlikely that companies will ever aggressively devote substantial funding to research and development of insecticides exclusively for human disease vector control. Mohammed AbbasOrange glovesNigeria“The goal here is to kill mosquitoes and other insects that cause disease.  The gear does make one very hot, but that’s not a problem. And what we do is very well received by the community. But only a few local governments are doing this. I hope this program can be expanded. It’s really important. Malaria killed a member of my own family”.
Mohammed Abbas, orange gloves, Nigeria: “The goal here is to kill mosquitoes and other insects that cause disease. The gear does make one very hot, but that’s not a problem. And what we do is very well-received by the community. But only a few local governments are doing this. I hope this program can be expanded. It’s really important. Malaria killed a member of my own family.”

Adam Nadel

Nadel spent about five weeks in the field photographing people living in regions affected by malaria, including Nigeria, Uganda, and Cambodia. Field workers helped secure permits for him or introduced him to people he would then photograph. He had creative control over the entire process.

Already an established photographer who had explored subjects ranging from war and its aftermath to the role of disease and civil unrest, Nadel was a logical choice to work on the project. But he still needed to get a grasp on malaria before he could start. “I did a crash course on malaria’s history, science, and future,” he said. “This is what I proposed the show to be about. It was easily over 100 hours of research and prep prior to even talking about shooting.”

Of course, once the talk of imagery was on the table, style was fully explored. “I joke about aesthetics as an entry drug to the science or history of my subjects,” he said. “Aesthetics that lead to education is the goal. Make a picture that holds the viewers attention due to composition and light, not sensationalism, is the very first step in getting the viewer interested in the educational caption. If I did my job correctly, a viewer would leave the exhibition with more knowledge about malaria than the vast majority of medical professionals in the West.”

Sarah Mbawomye, health worker, Uganda: “I have been out of [malaria] medication since 2007.  For over two years we have been promised, but it does not come. I am waiting anxiously.”

Adam Nadel

Local director of pharmacies, charged with finding counterfeit drugs, Nigeria: “It’s not easy; there are constant threats and powerful consequences. Death threats. We are trying to take an innovative approach to enforcement, and some of our initiatives have been successful. I have tried very hard to stop the trade of counterfeit and substandard drugs. I know what these fake drugs do. … My daughter was expecting a baby. She went to the hospital, and counterfeits killed her.”

Adam Nadel

The exhibit, first shown at the United Nations headquarters in New York in 2010, has been viewed by approximately 2 million people on three continents and a variety of venues.

Apart from educating himself about the disease, Nadel said working on the project was enlightening for other reasons. “I was constantly reminded how much people sacrificed trying to keep their families safe from these kind of diseases,” he said. “We are talking about countries where people spend over 30 percent of their yearly income to keep their kids and loved ones alive. To keep in prospective, that [amount of money is] a night out for theater and dinner in New York City.”

David Kachope, Uganda: “We are in training to catch mosquitoes. In order to capture the mosquito, you must expose some skin. When the mosquito comes, it will land on the skin, and you direct the aspirator (that’s the device at the end of the tube that is in my mouth), and you suck the mosquito into the aspirator. … Tomorrow we go to the village to collect mosquitoes for the research. One individual should be getting about 200 a night. We work in three-person rotations. I volunteered to do this. … This is an important thing to do. People will use this information to better understand how malaria works.”

Adam Nadel

Jackson Mburamanya, headmaster, Uganda: “The level of malaria in school is going down. The local heath center has the proper medication, and when they go, there is medication available. Of course, children still get sick and miss class, maybe once a term. That’s three or four times a year. But, a decade ago, the same student would get malaria possibly 10 times a year. If the students can’t attend class due to illness, they can’t learn.”

Adam Nadel

Larai Ibrahim, Nigeria: “I had malaria. … The people at the clinic said I needed an ultrasound to check something. I am not exactly sure what they are looking for. … This is my second child. The first one died from malaria, so I worry a great deal about it all happening again to my child, to me.”

Adam Nadel