The children malaria is taking in Lango

Malaria continues to claim young lives across northern Uganda, with districts in Lango among the hardest hit. Despite ongoing prevention and treatment efforts, hospitals remain overwhelmed and many children are still arriving too late to be saved.
This report follows the story of one mother who lost her four-year-old son, and takes us inside Lira Regional Referral Hospital, where health workers are battling severe cases every day.
As the world marks World Malaria Day, we also look at emerging solutions like gene drive technology, an approach scientists hope could one day change the course of malaria transmission.

Transcript

SPEAKER_01 0:03

A storm gathers as we take the turn off a patch road to Teoriang village, Nambieso subcounty in Kwania. It is dusk. Lightning flickers ahead, illuminating the rough road in flashes. It's raining where we are headed. Hello and welcome to the new Vision Daily podcast around Uganda, and today we bring you the children malaria is taking in Lango and Razia Asman. In the vehicle with us is 27-year-old Kela Obura, who has just buried a child she lost to malaria. As we navigate the bushy dark road, her mood changes. She grows quiet, lost in memory. Soon she is moved to tears. Obura's voice trembles as she points to the final turn to her father's home, where her son, Kichar Ward Timothy, was laid to rest. The journey from Lira City has taken two hours. Dr. Jimmy Alal, a medical officer at Lira Regional Riferro Hospital in Pediatrics, has come with us. He helps translate our conversation. His voice is calm but heavy with empathy. It's all emotional.

SPEAKER_07 1:47

But when we are prescribed for medicine after the facility, they were available.

SPEAKER_01 1:57

Ogura narrates how it began. This was where they lived along the shores of Lake Kwania. She struggled to find 15,000 shillings to reach Nambieso Health Center 3. Kichar Wat was diagnosed with malaria, but his condition worsened within two days. They were referred to Aduku Health Center 4, where transport cost 25,000 shillings by border border. With no money and her father, Henry Okone, a subsistence farmer, they borrowed the money. There, Dr. Alal and the team took over treatment, but it was too late. Complications had set in. On March 24th, 2026, four-year-old Kichar Ward Timothy was pronounced dead.

SPEAKER_07 3:13

That was I great. With a project multiple complicated, and then what it did, the towers evaluated.

SPEAKER_01 3:35

Kichar Wat's story is not isolated. Many families in Lango are facing the same threat. Some are already in the fight for survival. At Lira Regional Rifaro Hospital, cries of babies and young children fill the air. Records are taken at the acute unit of the outpatient department.

SPEAKER_09 4:03

Robson Okabo, the principal medical clinical officer, says If it means even carrying the baby, you will carry the baby and the mother follows you. So that the baby reaches the ward immediately and started on treatment immediately. The treatment may involve oxygen administration. It may involve uh IV attentionate, no longer aura. Of course, this one cannot swallow at that point. That means all treatment now will have to be through the veins. So it should be started immediately.

SPEAKER_01 4:40

The waiting area is full. Some people stand, others lean against the walls. A mother breastfeeds weak twins, one on each side as she waits. Names are called over a loudspeaker. Patients move from records to triage to clinic to laboratory and finally treatment. Okapu says, Those in severe condition are rushed to emergency and admitted, but not all arrive in time. Some, like Kicha ward Timothy, come when the illness is already advanced. Most children arriving here are battling severe malaria. The facility recorded 2,437 malaria cases at the outpatient department between October and December 2025. Dr.

SPEAKER_05 5:37

Andrew Odur, the director of Lira Regional Referral Hospital, says This fight came around March, March now, April, when the rains are up there, and we registered an increase of more than 15% in the cases that came to the family. But of course, among the people who are dying is maybe in um because of the city from the malaria. Sometimes because of identifying the problem, then they are coming. So among those that are admitting malaria, we will have mortality up to 5%.

SPEAKER_01 6:29

When malaria does not take a life, it takes quality of life. By the time many patients are diagnosed, complications have already begun. Doctors explain that in severe cases, malaria parasites destroy red blood cells and block small blood vessels. This reduces oxygen supply to vital organs. The kidneys, brain, and lungs are most affected. This leads to acute kidney injury, cerebral malaria, and breathing difficulties. Five-year-old Marceline Ayonge from Lira had not passed urine for a week. Her condition required dialysis to survive. Her mother, Rebecca Adimo, could not afford treatment locally. She was referred to St. Mary's Hospital, Lacho, for the affordable peritoneal dialysis.

SPEAKER_08 7:48

We keep our children out of hospital for proper medication and proper care. For them to be our future mothers and future generation that we are building them for. That is my only advice, and I'm not scared of anything at all. My girl has fully recovered and she's okay.

SPEAKER_01 8:25

The research follows them over two years to assess long-term kidney outcomes.

SPEAKER_06 8:30

Some die before reaching the hospital, but then others develop other complications that can affect the quality of life after this illness. So the study is looking mainly at how does this affect their kidneys and how many of them develop uh acute kidney injury, and then also the uh and then uh over over a period of two years, how many develop chronic kidney disease, but then also looks at the health-related quality of life.

SPEAKER_01 9:04

Some are treated as outpatients, others are admitted, and some children die before reaching hospital. At the Lero site, 26 of 200 sampled patients died. Dr.

SPEAKER_05 9:16

Andrew Odur says The challenge still remains that we need to continue to reduce the burden, and um most of the children who die from malaria usually because of severe anemia, that has been helped because of severe malaria, and uh some of them are getting active kidney injury. Whether their kidneys are not dialysis which we have here, we are able to um give them the treatment and take them through dialysis, and their kidneys recover. Um and my kidneys are children, and as a hospital here, we tend to prioritize and support them because their kidneys can easily recover and regain its functionality.

SPEAKER_01 10:08

Despite understanding what malaria does inside the book, prevention remains a challenge. Dr. Alal helped us when our car battery died. It was past 9 p.m. in Nambieso after visiting Kichar Wat's burial site. He rode off on a bicycle, found a battery, and returned.

SPEAKER_07 10:29

Oh, so that they removed this, they had vistas when when they were doing burial, they had to pick all the new ones, open them out so that vistas can be.

SPEAKER_01 11:47

Between 2009 and 2018-2019, malaria prevalence in children under five dropped from 42% to 9%, but new data shows a reversal. Prevalence has risen to 21%. In Lango, it reaches 59%. Even with existing interventions, malaria persists. This has pushed researchers to explore new tools. Dr.

SPEAKER_02 12:16

Martin Lukindu of Target Malaria says Most people fear that if we bring in novel tools, like genetic control tools, they are going to wipe out all mosquitoes. No, it's only those few species that have the capability to bite you and transmit malaria to you.

SPEAKER_01 12:32

Target malaria is part of an international research consortium developing gene-drive mosquitoes. These aim to reduce mosquito populations that spread malaria. If successful, it may be included in the national strategy. Dr.

SPEAKER_03 12:50

Jonathan Kayondo, the principal investigator at the Uganda Virus Research Institute, explains We are probably maybe six, seven years away if everything goes well before we can say we have a rule that we have been demonstrated to be efficacious. So we still have some time to have some ways to go, but that's also being very optimistic because it takes a lot of time also regulation because of this kind of technology and everything generally modified as requires you know regulatory oversight and for good reasons.

SPEAKER_01 13:35

It's being studied as a complementary tool alongside nets, drugs, and vaccines. No gin drive mosquitoes have been released in Uganda. Trials are hoped for by 2030. Until then, communities like Teoriang remain wary. They are worn and dirty. He jokes that Namieso was once chosen for development, but too many mosquitoes changed that plan. While future tools are still years away, the burden today is most visible in Apache. The image of Obura and her father at her son's grave at night remains. Mosquitoes are ordinary insects but deadly vectors. Apache and the Wider Lango subregion carry some of the highest malaria burden in Uganda. Dr. James Daniel Odongo, the district health officer, says children under five are most affected. In 2024-2025, the district recorded 3,441 cases. He says the decline reflects progress, but malaria remains rooted. Apache has also introduced malaria vaccination. About 2,255 children have received the vaccine with coverage estimated at 79%.

SPEAKER_04 15:26

Yeah, rain water, that provides breeding, good breathing places for mosquito modification and is free.

SPEAKER_01 15:36

Target malaria researchers are working to reduce the population of malaria mosquitoes because fewer mosquitoes carrying malaria would mean stopping the transmission of the disease. Between 2009 and 2018-2019, the country reduced malaria prevalence among children under 5 from 42% to 9%. The progress is driven also by residual spraying, but new data from the 2024-2025 malaria indicator survey by Uganda Bureau of Statistics shows a worrying reversal. Prevalence has risen to 21%. In some regions, the situation is even more severe, reaching 59% in Lang, 46% in Acholi, and 44% in Teso. And in Teoriang Nambieso, Kela Oburo still visits a small grave beside her father's compound. This reporting was produced with support from Target Malaria.