Warren Zapol’s quest to help children with malaria.

Transmitted by mosquito bites, malaria is one of the world’s deadliest diseases.

According to a 2008 World Health Organization report, malaria kills about 1 million people annually.  The vast majority of these deaths, 86 percent, happen in Africa.

And in Africa, nearly all the victims are children less than 5 years of age.

These statistics would be devastating enough, but are even more so because they are avoidable.

But Warren Zapol, one of Dad’s closest friends and the Reginald Jenny Professor of Anesthesia, is spearheading a two-year study in Uganda to try to improve the situation.

Warren described the project, on which my brother Jon may participate, over heaping portions of Chinese food and a number of glasses of red wine at his Cambridge home last night.

Warren and his fellow study supervisors from Uganda and France are collaborating with Medicins Sans Frontieres and the Mbarara University of Sciences and Technology (MUST)  in the southern part of the country.  Dr. Juliet Mwanga of MUST is the principal investigator.

The team’s plan: to see if inhaling nitric oxide can extend the lives and reduce the debilitating impact of those with malaria.

Doing so would increase the period in which children with severe malaria can receive lifesaving anti-malarial therapies.

In other words, breathing nitric oxide might give the immune system more time to marshal its resources for the fight against the all-too-often fatal disease.

A master storyteller, he inexorably draws the listener in with his quiet and lucid explanations. His synopsis of the study was just one of the evening’s many highlights.

One of the others: Nikki, Warren’s wife and another dear family friend, shared Emily Shackleton’s journal that they had recently bid for and won at a Christy’s auction.

More than 100 years old, the journal contains pictures of the great explorer and his wife and signatures by Queen Victoria confirming her attendance at one of the adventurer’s departure.

The background to the journal purchase is that Warren has had a multi-decade fascination with, and passion for, the South Pole that has led to his doing extensive research on seals in Antarctica (His portrait at Massaschusetts General Hospital includes him holding the original device used for the first surgery in the Ether Dome, the continent looming in the background and a seal swimming near the picture’s foreground. ).

For the malaria project, the choice of country is an appropriate one.

Malaria is Uganda’s largest cause of death.

The scenes Warren anticipates seeing in Mbarara will be far less pleasant than our idyllic and warm setting last night.

Close to 20 mothers come daily to the center where the study will be conducted, their often deathly ill children in tow.  The group will only study the sickest children, who at the most will be 12 years of age.

Some of these children will die, and the study’s positive outcome is far from assured.   Even if successful, the study’s small scale-they expect to test about 90 children during the two years-the scope of the disease and the many steps involved in moving from study to policy could make the challenges associated with the work seem markedly similar to those experienced by Dr. Rieux and the other residents in Albert Camus’ classic novel, The Plague.

Those obstacles are for later, though.

For now, Warren is ushering the proposal through the final stages of the five institutional review boards and preparing for this latest effort in his lengthy and illustrious career.

We will follow its progress with interest.


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