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Reporter visits Cambodia, Myanmar and Thailand to cover rise of malaria deaths in Southeast Asia Date: 06/28/19


Amy Maxmen

Amy Maxmen, a San-Francisco-based science reporter for Nature magazine, travels the world to cover global health topics. In 2018, her work took her to Cambodia, Myanmar and Thailand to cover the rising number of malaria deaths in Southeast Asia.

Her story “Malaria’s Ticking Time Bomb,” won first place in AHCJ’s 2018 Awards for Excellence in Health Care Journalism for a public health story published in the small market category. Here she talks further about how she did her story.

Q: Why did you pursue this specific story?

Malaria kills hundreds of thousands of children every year, so it’s an urgent problem – but also an old problem, i.e. not news. So I’m always looking for ways to make the issue a story.

I got a sense that there might be something big to write about in 2017, when the World Health Organization reported that for the first time in a decade, malaria deaths were rising. As worrying, the only drug that reliably cures malaria was failing in Southeast Asia. I called one researcher in Myanmar who said he’d found a way to eliminate malaria in the region — which would prevent resistance from spreading. Then I talked with a researcher in Cambodia who said his team was planning to launch a trial on a new combination of malaria drugs that he hoped would forestall drug resistance. And finally, researchers in the region were documenting the spread of drug resistance at an unprecedented level of molecular detail. With all of this research aimed at stopping drug resistance from spreading to Africa — where about 90% of malaria cases are — I felt that Southeast Asia was having a moment and I wanted to be there to see it.

Q. What were some challenges behind doing this story? How did you overcome them?

Originally, my editors and I were most interested in the genetics of drug resistance, but as I began reporting, I realized that the actual battle to stop drug resistance was to fight malaria in general. So, I tried to convince my editors that malaria elimination was the real story because that’s what I would be witnessing in Southeast Asia. But they had been interested in the molecular biology, and didn’t want to let it go. So my editor, Brendan Maher, helped me squeeze in both aspects. Our feature ended up focusing on the scientific, political and economic challenges of malaria elimination mainly, but also included an animated infographic that shows how drug resistant mutations had spread over time and place. I was worried that the infographic would slow down my narrative, but Brendan was right: It looks great.

The other challenge had to do with reporting. I planned to do the bulk of my reporting in Cambodia because that’s where drug resistance began, where it’s getting worse, and where researchers were launching a clinical trial. But just before my trip, the lead researchers on the study told me they wouldn’t be around while I was there. I started emailing other malaria researchers in Cambodia, but it became clear that they were reluctant to speak with the press due to government pressure. The Cambodian national malaria control program didn’t respond to me either. So I spent my days in northern Cambodia talking with people in villages hit hard by malaria about what it felt like to have the disease and why they felt the problem was growing. This gave me color I needed for a narrative. But I knew I’d need to find the science elsewhere.

Thankfully, I had called a researcher working in Myanmar just before I left for the trip. She was passionate about the work and had a fascinating history as a young political dissident in Myanmar. She had since become a top malaria researcher working with young Burmese scientists and the Burmese government. Although I had originally planned on spending just about a day meeting her in the capital city of Yangon, I changed my tickets to stay longer and travel with her to central Myanmar where her team was riding motorbikes into remote villages to see whether people who seemed healthy carried malaria parasites in their blood. And since we were joined by someone in the government’s malaria control program, I was able to learn a lot about when primary research does — and doesn’t — translate into nation-wide efforts that are essential to malaria elimination.  

Q. What recommendations can you give others when travel reporting?

Make plans, but expect them to change. If the reporting is going badly, move on. If it’s going well, stay longer. I try to carve out time at the end of the day to jot down the most memorable moments. And if I have time in the morning, I try to think about what holes I’m missing. If there are people who will be hard to reach once I leave the country, I prioritize asking them everything I can. I over report like mad.

I also try to travel within a country so that I hear different perspectives. For example, I reported a part of the malaria story from the Karen state of Myanmar that has a long separatist history from the rest of the country. Their point of view — even on matters of national malaria control — was different from what I heard in Yangon because of their fraught history with the Burmese government.  

A final tip is something I’ve yet to master: Don’t panic when your story seems to be bottoming out. It won’t. And let your intuition guide you towards brilliant people — that’s not too hard when you’re covering health because it attracts dedicated individuals. An editor once told me that a story can be as simple as a compelling character overcoming a difficult obstacle.

Q. What’s that chic must-have item?

If you’re traveling somewhere without a good health system, bring a good first aid kit with something for deep wounds, burns and fractures (i.e. not just Band-Aids).