Thursday, April 18, 2013

Stomping Out Malaria in Africa

Blog About Malaria Month

Malaria is the #1 killer in Africa.

April is malaria month, and I, along with over 3,000 other volunteers in 25 African countries are helping raise awareness around the world about malaria. Each Peace Corps country in Africa is in a competition against each other, scoring points for holding workshops, playing games, teaching songs, posting pictures and blogs, etc. So far I've heard Zambia is in the lead, so I'll do my part to keep us on the winning track.

I've mentioned in another post, I'm working as a research assistant in a net study looking at how nets are used in the village that will help to build better strategies in net distributions and prevention methods. Many of those nets do help decrease the spread of malaria, but malaria still plagues this part of the world. Luapula Province has the highest rates in Zambia. Although nets are given out, and even have descriptions of how to use, clean, and hang them (even in several different languages), many go unused, or used for other purposes (like fishing). Not only that, there are many misconceptions about malaria and it's deadliness in rural places like where I live.

During my first site visit when I spent a few days with an agriculture volunteer in Central province, I was talking with another volunteer who came to stay with us and help us cook and keep us company. We were talking about how some people will take any signs of sickness and associate them with malaria. I thought that although this is a bad way to go about it, it was nice to know that they weren't just blaming everything on juju (think witchcraft). Though it is nice to think that way, the most likely thing that happens is someone “put the juju” (think cursed) on another person to get malaria. So we're no further than we were before.

A few weeks ago I was talking through the next village with one of my counterparts when 3 villagers were escorting a frantic woman. She was being led by the arms by her family, a look of terror in her eyes, she couldn't focus on anything, her eyes darting around, and her whole body shaking. I asked Martin, my health counterpart, where they were taking her and what would happen. He said they were taking her to a traditional doctor. I asked what would he could do. Luckily, Martin is well educated, his response, “Probably nothing”. He asked me what I thought about it. I said that I wasn't a doctor and am not qualified to really help anyone, but that it appeared she could either be dehydrated, where all she needs is some water and rest, she'd be fine in a few hours. Or, we could be looking at another extreme, where she could have malaria, she's suffering from shakes that are associated with this type of malaria, and without treatment with medication specifically for malaria, she could be in serious trouble.

Many times I hear people finally make it to a clinic, sometimes dozens of miles away, where they can get proper treatment, and though they may get a test and test positive for malaria, the clinic is out of medicine like Coartem, and just prescribes Tylenol. But most of the time people will not seek the  treatment they need. Other times villagers may just assume any sick feelings must be malaria, so they buy Coartem to treat something that may just be a cold.

Around the villages tons of myths originate around malaria, and working against these myths to promote the truth is difficult to say the least. Most villagers believe:

·                     Getting wet in the rain will give you malaria
·                     Eating sugarcane can give you malaria
·                     Eating raw mangoes can give you malaria
·                     All mosquitoes can transmit malaria
·                     Drinking water from certain wells gives you malaria
·                     Any headache, body ache, cold or flu must be malaria
·                     Rest alone will cure malaria
·                     Using mosquito nets to catch fish is more worthwhile than sleeping under them
·                     If a pregnant woman has malaria, she’ll know it because her symptoms will be much worse
·                     Mosquitoes live in grass
·                     You can get malaria at any time of the day, therefore its senseless to sleep under a net only at night

The truth? Malaria in this area is of the world is caused by a bite from a female Anopheles mosquitoes, only when they are hunting from the hours of about 11pm – 4am, and only if they are infected with Plasmodium falciparum. In the daytime they rest on the inside walls of buildings. The best and cheapest prevention method is the widespread use of mosquito nets, especially from vulnerable groups like children under 5, pregnant women, and those suffering from HIV/AIDS. The best primary medical treatment is Coartem.

There are some other challenges that face Zambians besides misunderstandings. Making it to a clinic is time consuming and expensive. Hiring a taxi is out of the question, I've never taken a taxi to my hut because it's too expensive. I know my neighbors can't afford it. Then the only other options are walking all day with a sick person, or paying someone to bike, riding on the bike rack. And like I said, sometimes the clinics themselves are out of medicine. The World Health Organization recommends you begin treatment within 24 hours of symptoms. If I wasn't already supplied with a malaria test kit and Coartem provided by Peace Corps, I'd even have difficulties getting treatment within 24 hours. In more developed areas they spray the insides of walls (a method that has been incredibly effective where they keep it up), but I don't think they've ever made it near my village.

But there is hope. The misconceptions are getting more sparse, education about the real cause of malaria and it's treatment and prevention is everywhere. Being as how widespread and damaging malaria is in a place like Zambia is, the Zambian government, NGO's, and aid agencies around the world are pumping money and resources into decreasing the devastation malaria has brought, which may some day allow poorer countries like Zambia to benefit from one less debilitating disease and focus on development uninhibited.

What am I doing? I'll be working soon with Martin on a workshop for my surrounding villages. We want to focus on building tippy taps (handwashing station with a bucket of water and pedal to “tip” the water into your hands) to help with hygiene, SoDis (solar disinfection) to clean water without chopping down more trees to burn and boil water, and simple things people can do to decrease chances of getting malaria. What I'm hoping to do is find a few community members that I can teach with Martin to be “community experts”, if you will. They will be the ones holding the workshop, I'll be in the sidelines. My opinion is people coming in and teaching workshops, though helpful, are not as sustainable as they could be. I'm trying to work myself out of a job. If they have the power to hold their own hygiene workshop without me, I've done my job. For the malaria prevention I'm hoping to get higher up village members to show everyone their own mosquito nets, so all community members see that even the headmen or headwomen sleep under nets just like they should. Something I've seen is that many people don't try to fix holes in their nets, so I'll focus on 3 ways to fix holes, stitching, patching, and the easiest, a knot. I'll let you know how things go.

How will you Stomp Out Malaria in 2013?

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