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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Lake Tanganyika Pictures

Bird playing around in the grass.

David explaining how the car won't fit over the hole in the bridge.

Kalambo Falls and Gorge.

Kalambo Falls.

Kalambo Falls.

Lake Tanganyika.

Sailing back to port with sail made of old mealie meal sacks.

Lake Tanganyika

Made it back safely from my Easter vacation to Lake Tanganyika. The way up to Northern Province was quite a day of hitching. A group of us headed out around 6am, took 3 hitches down to Central Province, through Mpika, and finally made it to Kasama just after sunset. This was the first day I've spent the entire day in the sun. I even slept a bit on a canter. Luckily I didn't get as sun burnt as I would have imagined. The next day we headed up to Mpulungu to a lodge. It should have only taken about 3 hours to get there but we decided to flag down a cool looking truck which ended up being 1 of 10 mobile hospital trucks. They move slowly. We got there in 6 hours. But, it was neat to be in such a huge truck. Finally we made it to the lake for a few days of relaxation, beers, fresh grilled catfish, leftover banana bread, more beers, swimming, sleeping, and more relaxing.

The second day we decided to go to Kalambo Falls. Another group of PCV's had done the trip the day we got in, and hired a boat to take them across the lake a bit, then they hiked 10 km to get to the falls. We would have loved to do that, but didn't have the numbers to drop the price of the boat, so we took a minibus to Mbala, then hired a taxi for the afternoon. The falls are beautiful (see pictures), so far the best place I've seen in Zambia (even though I was looking into Tanzania). I wish we could have stayed longer, but our driver started getting impatient after a while about a storm coming.

The ride back we decided we'd try to take a more direct route to Mansa (home). We got a nice hitch into Kasama and started asking about the road that goes between Northern Province and Luapula Province. He said he would help us but needed to get diesel first. While at the petrol station, he poked his head out of the window, yelled across to another car asking if they were going to Mansa, and as luck would have it, they were. This is like stopping at a random gas station in Chicago and asking the nearest car if they are headed to Oklahoma City. Bizarre.

But it worked. We headed out shortly thereafter on our way across a road that pretty much closes down in the rainy season. Half the trip was pavement, half was gravel/potholes. Luckily it wasn't wet that day. We headed out about 10:30 and they said we'd make it by 16:00. Around 14:30 we picked up a lady on the road with a ridiculous amount of peanuts she was taking across the country, ended up filling the trunk so we were now smashed in the car with our bags on our laps. But we're only an hour and a half away, right? I thought I was uncomfortable about an hour after that, on the bumpy road, where my knees didn't fit, there was no arm rest, it was getting too dark and bumpy to read, my headphones weren't loud enough to drown out the blaring, incomprehensible Zambian songs on repeat, a woman was squishing me, my legs couldn't move, and my head was hitting the ceiling. We arrived in Mansa at 18:30. I have to say that was the most uncomfortable experience I've had in Zambia thus far. As we got back to the house for fried chicken, as our luck would have it again, we were told how amazing it was that we made that trip in the rainy season. Apparently it hasn't really been done before. Although it was a horrible ride, we made it back a day ahead of time, and saved a bit of money, so I can't complain too much.

Next week I'll be hosting second site visit for the new RAP intake, who arrived in country in the middle of February. The first site visit was the first week they were in Zambia, just like I did in one of my first posts. The second site visit is to go to their new province, stay with a current volunteer for several days, learning how to get around, shop, greet people, cook, ask questions, hold meetings, etc., then head to their individual sites for a few days to see their new homes. The new LIFE volunteers came through here on their second site visit and we got a change to meet them. It feels neat watching a new generation of volunteers come in as another prepares to leave. They seem like a great group, and we hear the RAP group is great as well.

Here's a map I made of my hut, I need to clean up a bit before I take real pictures, but this will give you an idea of how I live.