Dan Allen: My Final Lesson

Training Ethiopia volunteers about malaria is a little tricky, because, in this highland realm, a lot of volunteers live in malaria-free areas. Ethiopia is so interlaced by valleys and ridges that a volunteer could easily live in a malarial area, a few kilometers from another whose site is malaria-free. Malaria is also seasonal here, and sometimes several years go by before an epidemic sweeps through. As a trainer, it leaves me with a conundrum: how do you give a training to volunteers who don’t think it applies to them?
I learned last November that, preferably, you don’t. I faced a rough crowd of Education volunteers returned from their first three months at site. Despite being the Stomping Out Malaria Coordinator since January, it was my first training in half a year and to an audience of more than twenty. It was also my first time giving a training to Ed volunteers, and I was going off of a new training package, heavily modified to make it work for Ethiopia and to hopefully be of use for school-centered activities. I was thankful for the chance to finally give a training to them (most malaria work is education, and kids are a preferable target audience), but the time slot was less than desirable. The last day of a two-week in-service conference, food poisoning from recycled hotel food had decimated their ranks, and those left on the field were sluggish and sick of technical training. I knew I faced trouble when I started by asking how many had malaria at site and maybe a third raised their hands. Another third briefly looked up from their naps or laptops to see who else’s time was being wasted, and I had no choice but to take a deep breath and hope for a merciful two hours.
I received a couple of positive reviews, but many didn’t bother filling out the form, and–what really matters–only a handful would ever ask me for any malaria support. There was no ill will towards me, but malaria just wasn’t their problem. A month later, I would give the same exact training, to a much better response. My secret: I tricked them. It would be easy, because they were just trainees.
Volunteers don’t want a training about a disease they know their site doesn’t have. So, the reason I wanted to give my session at pre-service training: trainees have never been to their site. They’re clueless. And idealistic.
I gave them the whole spiel, how malaria was Ethiopia’s number one killer, and how they could do something about it! They laughed and danced and made puppets of mosquitoes! The reviews were glowing: it was their best training yet! I loved them and they loved me, and they would go to site armed with the knowledge they needed to stomp out malaria!
Three months later, at their in-service training, I knew it was time to pay the piper. The blow would be softened: I only had about 45 minutes, and my presentation was filled with colorful pictures of malaria projects other volunteers had done (and most of those projects can be adapted, for those two-thirds who do not have malaria in their site). It must of just been my own morbid curiosity that led me to open, once again, with, “So how many of you found malaria at your site?”
I was stunned (which is probably why I didn’t exactly count), but between two-thirds and three-fourths of them raised their hands. But the shocking thing was that they hadn’t been placed in new sites. I had been told long ago by Tigray volunteers that only one volunteer site there has malaria, and here were three new Tigray volunteers announcing malaria in their sites…and they all had veteran sitemates! But the clincher was in a volunteer raising her hand in the back corner.
Her predecessor at site had said for years how it was malaria-free, even explaining how an Ethiopian king had built his capital there specifically for that reason. Bragged about how he went two years and only saw three mosquitoes in his house. He even got malaria…somehow, somewhere…he hadn’t left site recently, so maybe it had just incubated in his system longer than usual. Or, even though Coartem cured his fevers in a matter of hours, maybe it was a different disease altogether. But I liked to admit to having had malaria more than denying it; it gave me more credibility as the Stomping Out Malaria Coordinator. But until she raised her hand, I knew that Gondar was malaria-free. And like millions of people living in Ethiopia–even those who have contracted malaria at home–I was wrong.
In the my last two months in Ethiopia, I heard more reports about malaria at site than in my first forty-one combined. A startling trend comes with all of these reports: the locals in the communities–including the Volunteers living there for more than a few months–flatly deny malaria exists in their towns. The fresh-faced idealists I trained during pre-service did not have the benefit of landlords and neighbors and colleagues telling them for three months that malaria didn’t exist; they went straight to the health office to get the real stats. And they learned that their communities are threatened by something even more dangerous than malaria itself. For malaria is, quite frankly, an easily preventable and treatable disease, but ignorance of malaria denies all means of protection from it.