Uganda Weekly Awesome: Malaria Awareness Week

Oh Uganda! The land of beautiful scenery, friendly people, and let’s not forget, ravenous mosquitoes. In our beloved corner of East Africa, it is not uncommon for a Peace Corps volunteer to awaken each morning to a battalion of mosquitoes patiently waiting outside of one’s bed net, quietly humming with the hope of retrieving a nutritious blood-fueled breakfast from their unfortunate victim. With a vampirish thirst and an ability to spread infection quite rapidly, mosquitoes in Uganda are more than just a nuisance, but a very real, and sometimes fatal, danger to those who reside here. Unfortunately, Malaria continues to be the leading cause of sickness and death in Uganda, especially with regards to children under the age of 5 years. But, in the face of these grim statistics, many Peace Corps Volunteers have sought to help put an end to this very preventable disease through the power of education.

In the northern reaches of the country, PCV Emily Cobbs spends her days teaching Math and ICT to her students at St. John Bosco Core Primary Teachers College. However, after a few months at her site, she quickly realized the vast amount of misinformation that seemed to permeate her campus about Malaria and it’s causes. “[I wanted to] inform the student body of Malaria facts and dispel any myths they held”, she writes. And so, with the help of her counterpart, Emily decided to organize a week of activities during the month of April dedicated to this goal.

On the first day of her “Malaria Awareness Week”, Emily invited a local Health Officer from Yumbe Hospital to come speak with her students about the causes of Malaria, how it is spread, preventive measures one can take to protect themselves from infection, as well as options for treatment. Armed with this new wealth of information, Emily then used her knowledge and love of drama to help her students create dramatic skits representing various myths and facts about Malaria. During this activity, Emily addressed many misconceptions that her students seemed to have about this disease, including the idea that Malaria can be spread from parent to child, as well as through saliva and sexual contact. However, one of the most alarming myths surrounding Malaria that Emily discovered was the notion that sleeping under a mosquito net can result in cancer.

As one of the leading ways to prevent contracting this disease, the idea that individuals in Uganda were avoiding the use of mosquito nets and risking their well-being based on misinformation was concerning. As such, Emily decided to address this issue by dedicating a large portion of her Malaria activities on demonstrating the proper way to wash, repair, and hang a mosquito net from a 4-poster bed, as well as from a single point in the ceiling (as is the preferred method in many circular huts or where beds are not available)

Following this activity, Emily created a fun role-playing scenario where she invited her students to pose as nurses, local health authorities, doctors, politicians, etc. and host their own pretend “Radio Show” for their peers. Students in the audience were encouraged to “call in” to their classmates’ “Radio Show” and ask for their expertise regarding a variety of questions about Malaria. As Emily says, “[my students] unironically love drama and skits and music here, which I love.”

As the week finally came to an end, Emily joined with herfellow tutors to host a “Game Show” program in order to quiz her students on what they had learned during the week’s activities. She discovered great strides made by her students regarding their knowledge of Malaria and its causes. “The entire week was exhausting”, she writes, “but the results were good. [...] While I’m thrilled with all the things I did, I look forward to doing more, multiple times a year.” In Peace Corps Uganda, we are very happy to have many dedicated volunteers like Emily serving to make their corner of Africa a little better each day.

Posted in Uganda, Weekly Awesome

Uganda Weekly Awesome: Using Visual Messaging to Increase Awareness

The students with their mural.

Written by Megan Carroll

We all know the saying “a picture is worth a thousand words.” This is especially true when creating effective health messaging. Murals are an excellent way to provide a message, regardless of someone’s literacy or educational level. In my village in southwestern Uganda, mural are gaining in popularity and impact.

The original mural painted at the health center

The original mural painted at the health center

During this years’ world malaria month, I worked with some of my coworkers and community members to create a malaria awareness mural, encouraging families to sleep under mosquito nets. We painted our message in both local language and in English, to ensure the language barrier would not be a factor for those that are literate. The mural was a success right from the beginning- as we painted, crowds formed around to see what we were doing.

Now that it is completed, people comment as they pass by it. People have even mentioned the mural to me while I am in the village, outside of the health center. School headmasters even commented how they wished they had something like that at their school. I jumped at this opportunity to spread awareness in other places.

Building on the popularity of the mural, I arranged with the headmaster of the local senior secondary school to create a malaria awareness mural in a public area on the school grounds. To best involve students, we decided to choose the deign by holding an art contest among students. Students in art classes were given the assignment to create an image for the message: “Prevent Malaria! A student without malaria is happy and healthy.” The students decided as a group which design they would use, and were anxious to get to work. They completed the mural over one weekend, and the students and staff were excited about the new edition to their school. In my community, we have arranged to paint two more murals with students once the new term begin- one at a primary school, and another at an all girls’ senior secondary school.

In Uganda, it is common at school to see small signs with sayings, called “talking schools.” While they technically provide a message, they are also very easy to dismiss, and they are small and not visually attractive (not to mention, I’ve never seen a malaria related one!). By using visuals to aid in message delivery, they create much more attention and discussion. Additionally, it gives those involved a sense of pride in the positive impact they are making in their communities, which only motivates us more to continue painting the town!

Posted in Uganda, Weekly Awesome

Land of the…. Mosquitoes?

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Chobe District, nicknamed the “Land of the Giants,” for its dense elephant population, shifted its focus to something smaller, much smaller, this past rainy season when people had to be extra vigilant about avoiding mosquitoes – in addition to the wandering elephants. As the malaria case numbers rose, so did the need for a comprehensive community response. The Botswana Red Cross Society, an important partner in Botswana’s fight against malaria, has been working to support prevention efforts across the country and within the Chobe District. Erica Johnson, a Red Cross-Kasane Peace Corps Volunteer and her counterpart Taboka Rotsi collaborated with the District Health Management Team (DHMT) to distribute an emergency relief supply of long lasting insecticide treated nets (LLINs) to one of the most at risk populations in the district – orphans and vulnerable children (OVCs).

However, Erica and Taboka quickly realized that many nets remained under utilized, misused or unused and reached out to STOMP Coordinator Kim True to brainstorm ways to increase their impact within the community. With the shared belief that malaria education should be fun, personalized and action-oriented, they decided to expand upon their already existing mentorship program. This program, which matches OVC families with an exemplary young person who acts as a personal guide, presented a perfect opportunity to build capacity. The idea was to teach the mentors who in turn would be responsible for sharing their new knowledge with their OVC family. Rocking her malaria themed life cycle couture, Kim trained the mentors on prevention, signs and symptoms and proper bed net hang up, use and care. She also assisted them in creating their own malaria life cycle dress in Setswana, the language in which they conduct their health education sessions. The mentors left the training “buzzzzzing” with excitement and ready to share their gained knowledge and skills.

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One of the Red Cross Mentors stylin’ in her Malaria Life Cycle Dress in front of PC Director Carrie Hessler-Radelet, PCV Erica Johnson and Counterpart Taboka Rotsi

The mentors were able to showcase their skills in action when Peace Corps Director Carrie Hessler-Radelet, Africa Region Director Dick Day and Country Director Tim Hartman visited the Kasane region. On site visits with each of their assigned families, they gave a brief malaria information session followed by a net distribution and demonstration. The fact that the mentors had established relationships with the families enabled them to enter the homes of the caretakers and help hang the nets over the beds thus increasing the likelihood of net uptake, as well as ensuring proper use. The mentors have continued to follow up since to make sure the nets are still being used properly.

PCV Erica, a Red Cross family and a properly hung mosquito net in the background

PCV Erica, a Red Cross family and a properly hung mosquito net in the background

In the words of PCV Erica, “it is this kind of integrated approach to malaria education that helps to ensure that the people that most need protection are, indeed, protected. By educating first we were able to stress the severity of this illness and the fact that it is preventable. Then, following up with a net demonstration and distribution, we were able to ensure that the families had the tools they needed to stay safe. Finally, by physically helping the beneficiaries find a way to hang their new net in their home (and in some instances providing hooks to hang them as well), we were able to better ensure proper use of the nets. Malaria is completely preventable if the correct steps are taken.” The Red Cross’ comprehensive solution to some of the more common barriers of correct, consistent bed net usage is inspiring and replicable. Finding ways to creatively increase the capacity of existing programs is part of the path towards a malaria free Botswana.

Posted in Botswana

Gambia Weekly Awesome: Let’s talk about malaria

I probably said this before, but I get so discouraged thinking about malaria. It is such a devastating and debilitating disease with long-term consequences. It also unfairly attacks sub-Saharan Africa because of the climate and the fact that anopheles mosquitoes here prefer to feed on human, while malaria-carrying mosquitoes in say, SE-Asia feed on cattle and livestock as well.

Presently, the tools for fighting the disease are: bednets, Indoor Residual Spray (IRS), chemoprophylaxis for pregnant women and children under 5, and early detection and treatment (preferably using Quartem). All these tools are utilized in The Gambia with funding coming almost exclusively from the Global Fund. There are major challenges though. Bednets require correct and consistent use year-round and usually need replacements every 2 to 3 years. IRS typically lasts for 6 months only, making it incredibly labor intensive. Additionally, there have been difficulties securing WHO-approved DDT, and the alternatives are extremely costly. Chemoprophylaxis are good and prevent most malaria in pregnancy. The Gambia plans to introduce the prophylaxis for young children beginning this rainy season for four-months duration each year. Clinics sometimes run out of Rapid Diagnostic Test strips for malaria as well as Quartem for treatment, enabling transmission with each prolonged case of malaria.

The vector behavior also complicates the situation. Studies have been saying that malaria carrying mosquitoes in the Gambia (anopheles gambiae) are endophagic (they bite indoors). So most interventions target indoor biting (bednets, IRS). Nevertheless, the incidence rate has been stagnant for the better part of the past decade. There are reasons to believe that the vector behavior is changing with increasing episodes of outdoor biting. Researchers assert, “because they (current vector control interventions) do not cover the full spectrum of all locations where mosquito exposure occurs, and even if only a small percentage of mosquitoes remain and bite outside, their existence could be enough to prevent the transition from very low to zero transmission” (Govella and Ferguson 2012). Mosquitoes are most active from dusk to dawn. During that time, any exposure can lead to an episode of malaria in malaria endemic areas like the Gambia.

The biggest problem is that you can only be so vigilant. Can you imagine living your entire life using bednets, applying insect repellent (if you can afford it), wearing long sleeves in incredibly hot weather, and having your house sprayed with DDT every 6 months? It’s pretty awful.

Most villagers stay outside at night. Some even until just before dawn. Culture does play a part in this behavior. People love chatting and brewing tea at night. But housing design also keeps people outside. Mud brick houses are HOT and a one room hut is not an ideal place to hang out. It is also dark unless you use a flashlight and generally not very comfortable. A house is a place to sleep and store things and nothing more. While people are the most exposed (therefore vulnerable) to mosquito bites outside, most prevention tools focus on indoor biting. To really make a difference, we have to either: 1. develop tools to prevent outdoor biting as well, or 2. make indoor attractive so that people do not have a reason to stay outside.

Improved housing condition is correlated with reduced malaria incidence. In a perfect world, people would have improved houses with screens directly prevent mosquito entry sealed eaves (the space between your roof and the wall) to directly prevent mosquito entry. I daresay indoor plumbing to combat standing water at least near the house and air conditioning/electricity for fans so that people would spend hot nights inside. Airflow also drives mosquitoes away.

I bet malaria would decrease with dramatic economic development that affects everyone in a nation. I believe the key to malaria control is genuine economic growth. Such improvements cannot be wrought by yet another development aid. There is very little political will for this type of “intervention”. It begs the question, “is it really the donors’ job to put window screens in everyone’s houses in sub-Saharan Africa?” The Gambia and Gambians must get richer. With home improvements that take night time social activities indoors, we can comprehensively limit people’s exposure to malaria-carrying mosquitoes. With development, the government can also do the above-mentioned interventions better. They would no longer have to depend on foreign money to keep RDT, Quartem, bednets, and IRS in stock at all times and roll out promptly as needed.

Malaria, as manifested here in The Gambia, is a disease of poverty. If people had improved housing, if people had access to medical care (both distance and financially), if the government could ensure that quality public health interventions are delivered timely and correctly, we would not have to suffer so much from this horrible disease.

Last year, approximately 1 in every 5 people got malaria in my village. The majority of the cases affected children under 14 years of age. The fight is still a long way from the end.

For more perspective on this matter, view Habitat for Humanity’s malaria and housing white paper.

 

To read more about Daniella’s experience in The Gambia, check out her blog.

Posted in Gambia, Uncategorized, Weekly Awesome Tagged with: , , , ,

Gambia Weekly Awesome: Launching Grassroots Soccer in The Gambia

Bed Net Ball
Originally published on Lindsey’s blog.

Since I came to The Gambia in March 2014 I have wanted to work with kids; now I’m finally getting my chance. After spending over a year in my primary assignment in the National Malaria Control Program, mostly at a desk, I have been itching to run all over playing sports with children. Living in the greater Banjul area with a very small host family in an entirely tiled compound, I haven’t had the experience I was envisioning when joining Peace Corps. Most Peace Corps volunteers go through this adjustment period of what they were expecting and what their specific experience has actually turned out to include.

One thing I have learned after my 19 months in country is that this is MY service. This is a bit of a tricky concept because after all it is service. I came to serve, wherever there was need and however I could. But if I am unproductive or unhappy that service can start losing its meaning very quickly. The last few months I have begun to add a few secondary projects to the work I am doing here and it has transformed my experience. I might not be making a difference, it’s hard to tell…but I am happy again and happiness makes it a lot easier to keep trying. One of the most exciting secondary projects that I have added is the launching of the Grassroots Soccer’s “Malaria Skillz” curriculum in a local Senior Secondary school. This simple, exciting and engaging curriculum uses games with football to teach essential malaria lessons.

Teaching About Bed Nets

Teaching About Bed Nets

An education PCV who was getting ready to finish his service heard our Stomp Out Malaria presentation at the All Volunteer Conference in April. During the Stomp presentation we talked about the Grassroots Soccer program as an example of a project that we want to try in The Gambia. This volunteer Justin (better known as Omar in The Gambia) introduced us Stomp alumni to the school he had been working at for two years. It turns out that one of Justin’s main secondary projects was creating a basketball team for boys and girls as well as developing a Physical Education Program at the Senior Secondary school he was assigned to. He thought his school sounded like the perfect fit for our curriculum. We went to the school to approach the principal and the teacher’s sports committee about the possibility and they LOVED it. That’s how the first Grassroots Soccer Program was born in the Gambia.

Bed Net Ball

Bed Net Ball

We developed together a plan for a summer school soccer program that would begin after Ramadan and conclude in September with a football tournament! The program is planned to include 6 teams, 3 for boys and 3 for girls. Each team has 20 students; the training will be for 120 students in tenth and eleventh grade. It will be twice a week for 4 weeks. The girls and boys are separate for all activities as this is a conservative Muslim school. The training for coaches was held in July and the program begins August 12! Since this is the first time Grassroots Soccer is being used in The Gambia, it is a bit of a guinea pig project but the enthusiasm and support of other PCVs, counterparts and the students makes it a promising project. Other volunteers have already made plans in their communities to run similar programs!

“Can I get a KIIILLLOO?!”…

Watching the teachers and students engage with the activities and the malaria information has been so invigorating! The curriculum does all the work-we just have fun. My voice may be gone twice a week, but now I am smiling again here in the “Smiling Coast of Africa”.

KILOS!

KILOS!

 

Posted in Gambia, Uncategorized, Weekly Awesome Tagged with: , , , ,

Gambia Weekly Awesome: Welcoming Rainy Season with Warnings about Malaria

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After a June storm that rendered the sky dark saffron from dust, the air chilled from turbulent winds, and the land moist from rain, The Gambia officially entered the rainy season. Health Volunteer Di Yi “Jessica” He welcomed the change of weather by coordinating multiple malaria sensitization activities in and around her Upper River Region village called Kulari.jess

“Kame ke gana li, sirimu gabu wa liini; siriumu ku gana li, I lawa malaria kini angda ado ang dimbaya da.” Jessica explains in Serehule: when the rains come, many mosquitoes will come, too; when the mosquitoes come, they are able to give you and your family malaria. This phrase initiated many of Jessica’s malaria-related activities including malaria sensitization sessions, bed net stitching, and neem cream (a local, homemade insecticide) demonstrations.

Jessica began by reading a basic malaria training manual composed by Stomp Out Malaria alumni Justin Wellins with village leaders and friends. After reading together and discussing each page, these individuals became malaria teachers for the community. Kulari’s Community Health Nurse hosted the first and second malaria-related event where he led a sensitization session with the Women’s Organization and Village Support Group.

During the second malaria sensitization session, the Community Health Nurse invited his friend, who was a teacher at Badare, a neighboring village, to attend. The Badare teacher felt inspired to bring the malaria sensitization session to his school – but asked to include an interactive demonstration to cement the knowledge into his students’ memory. The third event fleshed out into a neem cream demonstration and malaria sensitization session geared toward a high energy group of students in Badare’s Basic Cycle School’s Peer Health Group. This event triggered two more teachers to ask for assistance with teaching malaria – resulting in two additional neem cream demonstrations and malaria sensitization sessions in Badare’s Fourth Grade class and Kulari’s Fourth, Fifth, and Sixth Grade classes.

When the bed net distribution campaign completed their assignment in Kulari, Jessica took her own bed net to the Entertainer’s Group President’s home and started stitching a design onto the material. This excited young girls and older women to stitch along which became the perfect environment to initiate conversation about the use of bed nets and their role in preventing malaria. The Entertainer’s Group President approached Jessica at the end of the event about conducting a neem cream demonstration and malaria sensitization session in the center of their 6,000 population village. A week later, this event was spearheaded by the Entertainer’s Group President and the Kulari Ward’s Counselor. It attracted the attention of an elder from a neighboring village, who invited Jessica, The Counselor, and the Entertainer’s Group President to his home and to educate his community. A few days later, another malaria event was hosted in the elder’s village of Koli Kunda.

June was a compact month and it did not end without results. Jessica recently hosted another neem cream demonstration and malaria sensitization event in her compound led be a family friend. This program was for residents in the outskirts of Kulari. An older woman strolled into the compound and chatted about the malaria knowledge she learned after the previous session in the center of town. Indeed, the older woman remembered all the important facts, and ended up co-teaching the event. All in all during the month of June Jessica begun 7 sensitizations, teaching 109 males and 196 females, as well as involving 9 male and 6 female counterparts! The Gambia is proud to have Jess He on our team.

Posted in Gambia, Uncategorized, Weekly Awesome Tagged with: , , , , , , ,

Ramping Up Malaria Prevention After Successful IRS campaign in Rwanda

In 2012, Rwanda’s Nyagatare District, located in the northeast corner of the country bordering Uganda and Tanzania, had 40% of all malaria cases in Rwanda. Due to its relatively flat geography, high temperatures and cross-border contamination, Nyagatare has all the ingredients for a malaria disaster. During the months of December 2013 and February 2014, the Ministry of Health (MOH) and the President’s Malaria Initiative (PMI) were able to conduct rounds of Indoor Residual Spraying (IRS) to every house in Nyagatare District, which, according to the 2012 national census, is the second most populous district in Rwanda. This was not the first time Nyagatare residents had been selected for rounds of IRS. It was, however, the first time PMI had used a different chemical compound in the insecticide from the first rounds because studies were showing resistance already building in mosquitoes.

After both rounds of IRS, my counterpart, Kibingira Claude, and I went to 50 households and talked to 259 residents of my village and surrounding areas. We conducted a survey to find out their perceptions of IRS. We wanted to know if they experienced any negative side effects from the new chemical as well as their opinions of IRS in general. The results were overwhelmingly positive in favor of IRS. Out of 50 houses only two homes reported that they would not want IRS to be done again. One interviewee said she didn’t like strangers entering her house, and the other said she thought that the IRS had increased the bugs in the home.

However, one unexpected negative result was that because IRS has worked so well, villagers were convinced that they no longer needed to worry about malaria or sleep under their mosquito nets each and every night. In June of 2013, my health center had over 1,700 people test positive for malaria. This past June we had less than 10. In order to keep the community engaged in the fight against malaria, I knew I needed to do something.

Over the past two weeks, three counterparts and I trained 119 community health workers on malaria prevention, behavior change communication, interactive education & community mobilization. As Rwanda has a huge culture of per diem for trainings, I decided to not pay the CHWs in full until they showcased what they had learned at the training in each of their villages. By planning with them to create over 42 community-based interventions on malaria prevention, the CHWs will use their new knowledge to engage their own communities.

By the end of August we expect each village in my health center’s catchment area to have had their own community education event. The month will conclude with a completion ceremony with certificates (of course), and new electronic thermometers for CHWs to use in helping detecting fever and promoting patients to seek treatment early. Also, thanks to a SPA Grant, the health center will receive a laptop for data collection, as well as a projector to be used in future trainings or as an income generating activity for the center to have movie nights with health messaging “half-time”shows.

Take a look at the final report here -> IRS Survey Final

Posted in Rwanda, Weekly Awesome Tagged with: , , ,

Tap Tap SWAT! Ghana adds a modern twist to one of Peace Corps oldest initiatives

Ghana STOMP Hackathon

For Peace Corps volunteers, the rate at which we are required to adapt to new situations with creativity and flexibility can at times be overwhelming. The limited stay in our host countries, combined with the speed at which the international community is developing alongside our villages, builds pressure for action. Thankfully, recent technological developments and greater ease of access to various mobile devices has set the stage for a dramatic shift in the way Peace Corps volunteers work with their host countries to disseminate valuable life saving information.

Ghana STOMP Hackathon

Participants in the Ghana STOMP Hackathon

In an effort to optimize resources, Peace Corps Ghana’s SWAT Malaria Initiative (Standing With Africa to Terminate Malaria Initiative) teamed up with Tech Think Tank and an impressive crew of nearly 27 computer programmers to address one of Ghana’s greatest burdens, malaria. The result of this collaboration was a “Hackathon,” with malaria being the sole focus.

With the support of Coders4Africa and space provided by Mobile Web Ghana, the event kicked off on the morning of July 12th in Madina with 23 host country nationals and 4 PVC’s present, including hackathon innovator Joshua Kim. After greetings, PCV and Masters International student Matthew Ward gave an introduction, which included the event’s goals and some humbling statistics to aid participants in understanding the magnitude of the challenge before them. Patrick Choquette and Matthew McAllister of Peace Corps’ Department for Innovation in DC even took time from their weekend to Skype-in during lunch and offer their support.

Living in a malaria endemic country, it is of the upmost importance that we fully understand the problem and continuously work towards new solutions. With nearly 3.5 million reported cases of malaria annually, it remains the number one killer in Ghana. Roughly 1/3 of all reported cases in Ghana are in children under the age of five. This equates to nearly 7 newly diagnosed cases of malaria every minute and almost 40 deaths of children under the age of 5 every day.

Following the introduction to the mission, Matthew Ward & Joshua Kim laid out 4 different projects that focused on designing software applications to strengthen the fight against malaria by increasing awareness and education. Motivated participants wasted no time and began furiously coding, both adapting old ideas and constructing new solutions. Participants included representatives from Wikimedia, Google, Meltwater Entrepreneurial School of Technology and Coders4Africa, just to name a few. The first day wrapped up with devoted participants requesting permission to work on their projects at home.

Cooperation and idea sharing continued to flow like ‘fanta’ as new faces including a few curious PCV’s arrived the second day. In talking with Selom Banybah, representative of the Ghana chapter of Coders4africa, he shared his sentiments for working with Peace Corps volunteers by stating, “They bring joy to all the work they do.” This was the third hackathon Selom participated in with Peace Corps volunteers and definitely hopes it will not be his last.

After a few concentrated hours it was time to display the finished products; presenters plugged into the projector and shared the work of the last two days. The first mobile application, modeled off the game show Jeopardy, included 4 sections of malaria related questions rated on level of difficulty. As players answered correctly, the questions became increasingly more difficult. The second mobile application likened a modern version of duck hunter, wherein players swatted mosquitoes as they flew quickly across the screen. Players were awarded points for killing as many mosquitoes as possible, all the while being provided the option to make monetary donations to malaria prevention efforts. The third and final mobile application of the day shared a quiz bowl type game that included a variety of informative malaria facts.

Mobile applications were then judged on a number of criteria, including: practical application, visual completeness, and overall identification with the malaria mission. Peace Corps Volunteer Matthew Oneil closed the event by presenting awards to each of the participants. Overall the event succeeded on multiple levels, bringing together local experts with Peace Corps Volunteers and generating new tools in the age-old fight against malaria in Ghana.

Posted in Ghana, Uncategorized Tagged with: , , , , ,

TBT: My one year anniversary on World Malaria Day

Sarah Genelle Castagnola, PCV Uganda

Do you miss reading about World Malaria Day? So do we! This week we are throwing it back to an incredible volunteer, highlighting her admirable efforts on World Malaria Day. Check out  Sarah Genelle Castagnola, as she reflects on her first year of service and her innovative radio show project. 

Sarah Genelle Castagnola, PCV Uganda

Sarah Genelle Castagnola, PCV Uganda

Today marked my one year anniversary in Uganda. Everyone says in Peace Corps the days are long but the two years go by quickly. So far, I couldn’t agree more. Out of our group of 28, we are now 23 in country. I can say we all have had really high highs and really low lows. When I look back now on the 4 months I spent in Ghana or the 2 months I spent in Aceh, Indonesia or Nicaragua I am shocked I accomplished anything. I feel like I am only now starting to really understand the culture I am immersed in and the people who I spend everyday with.

Today I traveled to Kasese town (Yes 3G internet!) to do a radio show for World Malaria Day. Malaria has a huge emotional and economic impact in Uganda. It is the leading cause of death in Uganda. In fact 90% of all malaria cases are in sub-saharan Africa. In a recent survey published, an estimated 25% of Ugandan’s income is spent on treatment for malaria. Where I live the number one thing to prevent malaria is to simply sleep under a mosquito net. I religiously tuck my net around my bed every night. This is admittedly to keep not only mosquitoes but also the mice and other insects that roam freely around my house out of my bed.

Human behavior is difficult to change. The government distributes nets for free throughout Uganda however most people use them for fishing and chicken coops. The most you can do is to provide information, incentivize healthy actions and try to stage interventions to improve the usage rate of nets. I wrote and received a small grant to put on a radio show to talk more about net usage, treatment options and to give people the opportunity to call in and ask questions. Lady J of Kasese’s Radio Messiah hosted me, a doctor from Kagando (whose mother is one of our farmers), Manasi, a radio host who works closely with Bukonzo Joint and Will, another Peace Corps volunteer in Kasese.

The doctor talked about malaria in Uganda explaining what it is, prevention, transmission and treatment. We also had people call in and ask questions. Questions ranged from, “What malaria drugs are okay to take while pregnant?” to “I heard that if you sleep under a net it makes you crazy and you start speaking incoherently and have nightmares, is this true?”

As with most projects I do here, there were a lot of challenges which all worked out in the end. The doctor, who was our main presenter, arrived 20 minutes late due to the CDC visiting his hospital on the same day. We also had a miscommunication about the price of the show. It turns out the show was 9,000 ugx a minute so the amount I received from the malaria grant only afforded one hour not two. Also, during our malaria trivia game both MTN and Orange phone networks went out and Warid was going on and off. Despite the doctor arriving late, he did an excellent job and was completely prepared for the show. I was able to negotiate two hours, though we only paid for one, with some charm. We also decided that the malaria trivia would be asked on the radio the next 5 days 3 times a day giving listeners the opportunity to call in and to win the roasted coffee Bukonzo Joint had donated as prizes. Overall, all these issues worked out to our benefit. Malaria information will now be repeated and disbursed throughout the week and Bukonzo Joint will continue to get free advertising for 5 days instead of 1. We wrapped up the show by 7pm. An estimated 500,000 listeners were tuned in tonight. I am hoping a few more start sleeping under their net.

Read more about Sarah’s experience on her blog!

Posted in BAMM, Uganda, Weekly Awesome Tagged with: , , , , , , , ,

Cameroon: Reinvigorating malaria prevention efforts

How can you make a town hear a message they’ve fallen deaf to? Well, with a megaphone, of course!

Unfortunately, people here in Cameroon already know about malaria. I call it unfortunate because if they had never heard of it, and you told
them about a brand new illness that killed more African children every year than anything else, they would fear it. They would rise up in arms to fight it at all costs, saving their lives and their children’s lives. But malaria isn’t new to them. It isn’t sexy. It’s mundane, and they aren’t motivated or compelled to inconvenience themselves to fight it, even when the inconvenience is hanging a mosquito net that was given to them free of cost.

When it comes to taking lives, malaria has a partner in crime: apathy. We already know how to fight malaria; our next battle is against its accomplice. This was the mindset I tried to take when planning my World Malaria Day project. What is holding the citizens of my town back from protecting themselves and their families against this deadly illness?Antonia Lloyd-Davies, PCV Cameroon

One: Inertia.

A number of people in my town and throughout Cameroon received free mosquito nets in a country-wide 2011 distribution, but have yet to hang them up. They brought them back to the house from the health center and put them in a drawer somewhere to age with dignity, while never serving their function. In an effort to kick people back into gear, several other volunteers and I started a door-to-door net hang-up campaign. We brought hammers, nails, and twine and, perhaps most importantly, a nudge to get those dormant nets up and hung at last.

Two: White Noise.

paluproj3Warnings and threats about the dangers of malaria have become a
buzz in the background of daily life. I wanted to personally engage the people in my town by having one-on-one conversations. An educational poster or banner is too easy to ignore. During the door-to-door component of my project, we got to have frank discussions with each neighbor. The information and advice we gave them was tailored to their situation. If they had a mosquito net, we made sure that the most vulnerable members of the family were the ones sleeping under it. If they didn’t, we informed them of other preventative measures and encouraged them to purchase a net at the pharmacy.
By literally entering their homes and confronting them, we made the danger of malaria impossible to ignore.

The second stage of my project, setting up a market day booth, similarly focused on bringing our information to the front of people’s minds. We made announcements via megaphone in French, English, and the local language to be accessible to the largest number of people. When visitors passed by, we engaged them in a conversation about malaria and offered them an interactive bag of questions to quiz themselves. This engagement is the key difference between back-of-the-mind knowledge and actual behavior change.

Three: A “Wow” Factor.

Teaching about the parasitic life cycle of female Anopheles mosquitoes has its place in malaria prevention, but it doesn’t exactly scare people into action. The citizens of Bafang have heard a million times that they should use a mosquito net. I wanted to tell them something new, something that would make them really see the gravity of this disease. Our market booth had bottles full of beans to present new information in a visually gripping way. Each of the five bottles represented one of the top five causes of illness (in Bafang in 2013), and contained one bean for each case. While respiratory infection, the second greatest cause of morbidity, had 803 cases, malaria, the first, had 4532. As people walked by our booth, they saw over five times the number of beans in the malaria bottle as in any other. This new way of presenting information, along with a number of other chilling statistics, hopefully uprooted their belief that malaria is an inevitable and nonthreatening reality of life and lit a spark for concern.

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Although malaria will surely continue to be a problem in Bafang and throughout sub-Saharan Africa, I believe my project was successful in planting the seeds of change for at least some members of my town. Through the door-to-door campaign, we sensitized over 150 households and hung up seven previously idle mosquito nets. At our market booth, we distributed 400 informational pamphlets, and reached countless passers-by through conversations and megaphone announcements. We encouraged all those with whom we spoke to spread and share the information to their family, friends, and neighbors. We may not have eradicated malaria. But if some citizens of Bafang begin to take malaria more seriously and practice preventative measures, especially for the most vulnerable members of the household, then I think we can all, under our insecticide-treated nets, sleep a little more soundly.

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