For the past week or so I have been in Senegal on the West side of Africa learning about best practices for malaria prevention programming both broadly and for Peace Corps volunteers. Waaay over here:
All the way across the continent – First time to West Africa!
Over two weeks we are learning more about malaria and mosquitoes (anopheles female variety of course) than I could ever want to know. Did you know they rest perpendicular to the wall? Did you care? But in the middle of the science, the entomology, and the details of funding schemes, we are also sharing best practices, practical programs and visiting a beach or two.
More on the conference later, but Monday night we had the opportunity to attend the launch of malaria prevention program in one of the villages outside of Thies (pronounced Chezz) lead by a man who has a personal connection to the cause.
Monsieur Elhage has started malaria prevention programming in Senegal in over 10 villages around the area. Starting by walking door to door, he garnered support from village chiefs, women’s groups, and community leaders so that in a country where malaria is endemic, these villages have had 0 reported cases this year.
The “trois Toutes” (3 Alls) program- The whole family, the whole year, every night
A skit about the importance of a bed net, and seeking prompt care
But these results have been the blood sweat and tears of over a decade of advocacy. One morning in 1999 his daughter fell ill, and asked her father, then a photographer for UNICEF, to pick up apples and oranges in the market. He went to work, bought the fruit, and mid afternoon received a call from his sister telling him of death of his 12 year old daughter Ami only 10 days before the start of school. A severe malaria epidemic rocked the region that year with children and pregnant women dying for no apparent reason. After a gathering with the health workers in the area, Elhage began to understand his daughter had died from malaria.
What was worse, she could have been saved had she been treated quickly, or prevented the bite. So Elhage rededicated his life to malaria prevention education. Working at the village level he employed a few different strategies to get buy in from the community. He worked with the women’s groups, youth, and village leadership to develop a health community committee and fund. The fund would pay for education supplies as well as treatment costs for malaria cases.
The village clean up celebration
Leaders of the health committee and women’s groups
With push from village leaders and a mass bed net distribution from the Senegal government (in partnership with the US’s President’s Malaria Initiative), confirmed malaria cases dropped in these villages. But there was still a hot spot of infection – students coming back from summer vacation who had visited families in other villages or towns and were coming back with malaria. To combat this migration effect, the schools developed a “vacation card” and kit that gave the kids nets to take on their trips with them.
The “vacation” card, it says: “I will protect myself from malaria, I will sleep under a bed net”
In addition to the health education and bed net distributions, village chiefs put together a “night watch” group that would go around to houses in the evening to check if bed nets were up. If they were not, the household would be fined $5 (USD) – a LOT for the villagers. The fines would be added to the community health fund. This was a completely internal idea, and worked to keep usage rates high, even in the dry season.
As malaria rates went down, funds needed to treat cases also shrank, freeing up the community health fund to dream up bigger and better projects. Elhage began to advocate larger development goals, and he developed three philosophies needed for moving forward: politeness, cleanliness, and punctuality (a frustration for any aid worker across the continent).
Politeness, Hygiene/Cleanliness, Punctuality
For his hard work in malaria prevention and social behavioral change, the head of the President’s Malaria Initiative (Admiral Tim Ziemer) presented Elhage with a medal. Elhage has continued to promote vigilance against malaria infection and other small scale development goals.
Obama on a Medal
Elhage talking us through his work
As we hear about best practices in malaria prevention across the continent, it is always important to connect with the people who have poured their lives into the cause. People, like Elhage, who have worked for decades and pursued his message and worked with community members to affect change. Change that was home grown, and sorely needed to protect against a deadly disease. His story, while tragic, was one of the most motivating moments of the conference. With stories of his success, we volunteers can head back to our own communities and hopefully support people like Elhage.