Tag Archives: mosquito

A Passion for Prevention

25 Sep

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!

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

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

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

The village clean up celebration

Leaders of the health committee and women's groups

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

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

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

Obama on a Medal

Elhage talking us through his work

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.

Mimi Gets Malaria, and Other Fairy Tales

27 Apr

For World Malaria Day I took over my sitemate’s English class to teach a group of 7th graders about malaria. Because we wanted to teach both health and English we put together a reading comprehension lesson using C-Change (a Behavior Change Communication strategy organization)’s storybook for kids about a girl named Mimi who gets sick with malaria.

Reading Mimi's story to the kids

Reading Mimi’s story to the kids

The book was specially formulated for Ethiopian kids with character’s like Bitika and Litika the malarial mosquitos (female anopheles variety of course), and Mimi being told to finish her entire round of medication without sharing with family members (a common problem here and the source of drug resistant and recurring strains). The story went through transmission (Bitika and Litika live in a pond that appeared during rainy season), symptoms (always go the health center if you have a fever!), treatment (take ALL your medicine), and prevention (both bed nets and spraying). Plus we coloured in the pictures and put it on bright construction paper so y’know… it’s cool.

Got some help from Morgan, the English teacher – Peace Corps Ethiopia G7

Got some help from Morgan, the English teacher – Peace Corps Ethiopia G7

Cross sector activities for the win! Here were was our lesson for the day:

OLYMPUS DIGITAL CAMERA

After practicing both listening and reading comprehension we went over some of the details of the health content. A question that came up was whether you could get HIV from a mosquito bite, since they suck your blood. Logical, but luckily (unluckily?) the H in HIV stands for Human so the virus dies inside a mosquito, and they can’t transmit it.

This kid used his science textbook to draw his mosquito

This kid used his science textbook to draw his mosquito

Using what they learned, we had the kids work in groups to make posters about the transmission and prevention of malaria. At the beginning when asked, only 1 student said he had a bed net in his house. At the end, the kids all wanted to know when to get a malaria net for their families (answer- health centers).

World Malaria Day in English and Amharic

World Malaria Day in English and Amharic

In Ethiopia, 68 percent of the country is officially a malaria zone, especially the lowlands. But as global warming contributes to crazier weather and mosquitoes migrating higher, highland areas on the malaria line (like Gondar) are seeing more cases. Days like World Malaria Day remind people that conditions can change, and awareness is the first step in prevention.

Here are the posters the kids came up with. Explanations in the captions:

They loved that book! Left it in the library for the future.

They loved that book! Left it in the library for the future.

Bed Nets are the best prevention
Bed Nets are the best prevention

Working hard!

Working hard!

These kids were gobez! The pond in the bottom has the life cycle of the mosquito while the one house without the net has a sick person, the house with the bed net is cool, and they drew the health center!

These kids were gobez! The pond in the bottom has the life cycle of the mosquito while the one house without the net has a sick person, the house with the bed net is cool, and they drew the health center!

Malaria transmission and prevention

Malaria transmission and prevention

This poster was location specific- Malaria in Gondar! (hence the castles)

This poster was location specific- Malaria in Gondar! (hence the castles)

This mosquito had malaria... it also maybe took some acid

This mosquito had malaria… it also maybe took some acid

A Little Experiment

10 Apr My Bed Net - sometimes it feels like a princess canopy… if I pretend

Malaria is the number one cause of mortality for adults in Gondar. Yet, almost no one seems to think it’s an issue. To be sure, there is a season for it (right after the rains), but if the numbers are correct almost 57 out of 1000 adults and 34 out of 1000 children under five years old will contract the disease in this city next fall. For a city estimated to be about 320,000 people, that means a lot of malaria cases.

April 25th is World Malaria Day (Happy Birthday David!). Along with the plethora of other diseases plaguing Sub-Saharan Africa (see Peace Corps Health volunteers all over the continent), these awareness campaigns tend to get lost in the mire of public health announcements. So I decided to get personal with it. As an example for the people on my compound I conducted a little experiment.

Kids, don’t try this at home, unless you are taking malaria profylaxis. Mine is a weekly called methlyquine (the dream inducing kind—it’s groovy man).

Every night I sleep under a treated mosquito net provided by Peace Corps. Last night, I decided to stick out one of my legs. If you had asked me a week ago, I would have said there aren’t any mosquitoes in my house. I don’t hear them when I sleep, and because I sleep under the net I don’t get bit. Here are the results:

Out of the net - I count 14 bites just in the photo!

Out of the net – I count 14 bites just in the photo!

Under the net – No Bites! just a few freckles

 

 

 

 

 

 

 

 

 

These are not a model’s legs, no thanks to the angle of the photo, but let it be known I swathed on hydrocortisone cream for the next few days.

I don’t know if I changed any behaviors, but the next day after I poorly explained my “bimbee” bites to my compound mates, I saw a malaria net washed and drying out on the line. I’ll count that a success.

Net distributions are scheduled in towns every three years according the government health office. The next distribution in Gondar should be in about two years. If anything, I’m just going to keep asking about it. Malaria is one of those disease where if caught early it is easily treatable, if you don’t catch the fatal strain. But even more than treatment, prevention is simple—don’t get bit. And since malarial mosquitoes are most active at night, a bed net is one of the most effective and cheapest solutions.

My Bed Net - sometimes it feels like a princess canopy… if I pretend

My Bed Net – sometimes it feels like a princess canopy… if I pretend

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