Stomping Out Malaria in Africa

I spent my service living at the last matatu stop of an urban area. What lay beyond were endless maze, cassava, bean and banana fields with mud-brick structures scattered here and there with swamp lands and dense jungle intermitted. I worked with a Community Based Organization (CBO) and a health center teaching both community volunteers and also health professional staff outreach curriculum and implementation practices. Malaria remains one of the greatest health issues in Uganda so it was only fitting that we spent significant time doing trainings and outreaches on malaria education and prevention.

Immaculate, the director of the CBO, was a small Ugandan woman who cared deeply for her community and wanted to see health prevail as much as possible. She believed it was the responsibility of the community to fight for one another’s health. We discussed endless initiatives we could take up, different health topics we could focus on and ways to present them.  It was malaria that sparked the greatest passion in Immaculate. In a country where you hear of someone dying from malaria almost every week, it wasn’t surprising this topic was something people wanted to talk about. When World Malaria Day came around, it seemed the perfect occasion to mark the day as a whole community and start our work on malaria education and prevention.

The months leading up to April 25, we divided into teams and spread out to convince others to support us and join efforts to host a community malaria health fair. A local school agreed to create and sing a song about malaria, an NGO would provide a tent and chairs, a church would donate a sound system, the mosque gave a generator, a doctor would speak on the physical process of malaria on your body while a nurse would speak on prevention and treatment, and we as a CBO would do a drama. We found an NGO from the capital who did malaria work and agreed to come and sell treated mosquito nets for a subsidized price. Then, it was just a few short weeks away and we did our best to spread the word. Announcements were made in churches and mosques along with across the local announcement system. We put posters up in the market, at the clinics and we all talked it up no matter where we went. 

Since Immaculate wanted to include as many people as possible and our community was at the end of an urban area going into a rural area, it was decided that a march would be a great way to gather and reach the most people.  With a handmade banner and donated primary school brass band, we marched from a rural post to the main soccer/football field in our town inviting people to join us. After over an hour of marching we only had a handful of community members with us. I was nervous this event was going to flop. We had estimated we would reach around 150 – 200 people but at 2 pm, when our presentations were scheduled to begin, there seemed to be just 40 people or so. So we waited. Another hour later we had a few more people and decided to go ahead. The speeches started, the songs were sung, the talks were given and in true African time people trickled in over the next several hours. Our estimated 150 people grew to nearly 1000.  Over 800 mosquito nets were sold and throngs of people wanted to buy more.

With each mosquito net that was sold we collected as much information about the person as possible so that we could follow up with them in the future. 3 months, 6 months and 9 months out, we sent teams to gather data on if people were still using these nets, how many cases of malaria they had had and where they went for treatment if they were infected. There were times I entered a compound and found the net being used as fencing for a families chickens or a covering for their water pots to keep things from falling in. But there were also times I found the net properly strung up around their beds and reports of no malaria in the last 3 months. 

While our CBO covered many health topics we became known as the “malaria people” in surrounding villages. We hosted another community-wide malaria fair the following year and continued to do follow-ups and outreaches. Immaculate lead with passion and inspired team members to be ready to talk about malaria at any time. Malaria is still pervasive in our community and the country as a whole faces many challenges in eradicating it, but there are many people who are fighting to raise awareness and knowledge so that they can have a healthier community.

 - RPCV Amanda Rodriguez, Uganda 2009 - 2011

After gathering community members in our community center, my
counterpart George and I welcomed everyone to our World Malaria Day
event. The first half of the event included demonstrating how to
properly hang, repair and wash a mosquito net. We utilized our new
S.W.A.T. Malaria Bucket lid to hang the rectangle treated net in a
‘princess’ fashion from an overhanging beam. Since we had to cut a
small hole to run the rope through the net, we then demonstrated how
to repair a hole in the treated net with needle and thread. And for
the last part of the demonstration, we gently washed the net with key
soap and hung it in the shade to dry.

Soon we were off to the discussion portion of the event. Utilizing the
high-risk / low-risk cards we discussed the importance of covering
your water and the consequence of not sleeping under a treated net
properly. Next, we emphasized how vulnerable and dangerous it is for
pregnant women and children under the age of 5 to have malaria. Our
community asked many questions varying from whether local herbs were a
way to treat malaria to how to prevent malaria during the rainy
season. After the close of the event we gathered together to take a
photograph showing how excited we all were to learn more about the
prevention of malaria. Today has been a great day in Dabir!

- PCV Johanna Twiford