Bug off, malaria!

When you live in a country like Madagascar, malaria is no longer some abstract tropical disease that affects people thousands of miles away. It is very real, and it is very serious. Mosquitoes are more than just annoying, and every bite can be a potential killer. In fact, malaria is the number one killer in Africa—not AIDS, not malnutrition, but malaria. That’s why a large focus of our work as Peace Corps volunteers is all about malaria education and prevention, even if we don’t work in the health sector. And because April 25^th is World Malaria Day, the month of April becomes our busy season when we try to blitz the country with educational messages and awareness events.

Ever since last April, when I learned that I would be serving on the southeast coast of Madagascar, I knew that malaria work would be an important component of my work in Vangaindrano. Although there is malaria throughout the country, it is widely concentrated on the east coast, while it is not very prevalent in the cooler highlands region in the center of the country.  At our malaria event last year during Pre-Service Training, I was able to speak with a USAID representative about the mosquito net distribution program that was scheduled for my area in December 2012. USAID, along with several other aid agencies, funds a massive net distribution plan for the coastal areas every few years. In 2012, the focus was on the Sud Est, and so in early December, every town in my region received a distribution of free mosquito nets for each household.

Because so many people in the area received nets in December, I decided that for World Malaria Month this year, I wanted to do some programming in my town about how to properly care for and use a mosquito net. I thought this would be good follow-up on the distribution from 4 months ago, and reinforce to people that it’s vitally important for them to use the nets every single night, and to take proper care of them so that they’ll last for a long time. So in February, I applied for special project funding from Peace Corps to cover the costs of an event, and I worked with Peace Corps Madagascar’s malaria initiative coordinator, and my region’s malaria campaign volunteer coordinator, to plan out a great event for my town.

This past Saturday, we set up a booth in front of the Vangaindrano post office, which is in a high-traffic area in my town’s market, and got to work spreading educational messages about bednet usage and care. Two of my neighboring volunteers, Yu and Jeremy, came to help out, so it was great to have some extra manpower. Festooned with banners and posters about bednets and malaria, our booth quickly attracted a large crowd of curious people. Throughout the morning, we held demonstrations on how to repair holes in a mosquito net with a needle and thread, which ensures that mosquitoes can’t get in. We also demonstrated how to properly wash a net, using just bar soap and water (not detergent, which is too strong), and how to hang it to dry in the shade so that the fierce sun won’t disintegrate the insecticide that each net is impregnated with. And, we showed how to easily transform a rectangular net into a circular one, which is helpful for people who don’t sleep on a bed, or don’t have a good ceiling to hang a net from. For each of these activities, we had different onlookers come participate to demonstrate how simple each of these tasks were, and this caused riotous laughter and spirited engagement from many of the people watching. We were also joined by Max, a Malagasy health workers at my town's private hospital, so it was really good to have a community member join us. It ended up being a fun morning, and as I stood on a pedestal in the middle of my town’s market, speaking about malaria, in Malagasy, over a microphone, it was one of those moments that reminded me of how far I’ve come as a volunteer in the past year.

Me, Jeremy, and Max (a local health worker) holding up a net in our booth. The banner behind us says "Fight Malaria" and lists the towns in the Sud Est region which are all hosting Peace Corps anti-malaria events this month.

Jeremy and Yu hold up a net that the woman in the center repaired using a needle and thread.

Yu talking to the crowd about malaria symptoms and what to do when they're spotted.

This little girl is really cute and says my name as "Semolina". She was eager to participate, so we had her show that repairing nets is easy enough even for kids to do.

Yu and a local woman showing how to wash a net with plain bar soap and water.

Me on the microphone, narrating the net-washing demonstration.

Showing the crowd how to use an adapted circular bednet.  We were assisted by Max, a health worker at my town's hospital. (Note the malaria mural in the background, which was done by a group of PCVs last year, just before I arrived!)

After a lunch break, we got back to work handing out informational pamphlets in the market area. Each of these pamphlets was a mini-handbook for how to spot the symptoms of malaria, and how to treat it before it becomes life threatening. Although pamphlets are a dime a dozen in America, and you’ll always find people foisting them on you in the street, they are a lot rarer here. In fact, reading material in general is hard to come by here, so people were grateful to be receiving them, and I quickly ran out of pamphlets after people ran up to me asking for them.

Finally, we ended our day by playing some educational games with the kids in my neighborhood of Ampasy. I was excited for this because I’ve been so busy lately that I haven’t had a lot of time to hang out with “my” kids. The first thing we did was talk to them about malaria, in very basic terms, and explain the importance of sleeping under a mosquito net. We also used the frame of a halfway-built house to have them learn how to hang a net properly, and how to tuck it in so that mosquitoes are effectively shut out. The kids were already giggling and laughing and having a great time, so they were especially engaged for our next activity, which was a game a la sharks and minnows. We set up two nets on opposite ends of a field (held up by adults who came to help out), and the kids had to run from net to net without being “stung” (tapped) by the “mosquito” (Jeremy) who was standing in the center. The kids had a blast and didn’t want to stop playing. And although it sounds like a trivial game, this is an example of a situation where every little bit counts—each activity reinforced to the kids that mosquitoes are bad and need to be avoided, or else they’ll harm you. Because the kids wanted to keep playing but were full of energy, I decided that a fairly simple game would be in order. So I resurrected the “parasy, parasy, moka” game that we played with the kids in Mantasoa last year! This game is basically just duck, duck goose, but with the animals transposed into parasy (flea) and moka (mosquito), again with the aim of running away from the mosquito. Once again, the kids had a blast, and when the sun began to set on our long and busy day, we reluctantly ended the game and headed back to my house.

Local kids in the mosquito net they learned how to hang.

Playing the 'sharks and minnows' game, with Jeremy as the mosquito (shark) trying to "bite" the kids!

I was nervous about hosting my first event in Vangaindrano, but at the end of the day, I was really pleased with the work that my fellow volunteers and I did. Not only do I feel like I’m a better volunteer now (because I have learned how to talk to people about health issues), but I also feel like the people of Vangaindrano absorbed some helpful information. One of the best moments of the day was during our net washing demonstration, when I overheard one of the onlookers explaining to another woman, who had just arrived, what was going on. She repeated our instructions about using bar soap and not detergent, while her friend nodded in understanding. I was quietly thrilled to realize that not only were people getting the message, they were actually passing it along. And to make an impact on eradicating malaria in Madagascar, that’s exactly what’s needed.

So now you’ve read about what I did. Now, how will you stomp out malaria in 2013?