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Monday, May 11, 2015

Stomping out Malaria!

In 2011, Peace Corps Senegal joined with other Peace Corps countries in Africa to form the initiative “Stomp Out Malaria in Africa.”  This program means that the ~3,000 volunteers across the continent (including the 250 or so in Senegal) are working together with NGOs and local governments to bring malaria deaths down to zero by 2020.  Here in Senegal, volunteers have been hard at work painting murals, doing radio shows, leading bed-net repair and care sessions, and talking to school groups about malaria prevention and treatment.  In my region of Kolda, volunteers planned a community block party to help spread the word about malaria prevention (I did not attend because I was at a different block party, in Minnesota, celebrating the joining of houses Brock and Michel). 

Why is all this malaria prevention work a big deal?  Well, malaria is the leading cause of death in Senegal.  Due to mosquito biology, it is more prevalent in the rainier south (where my site is) than it is in the drier north.  According to the World Health Organization, 345,889 people in Senegal got clinically treated for malaria last year, but there were almost certainly many more people infected than that.  I don’t have local statistics, but I can tell you that last rainy season, three people in my village of 1,000 died of malaria…at least, three people that I know of.  It could have been more. 

Trying to wrap my head around these deaths has been one of the hardest parts of my service.  A cure for malaria has existed for hundreds of years, everyone in my village was given a free bed net two years ago, and the Senegalese government subsidizes all malaria testing supplies and medication, so they’re free for everyone.  Why do people continue to die? A much better writer than me attempts to answer that question here.

It’s worth your time to read the above article, because it’s great, but if you didn’t, this paragraph sums up the problem nicely:

Part of the issue is cultural – in many parts of the world, malaria is considered akin to the flu, and even in the US the flu vaccine is woefully underutilized. Part of it is distrust in the system – despite truly heroic efforts on the part of many Ministries of Health, supply chain management remains a stubborn, persistent problem, and in many places stock-outs are still common.

As an additional barrier, although the treatments for malaria are free, transportation is not.  If families have the choice of paying to go to the hospital to get medicine to feel better, or just waiting until they feel better on their own, they sometimes make the choice not to go in.  Every CFA counts.

To hopefully solve the care-seeking gap problem, a new malaria treatment model is starting up in my region this rainy season.  Under the new model (called ProAct in the above article, but more frequently called PECADOM+ here) instead of waiting at a health structure for sick people to come to them, now health workers, armed with backpacks full of testing supplies and treatment medication, are actively going out into villages to hunt down the malaria where it lives, giving sick people treatment, free of cost, right at their homes.  The program was successful last year in the region of Kedougou, and I’m excited to be involved in it this year in my region of Kolda.

I don’t yet know what my involvement will look like – whether I will actually be accompanying the volunteer health workers into the villages and distributing medication, or whether I’m be involved more in the data analysis, or whether I’ll just continue to coach people in my village on good malaria prevention practices, but regardless of what I do, I'm looking forward to making a difference.