Teta village

Teta Village Malaria Day

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Michael Lessmeier is a rural education volunteer in Central province of Zambia teaching English at Teta Basic School for students in Grades 8 and 9.  Michael observed a high absentee rate of students caused by malaria and decided to work with the community to address this issue.

PCV Michael Lessmeier distributed nets to his community.

First,  Michael met with the local village leader,  Mr. Davis, who is addressed as the headman.  Mr. Davis instructed the neighbor health committee (NHC) volunteers  to complete a census to determine the number of households and bed spaces. Data from the census concluded that many households did not have enough nets for the sleeping spaces.  Michael also surveyed  550 students in grades 3 to 9  and found less than 10% had slept under a bednet  the previous night.

Alarmed by this information, the headman, clinic staff and neighborhood health committee (NHC) members gathered in October to determine the best course of action. They recognized the need not only for more bednets but more education on malaria and prevention. To begin this process Michael submitted a Small Project Assistance grant (SPA) to purchase the 500 nets needed for the village.  Then he worked with NHC members and teachers at Teta school to develop a malaria program.

On November 15th, Michael conducted a workshop  for eight  NHC volunteers on how malaria is transmitted, signs and symptoms, prevention methods and ways to repair a bednet.  One of the teachers from the school assisted in translating the information. The purpose of this training was to have these volunteers teach this information at antenatal clinics and under five clinics.

NHC members demonstrating net repairs.

On November 16th, Teta Malaria Day was held at the health post facility near the school.  Each household in the village was eligible to receive a bednet, and an adult member of the household had to attend the malaria information program in order to receive the net.  The training information was provided in four stations:  transmission, signs and symptoms, prevention and how to properly hang the net. A station for net repair was done by NHC members. A teacher from Teta School conducted these 10 minute sessions in Bemba, the local language.  These information sessions were conducted in groups of 25 people.

When all the information sessions were completed, the nets were distributed to each household member from the census.  The package of each net was opened and given to the household member and an information brochure on malaria was included with each net.

Two members of the neighborhood health committee are also trained in maternal and child care, and affiliated with the  Safe Motherhood Action Group (SMAG) assisted in the day’s events.  These members  conducted brief talks on the importance of attending antenatal and the benefits to for the mother and baby.  Michael also had assistance from other PCVs, Andrew Bernhard, Courtney Gandy and Jennifer Parks in distribution, health information and bed net repairs.

The Teta Village Malaria Day was a great success with 500  families receiving much needed bednets and malaria prevention information.  Mr. Davis, the village headman, said he was “very grateful to Michael and Peace Corps” for helping with malaria prevention.

Malaria Think Tank Springs Into Action

Last week the newly formed Peace Corps Uganda Malaria Think Tank held its first meeting! Comprising the Think Tank are Malaria Team members Matt Boddie and Ashley Givan, as well as Community Health Volunteers Sarah Cornett, Kristina Sandfoss, and Chris Peterson.  The Think Tank had the opportunity to sit down with Country Director, Loucine Hayes;  Director of Programming and Training, Paul Sully; and Health Program Specialist, Cotious Tukashaba, to form a strategy that will engage Peace Corps Volunteers in all sectors to fight against malaria.

Capitalizing on the strength and innovation of other Volunteer groups within Peace Corps  Uganda, the Malaria Think Tank will collaborate with the Water and Sanitation for Health, Micro-finance, and Agricultural Think Tanks to exchange information, resources, and plan cross-cutting projects together.  The Think Tank will also work closely with the Technology Committee to make information more readily available to all Volunteers through the Peace Corps Uganda website.

Potential projects of the Malaria Think Tank include: regional malaria trainings, conducting a survey on net use and care at the household level, using Village Savings and Loans Associations as a platform for malaria education, utilizing mobile clinics to deliver education on nets, teaching tailors how to embroider decorative patterns onto nets, carrying out a study on how subsidized nets are adopted in a community, and researching treatment and pesticide resistance at a national level.

The Malaria Think Tank will meet again in January. However, members already communicate on a daily basis. They are enthusiastic about forming partnerships with civil society organizations, local governments, and international organizations.  But most importantly, they are very dedicated to ending malaria in Uganda through its best resource: Peace Corps Volunteers.

Hammock from Ngora

Income Generation Through Mosquito Net Hammocks

Aigi Mary-Immaculate and Obote Denis showing off the hand-sewn bags that each hammock comes with.

Finding employment is difficult for youth in Ngora parish, located in eastern Uganda. Many haven’t completed their schooling and do not have the financial means to do so. The Ngora Parish Harmack Company is a community based organization founded in February 2011 by PCV Matthew Boddie and his counterpart Denis Obote. The goal of the organization is to help students continue their education by providing life skills training and assisting with school fees. Among these trainings, the NPHC teaches business skills and the fundamentals of microfinance to local youth.

Boddie is currently working with NPHC on a project that teaches youth to produce various types of hammocks, including some with built-in mosquito nets, to sell to local Ugandans, tourists, and companies. In addition to learning invaluable technical skills, the youth also manage the company’s profits. Selling the hammocks to local clinics that face bed shortages, the project both addresses healthcare needs and creates a sustainable income-generating project.

The NPHC decided on the “Off the Ground, Under a Net”  initiative after realizing the number of children who sleep on the floor, without a mosquito net. It is their mission in Ngora to provide every youth, especially those under the ages of 5, with a bed and a net to sleep under. The organization is able to help these children by using left over material to make additional mosquito-net sewn hammocks and selling them at a reduced price.

To date, about 63% of the hammocks sales come from companies and tourists, and 37%  from locals. The NPHC is trying to market more to locals through sensitization campaigns about the foreign type of bed and malaria prevention.

NPHC staff work through the night to complete a large order for a Ugandan resort. Several companies within Uganda buy NPHC hammocks for re-selling.

Currently, the organization is run completely by the youth who were trained in its first year. The project has now received funding from the U.S. Embassy Small Grants Office  to scale up their project.  The grant will be enough to create a two-room building complete with sewing machines, computers, and solar power.  Once complete, the NPHC will start to teach the skills they have learned to other at-risk youth within the area.

To date, the NPHC has sold 473 hammocks. 7 kids have been sent off to a full years’ education, one of whom was able to purchase a laptop for his college education.  Once the scaling up is complete, NPHC is hoping to increase their production 5-fold.  Stay tuned, because the NPHC also hopes to start selling globally soon!

Camp GLOW

Filling the Gap in Malaria Prevention Education: The Role of Education Volunteers

Education Volunteers Teach About Malaria in the Classroom

Education Volunteers Teach About Malaria in the Classroom

Getting Education Volunteers on the malaria bandwagon can be a difficult task. They give us a quizzical look before questioning, “Malaria? Isn’t that a health issue? What does that have to do with education? With us?” In truth, malaria has a lot to do with education.

Here in Rwanda, Peace Corps was invited by the Government of Rwanda to work in two sectors- health and education. It’s easy to get Health Volunteers on the bandwagon. Their work in health centers and with Community Health Workers is directly linked to malaria. These are the primary actors in the decentralized implementation of malaria control interventions in the community. Health Volunteers in Rwanda support their activities, including those of malaria prevention and treatment.

Education Volunteers are a bit more difficult to convince of their role. They not so directly involved in malaria activities, making the link between their work and malaria a little more difficult to establish. But, the role of Education Volunteers in malaria control should not be overlooked.

First, malaria causes a significant education burden. Malaria in childhood can lead to impaired cognitive development and is the leading cause of school age absenteeism in Africa. As a result, malaria can greatly hinder a country’s efforts towards development and our ability to achieve the first goal of Peace Corps: to help the people of interested countries meet their need for trained men and women.

Education Volunteers fill a gap that is usually left in malaria prevention education. Health Volunteers and their Community Health Worker counterparts target families, mostly mothers, with key health messages and behaviors. But what messages and behaviors are being promoted to youth in the period before having families? The answer is, not many.

Peace Corps Volunteers manage health clubs

In Rwanda, most students attend boarding schools outside of their communities. As a result, they are away from the influence of their families and responsible for their own choices concerning health. Their schools become their new communities; their peers their sources of influence. What would happen if their environments were malaria-friendly, and their friends informed peer educators?

I would assume that malaria among students in secondary schools would reduce. I would even venture that attendance rates and test scores would increase. Further, empowered youth would return to communities and share their values with families during school breaks, encouraging them to adopt the similar behaviors. The impact would be substantial.

Who will be responsible for engendering change in schools? Education Volunteers work as teachers and are in an ideal position to implement the types of activities that would produce the desired results. What activities am I referring to? Classroom lessons, health clubs, and youth camps are a few examples. I’m sure you can use your imagination to brainstorm more.

Rwanda’s Malaria Volunteers attended a Pre-Service Training for the new group of Education trainees. Our goal was to reject this commonly-held view of the traditional role of Education Volunteers, and inspire a new understanding of the link between education and malaria. Through our presentation, we empowered them to take on a new role in the name of malaria prevention.

Weekly Awesome Senegal: An Extensive Malaria Radio Program

By: Team TEWDU FM (94.0 rajo men oo Diaobe), PC/ Senegal

The TEWDU FM (94.0 Diaobe) Peace Corps radio program has completed the early stages of an audacious, eight show series about malaria. The series has at least three broad goals: to produce high quality mass media communications to disseminate educational messages about malaria; to  involve local health workers, theater groups, musicians, and the everyday listener in show production to increase villager interest and investment in the program; and to increase exposure to Peace Corps and foster a positive representation of Peace Corps activities across the entire catchment area of TEWDU FM.

The series plans to cover a comprehensive malaria curriculum with the following proposed topics:
1) a review of the Senegalese government’s National Malaria Control Program
2) the malaria parasite and malaria transmission
3) prevention strategies (other than an LLIN)
4) mosquito nets
5) symptoms and warning signs of dangerous cases
6) disease and treatment (general)
7) treatment of malaria
8) review

The Show

Each show is paired with a “focus village” within the catchment area of TEWDU FM, and that village receives two visits from volunteers around the time of the show. During the first visit, usually a week or so before the show airs, the team seeks to meet with the village’s health workers to review the curriculum for that specific show, to pretest individuals on specific curriculum points, to take fun audio clips from villagers, and to convene a focus group to listen to the previous show. The day after the show airs, the team returns to that same village to elicit informal feedback, to formally post-test the villagers pretested during the first visit, and to hold a formal training to review and emphasize the curriculum points presented in the previous night’s show.

Pending favorable weather conditions, shows are performed live, using a full script written with the help of a local health extension agent and the polished audio clips from the village of focus. For example, short PSA jingles used by the NGO Malaria No More (MNM) to remind listeners to use their mosquito nets has been one consistent element of each show. The MNM jingles use celebrities such as Viviane (a national sensation in Senegal) and Akon (an international sensation by all accounts), but for TEWDU FM shows, the melody of the jingle combines with the audio of health workers from the focus village.

The first two shows of the series aired on 03 and 17 of September. Initial feedback from the first two shows has been overwhelmingly positive, and the team hopes to improve on these early successes by increasing the involvement of the Senegalese health workers and local musicians and by collaborating with local theater groups. Recall and comprehension of the shows’ content has been mixed. Informal feedback shows that villagers sometime can recall specific points of information presented in the show, but when asked directly for recollection of specific curriculum points, it is unclear if villagers consistently add to their existing knowledge about malaria.

Follow-Up

The “clean up causieries” during the follow up visit to the focus ville are crucial opportunities to ensure at least a small group of the broad listenership has heard all the information presented in the show and has gained understanding of the presented curriculum. The team is making a strong effort to make these trainings as dynamic and effective as possible. For example, during the follow up visit of the second show, the team showed pictures of nematodes in tomatoes and humans to help explain microorganisms in general and provide a perhaps more common example of a parasite.

Next, participants were shown pictures of the malaria parasite. rapid tests were then explained and participants were shown an example of both a positive and a negative test. Village health workers then performed a new test, and the results were read later in the presentation. The villagers were shown a large picture of a female Anopheles feeding, and attention was called to the blood being drawn through the proboscis and the blood filled stomach. To clearly show malaria transmission, the team performed a simple demonstration. In its simplest form, one villager was given a small, clear plastic bag with clear water inside. This bag, it was explained, represents a healthy person’s blood. Another villager was given a bag with water colored by red juice and black ink from a pen. This bag, it was explained, represents the blood of a person sick with malaria (see the parasites coloring the blood?!). A third villager held the picture of the feeding Anopheles and played the role of the mosquito. The PCV played the role of the proboscis, using a straw to draw fluid from a sick person’s bag and to deposit the fluid teeming with malaria parasites into the healthy villager’s bag.

This scenario was re-explained and repeated several times to teach and emphasize different points relating to transmission. For example, what happens if both people in the scenario are healthy?  By combining the radio broadcast itself with a small group training and one on one interviews, the TEWDU team strives to help the focus ville’s gain maximum possible understanding of the content of its show.

Next time you come to the weekly and world renown Diaobe luumo, stick around for the next show. The third show in the series airs (in sha’Allah) on 01 october.

A Busy Month of September in Ghana

By Danny Suits (Photo: PCV Austin Pruett makes an impact while educating his community on malaria)

On Wednesday, September 12, PCV Austin Pruett and I met to plan for an event in the Brong Ahafo Region. Headmaster Clement Boamah of the Stanford Basic School was present and together we agreed to demonstrate in front of the students and the parents the method to make neem cream. The following Friday, September 14th, about 20 young primary school children and about 17 mothers gathered at the school. During idle periods of the neem cream demonstration, myself, Austin, and PCV Andrielle Yost presented alternative prevention methods and basic diagnosis of malaria. The bed net demonstration taught mother’s how to properly care for their nets and the importance of sleeping under them. Andi presented the signs and symptoms of malaria and the importance of early treatment. Austin and I presented a short drama to the small children teaching them the importance of sleeping under a mosquito net. As the presentation ended about 2 hours later individual vials, supplied by the S.W.A.T. bucket, were filled and passed out to the audience while Austin spoke about the potential income from selling the neem cream. The S.W.A.T. bucket is a resource available to all PCVs in Ghana. Each regional representative has a bucket to help support malaria activities in their respective region.

All in all, it was a very efficient and effective presentation. It also presented an opportunity for me to train two volunteers on malaria awareness. Austin introduced a game similar to “tag” to the students of the basic school. The point is that if you’re the mosquito you have to buzz around and “bite” the other kids, unless they are using their friend as a shield (mosquito net). It sends a simple message that mosquitos carry dangerous diseases and can transmit them through biting, which the kids simulate by tagging each other.

PCV Richie Kneski smiles while utilizing the BCS Malaria Flipchart.

Soon after on Thursday, September 24th I convened with PCV Richie Kneski and his counterpart Oscar Oppong in another village of the Brong Ahafo Region to prepare for a malaria awareness event. The event was to occur the following day, Friday the 25th. We decided on demonstrating how to make neem cream, a mosquito repellant that is made from local resources. The event took place after a PTA meeting in the Hani Junior High School courtyard. There were about 175 people in attendance; adults and JHS students were mostly present. During idle times of the neem cream preparation (boiling water, boiling leaves, stirring, cooling) Richie and I presented information on malaria prevention and awareness. Richie discussed signs, symptoms, and costs of treatment versus prevention using supplemental materials from the SWAT bucket. A bed net demonstration was completed by volunteers from the audience while we discussed bed net maintenance and care. We presented multiple techniques for properly hanging a bed net and the appropriate way to store it during the day. The audience took particular interest in the cost of ingredients and the production and sale of neem cream.

We were able to get through most of the BCS Malaria Flipchart while keeping the audience actively engaged. The high-risk, low risk game was played for about 20 minutes and seemed to capture the audience’s attention quite well. At the end of the presentation, samples of neem cream were given to those in the audience who correctly answered questions about malaria and malaria prevention. This batch of neem cream filled about 75 vials.

Weekly Awesome Senegal: An Innovative Representation of the Economic Malaria Burden

By: PCV Ben Gascoigne

Kédougou is one of the regions of Senegal most heavily burdened by malaria. PCV Ben Gascoigne lives in a village of about 950 people 35 kilometers outside the regional capital into the mountains. Ben and his counterpart, Mamba Camara, decided to speak with members of their community about the amount of money they spent on treating malaria last year – a whopping 3,039,100 CFA or 6,078 USD. They hoped to raise awareness of the economic burden of malaria and motivate people to focus on prevention. Community members were impressed by the enormous figure but it was sometimes difficult to conceptualize the real value of such a large number.

To visually represent this figure, shortly after World Malaria Day, 196 sacks—3,039,100 CFA worth of rice—boldly lined the road between the community market and health post. Trained local youth, the community’s health worker, and local Peace Corps Volunteers demonstrated proper net maintenance, led discussions on the economic impact of malaria (e.g., money spent on malaria medication and consultations that could have been spent on food), and demonstrated how to change square nets to round nets for easy hanging. Participants learned that they could greatly reduce the cost of malaria to their families by sleeping under mosquito nets, seeking early treatment for malarial symptoms, and, for pregnant women, by attending antenatal care visits.

The Results:

  • Over 70 community members were exposed to the net maintenance stations and many more were exposed to the rice sack visual display and malaria prevention messages broadcasted through speakers at the health post.
  • 50 people were trained on how to sew torn nets and twenty-one nets with one hundred and thirty-five holes were repaired.
  • 30 people were trained in net-washing and twenty-four nets were washed.
  • 12 women were trained on how to transform a square net into a round net

Scaling Up

The success of the malaria Rice Sack Project in Gascoigne’s village in April inspired him and PCVs Ian Hennessee and Alex Piotrowski to scale-up the event to the regional capital of Kédougou. The event attempted to engage a larger number of PCVs in the region, raise awareness in the community about the economic burden of malaria and motivate people to focus on prevention. In 2010, Kédougou community members spent an impressive 4,466,000 CFA (approximately 9,000 USD) on malaria-related medication and consultations.

Children learn how to properly wash a bed net at the Kedougou Malaria Fair in Senegal.

On June 30, 2012, weeks before the incidence of malaria has been observed to spike at health structures during the rainy season, 308 rice sacks—4,466,000CFA worth of rice—lined a main road in Kédougou between the Kédougou Health Center and the “A Nos Morts” monument/public garden in the center of the city. PCVs managed stations that demonstrated proper net maintenance, lead discussions on the economic impact of malaria (e.g., money spent on malaria medication and consultations that could have been spent on food), and modeled how to change square nets to round nets for easier hanging. PCVs also taught participants to how make a natural insect repellent using Neem leaves (Neem lotion) and how to beautify mosquito nets with stencils of the leaders of the Senegalese Muslim Brotherhoods. Finally, a local theatre group, Gorgoru, performed skits that educated participants about the NetWorks-supported national routine mosquito net distribution at local health structures.

Twenty-six volunteers from all sectors joined together to ensure the success of the Kédougou Rice Sack Project. PCV Ashleigh Baker led the net sewing station, PCVs C.J. Cintas and Kyle Deboy led the net washing station, Piotrowski and PCV Marielle Goyette led the Neem lotion station, Hennessee and PCV LaRocha LaRiviere led the net modification and stenciling stations, and PCV TatHennesseea Nieuwenhuys was in charge of counting every person who attended at least one station.

The Results:

  • Over 230 community members were exposed to the malaria stations and many more were exposed to the rice sack visual display.
  • 19 people brought nets, 77 people were trained on how to sew torn nets, and 43 nets with 364 holes were repaired.
  • 57 people were trained in proper net- washing and 31 nets were washed.120 were trained to make Neem lotion.
  • 81 people were trained in net modification.
  • 66 people were exposed to the net-stenciling 11 participants received a stencil on at least one net, and another 55 people observed the net beautification/stenciling process.
  • Additionally, 124 people, some from the stations and some passersby, watched the theater performance about malaria, net maintenance, and how to obtain a net through the NetWorks-supported national mosquito net distribution at local health structures.

Participants and observers learned that they could greatly reduce the cost of malaria to their families by sleeping under mosquito nets, seeking early treatment for malarial symptoms, and, for pregnant women, by attending antenatal care visits.

PCV Ian Hennessee demonstrates how to transform a square bed net into a circular bed net at the Kedougou Malaria Fair in Senegal.

After a month and a half of preparation as the project approached, Hennessee, Piotrowski, and Gascoigne worked sunrise through sunset. The PCVs backs were sun burnt and arms were scratched all-over from stuffing rice sacks with dead grass. They made new friends through the theater group and realized the potential of volunteer collaboration. Gascoigne says he is excited to see the malaria work in PC Senegal and other countries across Africa grow and evolve through volunteer projects and the Stomping Out Malaria in Africa initiative. He is proud to be part of such a talented and motivated group of individuals.

The project created a lot of buzz in the city. The radio spots and rice sack visual sparked conversation about the economic burden of malaria. The data collected from the event is being reviewed and will be published along with a formal case study on PCSenegal.org and Stompoutmalaria.org.

Watch the video of Ben’s Rice Sack Project in his village below.