|Malaria Education Session in Ngaoumere|
Yesterday evening, the winds picked up, the sky darkened, dust swirled around to imitate a small, weak tornado, and then suddenly – I heard it: the pinging on my tin roof. It was the first sign that the rainy season is approaching. It has been unbearably dry, hot, and dusty lately as the end of dry season rears its ugly head. Food is scarce, and water is scarcer. What water I do manage to find to bathe, drink and clean with is the color of my bright red hair from all the dirt that falls into the few wells which have a scant amount of water remaining. People stay at home, choosing to nap in the heat of the day rather than be enervated by the blistering sun. The hospital is quiet except for a handful of cases every day from waterborne diseases, such as typhoid.
Most people in Ngatt are anxiously awaiting the start of rainy seasons in April. They know that with rainy season come mangoes, oranges, and avocados; it is a time to start sowing crops, which means an increase in income; it’s also a time when the heat lessens and everyone can go about their life again. What they don’t often realize, however, is that while the rain, their work outdoors, and increased plant growth means the end of some of the burdens of dry season, a new enemy arrives: malaria.
Malaria is a serious public health problem throughout Cameroon. Many Americans are often shocked when they hear that most of us PCVs get malaria at least once, if not several times, during our service. It’s known as a deadly public health menace all around the world, but here in Cameroon, it is business as usual when you have malaria. Unfortunately over the years Cameroonians have been so accustomed to having malaria that it long ago lost its shock value. Not to mention, many Cameroonians still have false information about malaria.
Locals joke with me about why I educate them on malaria when it’s considered a ‘normal’ burden of life for them. What they don’t seem to understand, however, is that while they might be able to go about life as normal when they have malaria, there are certain groups who are more vulnerable, such as young children, pregnant women, and people with HIV/AIDS, for whom malaria can spell death. And while many Cameroonians feel like malaria isn’t too big of a deal, they don’t comprehend just how much they spend on malaria treatment per year, which they’d be able to save if only they slept under a mosquito net.
People in Ngatt know of malaria, or as it is called in Fulfulde pabbooje. They are used to having it annually, and they thankfully know that when it’s bad enough, they need to seek immediate medical care. However, many people hold false ideas about malaria, such as it is caused by water, or it is caused by mangoes – both of which are easily believable for them since malaria cases skyrocket at the start of rainy season, which brings both lots of mangoes along with the abundance of rain. Most people know that the best method of prevention is a mosquito net, and many of the Fulbe do indeed use their mosquito net that was given to them by the Global Fund a few years ago. The Gbaya, however, prefer to use theirs to fish with or use it to catch those delectable termites.
The Cameroonian government recently released a tiered payment system for malaria treatment.
Treatment and testing for children under 5 is free, while pregnant women pay 4,000cfa ($8), and all others pay 8,000cfa ($16). This price includes testing, medicine, a quinine perfusion if necessary, as well as hospitalization costs in the case of severe, cerebral malaria. Between February 2014 and February 2015 we had a total of 38 positive cases of malaria in pregnant women at our health center, which represented 5% of overall 666 positive malaria cases last year. These 38 pregnant women paid 152,000cfa ($300) for their treatment. It’s absurd that these 38 women caught malaria in the first place, given that all pregnant women who go to their pre-natal consultations receive a free mosquito net as well as a prophylaxis medication. The challenge to eradicating malaria during pregnancy is a problem of behavior change communication, which means working endlessly to convince someone to change their daily habits. It is exhausting and takes time.
While pregnant women spent nearly $300, all other adults from age 6+ spent a whopping 2,896,000cfa ($5,700). Positive malaria cases for people aged 6+ nearly equaled the number of positive cases of children 5 and under. While we have a large under 12 population in Ngatt, it’s absurd that the number of cases under 5 equal all those over the age of 5. What this suggests is that parents take malaria seriously in their children when all treatment and testing is free, but once they have to start spending the $16 for treatment, they stop taking their loved ones to the hospital, choosing instead to go to traditional doctors or directly buy less effective medicines from vendors in our local market.
Over the next month, I’m doing a series of malaria activities in my community, namely a grassroots soccer malaria curriculum and presenting on malaria in Ngatt’s weekly market in an effort to increase education ahead of the arrival of rainy season. These last few weeks I finished two “Grassroots Soccer – Malaria” curriculums with the primary school and another with neighborhood kids. All the kids knew of malaria and have had it at one point, but they had varying opinions on what causes malaria and how to prevent malaria. The kids at the primary school knew a little bit about malaria, but the whopping majority of kids in my GRS activity in my neighborhood proved to know next to nothing about the transmission of malaria. After a few activities, the kids had a much better understanding of malaria, but still failed to take malaria seriously.
|What a Stank Face from this Sassy Girl|