4.07.2015

Combating Malaria in Ngatt

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.
Grassroots Soccer

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.
Certificate Ceremony after Grassroots Soccer

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
It’s a sad reality that malaria is so deadly, but yet so commonplace and ‘normal’ in Cameroon. Peace Corps Volunteers and community health workers face the tough challenge of convincing people to change their behaviors by using mosquito nets, seeking treatment, and actively trying to avoid malaria rather than accepting it when it comes. It’s most definitely discouraging work that sees little progress in the short time we are in our villages, but I think we all hold out hope that with enough education, slowly but surely people will start taking their health into their own hands for the sake of themselves, their family, and their community.

2 comments:

  1. Good morning, how are you?

    My name is Emilio, I am a Spanish boy and I live in a town near to Madrid. I am a very interested person in knowing things so different as the culture, the way of life of the inhabitants of our planet, the fauna, the flora, and the landscapes of all the countries of the world etc. in summary, I am a person that enjoys travelling, learning and respecting people's diversity from all over the world.

    I would love to travel and meet in person all the aspects above mentioned, but unfortunately as this is very expensive and my purchasing power is quite small, so I devised a way to travel with the imagination in every corner of our planet. A few years ago I started a collection of used stamps because trough them, you can see pictures about fauna, flora, monuments, landscapes etc. from all the countries. As every day is more and more difficult to get stamps, some years ago I started a new collection in order to get traditional letters addressed to me in which my goal was to get at least 1 letter from each country in the world. This modest goal is feasible to reach in the most part of countries, but unfortunately, it is impossible to achieve in other various territories for several reasons, either because they are very small countries with very few population, either because they are countries at war, either because they are countries with extreme poverty or because for whatever reason the postal system is not functioning properly.

    For all this, I would ask you one small favour:
    Would you be so kind as to send me a letter by traditional mail from Cameroon? I understand perfectly that you think that your blog is not the appropriate place to ask this, and even, is very probably that you ignore my letter, but I would call your attention to the difficulty involved in getting a letter from that country, and also I don’t know anyone neither where to write in Cameroon in order to increase my collection. a letter for me is like a little souvenir, like if I have had visited that territory with my imagination and at same time, the arrival of the letters from a country is a sign of peace and normality and an original way to promote a country in the world. My postal address is the following one:

    Emilio Fernandez Esteban
    Calle Valencia, 39
    28903 Getafe (Madrid)
    Spain

    If you wish, you can visit my blog www.cartasenmibuzon.blogspot.com where you can see the pictures of all the letters that I have received from whole World.

    Finally, I would like to thank the attention given to this letter, and whether you can help me or not, I send my best wishes for peace, health and happiness for you, your family and all your dear beings.

    Yours Sincerely

    Emilio Fernandez

    ReplyDelete
  2. Dear Karen,

    Thank you very much for the kind comment that you have put in my blog, of course I will send a message to you when your letter arrives to my mailbox in order that you can see their picture published at my blog.

    I send you again my sincere wishes of health and happiness to you and at same time, I hope that you can make your work in Cameroon in a pleasant way.

    A hug from Spain

    Emilio Fernandez

    ReplyDelete

Hello there! Thanks for reading my blog and leaving a comment! I moderate and approve all comments just to make sure they aren't spam, because let's face it, we get enough spam in our lives as it is. So as long as you're a human being, you should see your comment up here in a few hours along with a response. Cheers!