All About Malaria

 Here in Peace Corps Burkina Faso, we celebrated Malaria month in April, with World Malaria Day being April 25^th. So this blog post is a little late. But it's definitely still relevant, and actually matches up quite well with my current Malaria education-dominated activities at site. I was on vacation for most of April, traveling around China and Indonesia with my family, thus minimizing opportunity and motivation to really do any projects at site that month. Then, in the beginning of May, one of my counterparts and I attended a training on Malaria and HIV/AIDS in Fada, giving us the tools and a starting place for activities. We are currently heading into the rainy season in West Africa, and while rain does bring cool breezes and sprouting plants, it also means mosquitoes arrive and reproduce in hordes. From now until about September, the health clinics and hospitals here are going to see many cases of Malaria.

Malaria is the number one killer in Sub-Saharan Africa, affecting more people than HIV/AIDS. In Burkina Faso in 2009, there were 4.5 million cases of Malaria and it caused 54% of hospitalizations and 8000 deaths. This disease is entirely curable and mostly preventable. To address this issue, Peace Corps has implemented a continent-wide program, Stomp Out Malaria, to improve Malaria education and lower the number of deaths that occur due to it.

All I knew about Malaria before coming to Burkina was that it's transmitted by mosquitoes, it's present in tropical climates, and you should take pills to keep from getting sick. So for those of you who, like me, are lacking in tropical disease knowledge, here's a brief overview: There are a couple different types of Malaria, but the most common form is caused by a parasite called Plasmodium that lives in blood. Not all mosquitoes transmit the parasite; it's mostly female anophele mosquitoes that are out between dusk and dawn (mosquitoes feeding during the day are more likely to transmit dengue fever, another disease you probably want to avoid). Simple Malaria can cause fever, chills, body aches, diarrhea and vomiting. In other words, symptoms that can also come from many other diseases. That's why a blood test is needed to accurately diagnose Malaria. If simple Malaria is left untreated, it can become more complicated, resulting in seizures, brown urine, anemia, difficulty breathing, jaundice, and intense fatigue. It's especially dangerous in children under 5 and pregnant women.

It's pretty probable that I already have Plasmodium in my blood stream. Peace Corps requires that all volunteers take a malarial prophylaxis that basically keeps the symptoms from developing, and then at the end of our service, we take even more pills to kill any parasites that might exist in our bodies. We PCVs have to do this for 2 years, but for Burkinabe, preventative pills are not cost-efficient or even possible. So, it's best to try to avoid being bitten by infected mosquitoes.

In Diapaga, my counterpart and I have been holding sensibilisations with women in the community and schoolchildren to teach them about Malaria. When we talk to children, it goes something like this:

1. Ask them if they know what Malaria is and what causes it (children are pretty good at answering this, though it's often just the textbook definition they recite).
2. Explain how Malaria can be transmitted from person to person and play a small game to demonstrate. About 8 children come to the front of the room. One is chosen to be the “mosquito” or “person with Malaria” while the others line up against one wall. On the count of 3, the other children try to run past the “mosquito” but if he tags them, they become “infected” and help the “mosquito” tag others. After a few rounds of this, all the children will become “infected.”
3. Describe methods for avoiding mosquito bites, such as the use of a mosquito net (after a national campaign in 2010 to hand them out, almost all Burkinabe families have mosquito nets. However, many rarely use them.), getting rid of stagnant water in the courtyard, insecticides, skin coverage, and using mosquito repellant cream (more on this later).
4. Ask if the kids have any questions and dispel traditional Malaria myths. For example, many people here believe eating shea fruit can cause Malaria. It's our job to explain that Malaria can only be passed from person to person by mosquitoes, and abundance of shea fruit correlates with increase of rain, which also correlates with increase in Malaria cases. Classic case of correlation being mistaken for causation.
5. Review information given and teach the kids the “Malaria clap.” Clap, clap, scratch your arm. Clap, clap, slap your other arm. Clap, clap, clap around in a circle. Kids usually get a kick out of that.

When my counterpart and I talk to groups of women about Malaria, we also include a section on neem cream production. Neem is a type of tree here that has many useful properties. Its wood is sturdy and used for construction, its branches are often used as makeshift toothbrushes, and its seeds and leaves can produce pesticides and mosquito repellant. Obviously, that last quality is what makes neem important in Malaria prevention techniques. A lotion/cream repellant can be made by simply boiling neem leaves, then adding hard soap and shea butter to the neem water. In Diapaga, neem cream has been a hit. My counterpart and I have already taught over 50 women and children how to make it, and even more want to learn. My counterpart's association has been selling the cream, which, with the low cost of inputs, can lead to a decent amount of profit. So hopefully neem cream will end up being a successful business venture and Malaria prevention method!