Malaria training: Take 1

Sunday was our scheduled information session on Malaria. I had presented the idea a week before to the 6 helth committee members that were present. If I held information sessions once a month they could share what they learned with their respective villages and at the same time gather information on local prespectives concerning the health topic. Since there is one member representing each satellite village this could ideally reach a wide percentage of the population. The members seemed enthusiastic and so I went home to prepare.

I created a technical information sheet on the signs/symptoms, methods of prevention, treatment and groups that were at a higher risk than normal of contracting malaria. The health records have shown that the highest number of cases of malaria occur from August - September after the rainy season has subsided and the increase of mosquito breeding grounds has done its damage. Since we are on the verge of the rainy season I considered this to be a good time to be clear on ways to avoid getting sick and to whom this disease could potentially be fatal. As soon as the rain starts the majority of the local population will move out to live next to their fields which can be anywhere from 1 - 10 km from their house in village. Basically everyone will be dispersed and an audience for health information sessions will be hard to come by.

Our health session on malaria was scheduled for a week after the monthly health committee meeting. I arrived to find two out of seven members present and decided to wait to see if any more would show. An hour later I decided to get the show on the road. It's always a hard call to wait for more people or begin with those you have. If you wait too long then the ones who were there from the beginning will tell you they have to get back to work but the ones who have yet to arrive will always say they are on their way.

I asked if the new midwife, Ida, would like to join us and thankfully she obliged. As it turns out the president of the health committee is more comfertable speaking Jula then french and she is fluent. So for the next hour I presented in french, Ida would translate to Jula and the president would translate to Sonhrai for the treasurer. Honestly who knows what the final message was, hopefully something about sleeping under a bednet as I repeated myself maybe 30 times to emphasize the importance. Of course at some point it was going to be mentioned that there are people who are too poor to afford the $3 mosquito net that can sleep 3. No matter what the problem this argument will be used to contradict any solution that is proposed. My response was quick and simple, doucement doucement, little by little, they have to save. I could see their doubt but that could also have been disappointment that I did not offer like every other 'nasara' they have met, to help pay for it. They have grown accustomed to 'if you ask, you shall receive...' that their initial reaction is to serch for funding instead of paying it themselves. When the funding runs out they do not look towards internally available resources but instead towards who would be willing to support their efforts.

While clearly it is a constant struggle when there is never enough, I still think this illustrates a larger problem concerning their priorities. They are willing to pay for the medication when someone becomes too ill to stand and all traditional methods have failed; but to pay for a method of preventing said illness is just not considered. I tried to illustrate the cost and benefits of pursuing a means of prevention rather than treatment. Clearly it makes more sense considering the costs of treatment triple as compared to those of prevention. While my audience agreed and nodded enthusiastically I could tell they were not convinced and that it will take more time. We shall see what the future brings and of course I will keep you updated.

Hope all is well wherever you are and take care!