Wednesday, May 11, 2016

Ladji(stics): Bringing Malaria Prevention to the Masses

Most volunteers in Benin are placed in small villages to mid-sized cities, where we get to know our communities and work with them to assess and develop upon their needs. While all of us pass through Cotonou, some on a more regular basis than others, we rarely encounter urban poverty. This year, in honor of world malaria month (which we are celebrating from April 1-May 15 here in Benin), the Peace Corps and it's Benin Against Malaria Committee (on which I am an officer) partnered up with the community health center in Ladji named La Vie Nouvelle (the new life) to address malaria in the community.

Mathias going out to survey the community on their bed net needs.
Walkways are packed down trash on this landfill island.
Ladji is a large village, with a population of over 10,000, built on the shores and on Lake Nokohe. If you google Benin, you will likely pull up an image of houses on stilts, hovering over the water. This is one of those communities. Located about 20 minutes from the heart of Cotonou, this area is home to Cotonou's most impoverished: fisherman, farmers and small scale entreprenuers. This mini-city starts where the paved road ends, and much of it is built up on piles of trash, making it a man-made landfill island. While there are many other hygiene and sanitation issues that we could focus on, our project focused on malaria, behavior change and insecticide-treated net use.

On April 25th, 2016, in commemoration of World Malaria Day, we launched our week-long campaign to reduce the burden of malaria in Ladji. After a week of insane logistics: think distributing nets to over 1400 households, some of which are only accessible by boat, local leaders, including representatives from the Ministry of Health and military forces, kicked off a special ceremony and acknowledged the absolute necessity to address the issue of malaria in the community. Traditional stilt dancers and a local singer performed, also urging the community to mobilize in the fight against malaria.

Surveying using the CommCare Application!
You may think handing out nets is easy, but the Peace Corps has developed a strict protocol to control the number of nets distributed based on the family's needs and conduct follow up on proper net installation. After one day of training, which included malaria behavior change communication and instruction on the Peace Corps developed CommCare application for Bed Net Distributions, teams of local volunteers and PCVs dispersed into the community to conduct a bed net needs assessment. Walking house to house, or using boats to reach houses on the lake, the teams surveyed 1478 households, representing a total population of 9681 people. The application prompts surveyors to input the number of people living in the house (including children and domestic help) and the number of nets in good condition. Using the application to store household data and calculate the total need for mosquito nets in the community, based on the rule of 2 people per net, volunteers prepared to distribute 3422 nets over the course of two days.

Spread across five different distribution sites, PCVs and their partners from La Vie Nouvelle conducted 40 malaria behavior change communication sessions for 1331 people, including 147 pregnant women. We hit some challenges when a huge rain storm rolled in, turning the dirt roads to impassable mud puddles, but people were motivated to receive their nets and attend the educational assemblies. These sessions covered the importance of sleeping under a mosquito net, discussed the myths of malaria transmission and counseled on proper net maintenance and repair for long term malaria prevention. Using the android application, community members signed for their nets and PCVs were able to monitor the number of nets distributed in real time. This was the first time that the application, built by Benin PCVs, was used in a large scale bed net distribution, and we couldn't have done it without it!! It was an invaluable tool for coordinating the distribution of nets and tracking community participation.
Recipients sign for their nets after receiving a lesson on malaria prevention!

In one month, a team of volunteers will return to Ladji to conduct follow-up on the distributed nets, collecting data on who is using them and whether they are properly installed. As the coordinator for this initiative, it was the first time I had the opportunity to coordinate a large scale project, training and mobilize a group of volunteers. It was a great experience in problem solving, patience and the end result was knowing that many people are now protected against malaria. On the last day, I also had the opportunity to sit down with a journalist from BB24, the Beninese National TV station, for a 52 minute segment on malaria in Benin. I'm still waiting on the video, but it aired that night nationwide! I guess that makes me TV famous!
The happy recipient of a new bed net and the Director of La Vie Nouvelle

As World Malaria Month comes to a close, it's important to recognize our commitment to the fight against malaria. Volunteers distribute bed nets, conduct malaria behavior communication change in their local villages, and share the message of malaria prevention on the radio to be broadcast locally and on buses that cross the country everyday. The success of the distribution in Ladji showed us that, as a team, we can contribute to the progress made under the Millennium Development Goals and build on it to “End Malaria For Good.”

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