Thursday, April 12, 2012

What I love about malaria work.

World Malaria Day is coming up on April 25th, which for those of us in the malaria field means that Christmas is coming in the springtime.

For a year now, I've been Peace Corps Senegal's malaria person. After my two years in village, I came up here to Dakar to coordinate volunteers' malaria work and give them what support I could. I was also charged with beefing up our relationships with other organizations in Senegal, like NetWorksSpeak Up Africa, and Malaria No More. I've been in a great position to see the way malaria interventions are changing here in Senegal, and to watch as new volunteers come in with amazing ideas about how to fight malaria in their communities. Again and again, I have been blown away by what we can do together, and as World Malaria Day approaches, I've been reflecting on the past three years. I really believe that I work for the Peace Corps program that's doing the best malaria work on the continent. It was a messy road, at times, but it's been worth it.

The first health talk I ever gave in village was horrible, and it was about malaria. Each family in the village sent two women to hear me talk about the signs and symptoms of malaria and to watch me make neem lotion, a mosquito repellent made of cheap or naturally occurring ingredients that are easily available in rural Senegal.

It was a bust.

Having just been installed in the village about two weeks beforehand, I barely spoke enough Wolof to keep myself out of trouble, let alone talk about a complicated disease like malaria. I had made neem lotion before, during our brief but intense time in training, but never before a curious audience, and never by myself. As I poured in the shavings of a bar of soap, which melt in the neem leaf-infused boiling water, an exasperated lady in the front row of the crowd shuffled up to me. Grabbing the large spoon out of my hand and shooing me from the pot, she rolled up her flowing sleeves and started stirring powerfully. Apparently, I needed to be taught how to stir. Watching the soap dissolve, I wondered what the hell was I going to be doing in this village for the next two years. I couldn't be trusted with the simplest of daily tasks, so it didn't seem possible that I would be much of a community health educator.

A neem lotion causerie at the end of my service, when I had figured out how to stir.

At first, Senegal and I found one another mutually confounding. Babies cried when I, the white ghost, approached for their monthly weighing. Women my age with three children didn't understand why I didn't want a husband. Men in garages didn't know what to do with the dirty girl dressed in a tank top and a traditional Senegalese wrap skirt, who spoke choppy, aggressive Wolof and refused to pay the tourist price for her car fare. I occasionally forgot some of the conventions of politeness in Senegalese culture, once, for example, passing a market lady a handful of change with my forbidden left hand.

Luckily, and to my eternal wonder and joy, humans get better at things as they go along. I spent two years learning Wolof, getting to know the 300 people who chose to share their village with me, and found out more and more about malaria and the role it plays in the lives of the Senegalese people.

Malaria costs Africa $12 billion dollars a year. Malaria kills a child every sixty seconds. The numbers vary, but the total estimated malaria deaths range from 655,000 to a million every year. The vast majority of people who fall victim to malaria are pregnant women and children under 5 living in sub-Saharan Africa, which is great news, because that's a demographic that doesn't have enough difficulties to deal with in life.

And the real kicker? Malaria is a preventable and treatable disease.

Preventable and treatable. It's like someone in the States dying of a cold.

My slow grasp of these facts and my growing rage came upon me as I continued to integrate into my community in Senegal. I lived in a hut of my own, with mud brick walls and a thatched roof that housed a number of small birds, mice, and a couple of plump snakes. The hut had been built in the compound of the Gningue family, who took me in as if I were their very own, if slightly stupid, daughter. My host father introduced me around the village and helped me keep my hut standing through the windy rainy season and the hot dry months. My host mom dressed me up and took me to baptisms, weddings, and funerals, where she helped me become a part of the community of women who do so much of the work in the village. The children listened to me practice my Wolof, and laughed as they corrected my grammar and pronunciation.

Together, the community taught me what it was, what the members valued, what they wanted from their lives and from each other. They taught me how they saw malaria, what they thought of this threat to their lives, what they knew to do when they got sick. They helped me understand why they couldn't pay the $4 to buy a mosquito net, even though they knew that sleeping underneath one every night would protect them from being bitten by the mosquitos that spread malaria. They talked about being too scared to go to the health post to seek treatment for a suspected case of malaria when their infant sons and daughters became ill, even though they knew the disease was so dangerous. They surprised me with their knowledge and resources, and saddened me with their matter-of-fact statements about their perceptions of the limitations on their lives.

Over the first two years of my time here, the people of the village turned every idea about public health I had on its head. Not only did I have to learn how to stir a pot of melting soap slivers, I had to start at the absolute beginning when it came to figuring out how health care and malaria prevention education should work.

Luckily, Peace Corps get all this. Peace Corps Senegal, maybe especially so. Our volunteers are motivated, excited, thoughtful, and well-informed. When they are installed in their new villages, their new homes for two years, they're ready to study up. They find out everything they can about their communities, the health priorities there, the barriers to seeking health care, and what diseases cost the people the most.

I've written about malaria a few times on this blog. But I want to invite you all to be a part of something bigger than that.

April is Blog About Malaria Month, and April 25th is World Malaria Day. Peace Corps Volunteers, community health workers, NGOs, and other actors across Africa are rolling out anti-malaria interventions all this month. We're pioneering new techniques and scaling up old interventions, writing blog entries and op-eds and letters home. By the end of this month, more Africans will know how to protect themselves and their families from malaria than ever before. And more westerners will understand this disease and the crippling effect it's having on this continent than ever before.

Haven't you heard? Africa's going to end malaria by 2015. Find out more.

This is the time, guys. And I couldn't be happier or more thankful to be a part of it.

Love and guts,