The month of April is ‘Malaria Month’ for Peace Corps Volunteers because April 25th is World Malaria Day and so we are taking the entire month of April to do Malaria related activities in our communities. I truly believe in the grassroots model of development that PCVs use to create change but I ran across this article in the BBC today about malaria that got me thinking about the effectiveness of some initiatives. http://www.bbc.co.uk/news/health-22120936
The article, Malaria hotspots ‘need new approach’, talks about how in areas where malaria incidences have fallen overall some specific populations have actually seen an increase. For example, “In Sri Lanka, where malaria incidence fell by 99.9% between 1999 and 2011, the proportion of infections in men rose from 54% to 93%.” And so it is suggested that “More sophisticated and targeted approaches to identifying those people who are infected, and responding promptly and effectively, must be put in place.” I’m not entirely sure if Madagascar would be considered a Malaria hotspot that needs a new approach but I think there could be some improvement on where efforts are focused.
I live in the highlands of Madagascar where winter is already setting in and there is a significantly lower rate of malaria prevalence. According to the hospital in my town most of the malaria infections come from people who were traveling along the coast. So, while aid organizations can successfully report X number of mosquito nets were distributed in Madagascar the more important question is WHERE were those bed nets distributed and WERE THEY ACTUALLY USED!? Even along the coast you can find bed nets being used for everything under the sun, except for malaria prevention. That, however, can be a whole other issue that aid organizations face all the time.
I guess what I’m trying to say is that while Malaria is still causing many unnecessary deaths in Madagascar each year, Madagascar might just need some sophisticated and targeted approaches to 100% eliminate infections. Peace Corps Madagascar is trying to do just that by focusing Health volunteers along the coast and making Malaria education a priority. In no way am I trying to beat up on any organization or initiative but I think anyone in development should always be assessing and reassessing the true effectiveness of their efforts. Organizations working at the ‘grassroots level’ are constantly trying to find a way to put a number on the effect they have on a community but if financial backers only look at these numbers, they’re going to miss the real picture. And, if financial backers push for numbered results, they could end up with ineffective efforts, like focusing bed net distribution in low malaria prevalent areas (just an example).
All that being said, I’ll use this month as a reason to talk to different people about Malaria and stress the importance of prevention and seeking medical help if symptoms suggest malaria because I know people in my town are not immune to Malaria. As far as competing with volunteers in other regions, my hat goes off to those on the coast who are working in areas that see much higher rates of Malaria infection because the need is that much greater.