Tuesday, June 10, 2008

655 lives saved, thousands to go

Well, it's over! Sort of... Last thursday and friday we distributed 4700 mosquito nets to Kakoro and Tekwana Parishes. So now we wait and see if there are any significant drop in malaria cases and deaths. Only time will tell, but so far, the signs are good. Before we started the distribution, my supervisor Kateu and I moved around the community visiting some homes and the local health center to get a gauge on how things have changed for the 5 parishes that recieved nets 6 months ago. Well, the results weren't overwhelming, but they were promising. A more extensive survey needs and will be done. According to the local health center III, which covers the sub county, of the approx. 400 cases of malaria reported between February and June, 70 were from 3 of the parishes that we distributed to and the remaining 300+ cases were from the 2 parishes that we hadn't reached yet. The other 2 parishes that we distributed to mainly use the local hospital and we have yet to get concrete data from them. What was the most eye-opening thing about going through the HCIII's log book, was that almost every case was for malaria. Of the maybe 20 cases they'd see a day, only 1 or 2 would be for something other than malaria. I knew it was a huge problem, but when you see the evidence, it's amazing in a horrible way. So we'll do an extensive research before I leave and present the results to you, the supporters of this fight, and the donor organization.

As part of our research, we visted a CMD (village volunteers that distribute drugs and created our list), talked to a group of people in a small trading center, and visted the home of one man. This experience was positive in the fact that people said they were happy that they recieved nets and that malaria no longer crippled their family, but then they went on to tell us their other problems and that's when I started to feel drained. The CMD said that he didn't have records of people coming to get malaria treatment from him. I was suprised, because that's his job. "Why didn't they come?" I ask. Because they haven't received doses Coartem, a malaria treatment drug, from the government health center in over a year. So even though people have nets now, they can't get treatment without traveling long distances to get it. This infuriates me, cause there is no good reason why the drugs aren't reaching the CMD's and ultimately the people. I'm not going to use this blog to point fingers or place blame. However, the fact of the matter is that mosquito nets are only one part of the fight against malaria, and if treatment isn't available, then people will continue to suffer.

After we visited that guy, we went to another man's compound deep in the village. He had 2 wives and 19 children. He was very grateful for the 6 nets he received, but said it wasn't enough to fully cover his children. "Why didn't you receive more?" I asked. "Because our name was at the bottom of the list and when they got to us, they were running out of nets." ....sigh... They were running out of nets because the people who made the lists didn't count right and we didn't have time to double check. "But has malaria gone down in your family?" "Oh yes, it has" "Great!". Then we asked him what other health issues were affecting his family that my organization could possibly help with in the future. TB, scabies, worms, malnutrition, lack of shoes and school materials, etc. ...sigh... I'm drained just writing this.

So this is can seem negative, but it's what's really going on. I remember when my parents came, my dad and I were out front of my house just hanging out and he asks me thoughtfully "What would it take to change things here? Where do you start?" Well, we're starting with malaria control and then opening a nursing college to add trained health professionals to the area. That'll have margnial impact for the schools, infrastructure, and economic development of the area, but it's a start. The thought is that this will have a domino affect on the community and the long term result will be a better standard of living for the people that I now serve. It's a little overwhelming, but not impossible. Just because it's hard, doesn't mean you give up. I want to thank everyone for their hard work and support and even though it might not sound like it, what you did IS making a difference. Some people in Peace Corps are a little jealous that my big project is so tangible meaning that you can see the effects versus if you talk about issues in schools or train some people in a skill. However, they're wrong. People have nets and that's great and there already has been immediate effects. How that manifests itself long term is still to be determined. I have faith that things will get better for people and the fact is, malaria will go down, and I can't think of a better way to spend money in a rural African village. People complain that international donors don't really do anything but give people false hope and hinder self sufficiency and development. I think that's wrong. If a school is built, kids will learn. If someone has a net over their bed, then they're better protected against the most deadly disease. It is the role of government and the people to fill these needs, but in the absence of an efficient system, donors have to step in or more people will die unnecessarily. When you start with nothing, something is always better whether it gives some people in the community the wrong impression about foreigners or not. I don't care. That person's kid is going to have a little better life and that is all that matters, to continue to chip away at extreme poverty and disease.

The Against Malaria Foundation has a chart on their website that has a mathematical formula that claims that for every 20 nets distributed, 1 person's life is saved. Congratulations everyone, you helped save 655 lives. The fight isn't over and I thank everyone for all their support. Today's my birthday and I miss all of you very much. Take care,