World Malaria Day

             In his book Better, Atul Gawande says “When you make an effort, you find sometimes you are not the only one willing to do so.” I have had the good fortune to recurrently experience this insight during my service and, in today’s blog post, I’d like to talk about a foremost example, my school’s World Malaria Day event.

Malaria is endemic in Tanzania; half of the nation’s population is affected. Every five minutes, one Tanzanian dies of malaria, with the majority of deaths coming from the especially at risk group of children. Not only is Malaria is the #1 child killer in Tanzania, 1 in 5 children under five years old die of malaria related diseases. Statistics aside, probably the most harrowing experience I’ve had in Tanzania occurred when my youngest homestay sister, Swadia, contracted malaria. I had only been in country for a month, so I did not know the grim outlook for any Tanzanian child with malaria but, at the time, I was certain she was going to die. Because Swadia was so young and I was just learning Kiswahili we had to manage a different system of communication. Mostly, we communicated through smiles; hers was one of the most heart-stoppingly beautiful things I have had the privilege to witness. When Swadia had malaria, not only were there no smiles, she was too ill to stand or feed herself. Combine that with her inability to keep down fluids and Swadia was only getting worse. Seeing a child in such pain is heartbreaking and, looking back at my journal, my uncertainty and inaction racked my conscience. Luckily, my homestay family was well-off and recognized the need to hospitalize Swaiba; after a four day hospital stay, Swadia recovered. Most Tanzanian children aren’t so lucky.

Even if I’m rarely exposed to the lethality of the disease, malaria’s toll is something I see daily. Teachers and students frequently miss school because “wanaumwa malaria kidogo” (they’re just a little sick with malaria) and my neighbors have been hospitalized because they let their malaria progress unchecked and untreated. The frequency of hospitalizations, prevalence of mosquitoes, and bi-weekly discussions of “who has malaria” are constant reminders of the looming specter malaria imposes on my community.

So, it was my pleasure this past Friday to discover the enthusiasm with which my school tackled World Malaria Day. For me to take any credit for the event, beyond simple initiation and organization, would be disingenuous; my colleagues all took it upon themselves to understand and perform their roles as teachers exceptionally and my students were active and engaged participants throughout the day. The fact that all of them put up with my organizational skills speaks to the enthusiasm they showed towards the program.

Kiuta's teachers and students during the parade

The day started at Kiuta Day Secondary School, with an introduction about the global and national impact of Malaria. Students and teachers then signed posters proclaiming, “We are fighting to Stomp Out Malaria,” which the school then used while parading and chanting anti-malaria slogans through Kiuta Village. The students set off at a jog and would have continued all the way to neighboring Mkunya if I didn’t sprint up to the front of the procession. It could have used a drum major.

One of my Form IV students pledging to "Stomp Out Malaria!"

PARADE!

For the day’s main educational activities, students were split into four equal-sized groups which rotated through four teacher-run stations. By the end of the day, every student went to a 25 minute session that:

• 
  used a game (sharks-and-minnows, meet bed nets-and-mosquitoes) to detail the importance of bed net use and the impact self-protection has on community malaria risk

Form I students learning about bed nets

• featured a bed net demonstration and discussion on the lifecycle of the malaria parasite

Form I loved the bed net demonstration

• recorded statistics of student malaria prevention compliance and emphasized the active role students must take to prevent malaria
• used student input to dispel local misconceptions about malaria.

The main points of each session were recorded on poster papers that will be hung in the students’ classrooms so the day’s primary educational points can persist.

At the end of the day, I presented the school with three new footballs in thanks for their support for and hard work in malaria education. After the students went home for lunch and Friday prayers (Ijuma being the Muslim holy day), we celebrated a successful day by having a soccer match with our newly acquired balls. Somewhere, the Good Year Blimp expounded Ice Cube's virility.

Malaria Haikubaliki

The day was, in my opinion, a great success; however, I can’t help but be honest. Will this World Malaria Day event truly affect my community’s behavior? I have my doubts. Sometimes, I fear that education is much less effective at changing behavior than many of us would care to recognize and the necessary convenience that leads to behavior change will be borne by still far-off development. Then again, my doubts aren’t strong enough to stop me from trying. Also, minimal results probably speak more to my and other responsible parties’ failure to properly educate than the virtues of effective education.

What I’m trying to convey is that, like all of my experiences in Peace Corps, World Malaria Day left me feeling hopeful, just a little uncertain, and incredibly thankful. While I believe my students and colleagues got something out of the day’s activities, I know I benefitted tremendously from this experience and can’t stress how thankful I am to everyone who helped make this event happen: the community of Kiuta Secondary School, John Hopkins University’s malaria program, my Aunt Barbara and Uncle Tony (thanks for the soccer balls!), Peace Corps Tanzania, and the PCVs that created and provided the materials I used in designing my program (thanks for the hook up Deirdre!).

For more information on Peace Corps' Malaria initiative, check out this blurb: "Stomping Out Malaria in Africa is a Peace Corps initiative that uses strategic partnerships, targeted training of Volunteers and intelligent use of information technology to support the local malaria prevention efforts of over 3,000 Volunteers in sub-Saharan Africa. For more information go to stompoutmalaria.org and follow Stomp activities at http://www.facebook.com/StompOutMalaria."

“How will you Stomp Out Malaria in 2014?”

Rainy Season

Rainy season in Kiuta is an interesting thing. When I first arrived in September, which is the middle of the dry season, the first word I would use to describe my site is "red." All the plants were dead and everything was covered with a rust-red dust; if you opened the window of the Japanese Kindergarten bus you were taking down Mtwara's ever-present dirt roads, you would not only step off the bus feeling like you spent the last four hours in a blender but you would also acquire the pallor of a bad spray-on tan, courtesy of the dust.
But now, the Monsoon Rains are here and they are awesome in the original sense of the word; they put you in your place. The muddy red roads have become overhung by the vibrant green, encroaching bush and my nights are filled with the soothing sound of torrential downpours hitting my sheet metal roof; with time, a sound I once associated with The End of Days has become cozy. My mornings are still in the low nineties and sunny but by around four or five pm, conveniently after school ends, the thunder starts and the heavens open.
Everything becomes more isolated with the rains as well. Suddenly, the 12 km to town you used to travel in the back of a flatbed truck become an insurmountable boundary. Bajajis that used to take you to town now refuse to make the drive out to your school. The rainy season makes me appreciate my neighbors. Nothing is more comforting then, when I'm stuck in the village on a rainy afternoon, crouching around a wood fire while my bibi tells me about the good old days of carrying gargantuan clay jugs of water on her head and my babu tells me about his legendary days as the village's best bao (a game kind of like mankala that is always played by young men in the shade of a tree by the main road) player; after I asked "why don't you play anymore," he looked at the space just above my right shoulder, paused, and yelled "because now I'm blind!" We all thought this was exceedingly funny.
Sure the afternoons spent staring at the mouldy ceiling boards while rats dance in your crawl space and the rain sounds like two Boeings taking off in your head can make me question why I'm here. But, when I know the price of being content is getting a little wet and smelling like a campfire, there's really no excuse for getting too down.