Thursday, April 25, 2013

Who You Gonna Call….Malariabusters!

I never pass up a chance to wear a costume. So you can imagine my delight when my job gave me the opportunity to dress like a Ghostbuster…..or shall we say Malariabuster because it is much more fun?

Preparing to be a Malariabuster
It all started innocently enough. I traveled with two coworkers into the dusty hills of the Mwanza region of Tanzania. We would be working from three district medical offices collecting data from the first round of the 2013 Indoor Residual Spraying(IRS) campaign. According to the World Health Organization(WHO), ‘the main purpose of IRS is to reduce transmission by reducing the survival of malaria vectors entering houses or sleeping units.’
In average-person-words, IRS is the spraying of walls with an insecticide which kills the mosquitoes when they rest at night. IRS is not meant as a one-stop malaria control but rather as a supplement to sleeping under Insecticide-treated mosquito nets(ITNs). IRS is particularly beneficial during the evening hours when people are relaxing inside their homes before bedtime.

My third year extension placement is with the ResearchTriangle Institute(RTI) out of the North Carolina and funded by the United States President’s Malaria Initiative(PMI). Along with organizing and implementing the IRS campaign in northern Tanzania, RTI collects and evaluates data from the houses sprayed as well as the malaria patient statistics from local village health clinics. This is where I come in! I am part of the data collection team working directly with team leaders from each spray site to ensure data is being submitted correctly and efficiently. We also work with data entry staff to confirm data is typed into computers accurately.
Just as it sounds, my job involves a lot of computer work. So after the first few days of this trip, my antsy-ness caused me to casually mention an interest in learning the spraying process first-hand. By the reaction of my Tanzanian coworkers, you would have thought I had suggested creating a project with goats laying eggs instead of chickens! They were shocked I would want to dirty my hands with such a task.
One of the Site Headquarters

Well, let’s be honest… many volunteers would attest, much of our manual labor work is being ‘allowed’ by our local counterparts to try a task, being laughed at for our ineptness and then being told to rest while they do it correctly. And I do enjoy hamming it up to make them laugh while secretly learning their methods which are effective albeit can use my adjustments at times.
So I expected to be taken out to a spray site, spray two or three houses, share a few laughs, raise worker morale and then be done for the day. Nope. This team had a whole different day planned for me. My first suspicion of what was to come occurred when I was given the FULL safety attire: heavy coveralls, rubber boots, rubber gloves, a hardhat with a mask and an industrial-type mouth and nose mask. The outfit was topped off with my own spray tank- the perfect accessory!

I was then introduced to the spray operator with the best English vocabulary. I learned he had been chosen for the coveted position as my caretaker. I was very flattered by how the team wanted to take such good care of me and by how excited he was to be given the position. He made sure I received my equal share of chemical packets and supplies……which I wondered why I needed since I would only be spraying a few houses as a source of entertainment but I just went with it.
Repairing Drainage to Protect Surrounding Environment
We traveled about an hour to a more remote village, waited another hour for a rain shower to pass and then it was time to work! I quickly realized what makes this job harder in a Tanzanian village than an American town: spacing between houses. In American neighborhoods, houses are a few steps apart. In Tanzania, they may be a few steps apart or a few kilometers apart! Either way, we walked/sprinted to the next house as soon as one was done. Between the heavy air from the recent rain and all the layers of protective gear I was wearing, I was soon sweating more than a pig on Zanzibar.

But the villagers….oh the villagers….are what make hard work all worthwhile. At this point, I had been out of the village and living the sweet city life for more than seven months. I am not sure how to explain it. A year ago, I would not have believed it. But there is something so much more gratifying from spending a day in a village over a city. Some villagers had already heard about IRS through community outreach and radio spots. Others knew nothing about IRS but were interested in learning and protecting their families. There were a few skeptical villagers who preferred not to have their homes sprayed. One even claimed we were spraying malaria into the homes to kill villagers. My partner handled all situations with dignified calmness and appropriate responses.
One of the most common questions Tanzanians ask foreigners is ‘are you tired?’ This is one question I usually reply with an emphatic ‘NO’ whether it is the correct answer or not. I guess because I personally see being tired as a sign of weakness in these situations. By the end of my spraying venture, I was ready to change my answer to an emphatic ‘YES’! When various people asked, I quickly agreed the work of a spray operator is very hard and explained how much respect I have for them.

Coworker Showsoff New Tent-like Net
Fast forward about three weeks to the team leader trainings for the second half of the region, and I was even more grateful for my new first-hand knowledge. In their Swahili language (and my own charades-inspired-hand-signals), I described my experience. Conveying my appreciation for how hard their job is as well as my hope that they would remember how important their work is and how IRS gives them an opportunity to save lives in high epidemic area.
Annual malaria deaths in Tanzania are estimated at 60,000 with 80 percent of these deaths among children under five years of age, according to PMI’s website. The Mwanza Region has the fourth highest prevalence rate at 31.4% for malaria in children under five years of age. A 2010 study of malaria in Tanzania showed approximately one in 12 children died before their fifth birthday. A sad statistic indeed, however, this number showed an improvement from just six years prior when it was one in every nine children.

The improved statistics are the combined results of PMI’s four major malaria prevention and treatment measures:

Indoor residual spraying (IRS)
Intermittent preventive treatment for pregnantwomen (IPTp) with sulfadoxine-pyrimethamine (SP)
Diagnosis with rapid diagnostic tests (RDTs)or microscopy and treatment with artemisinin-based combination therapy (AC T)

Fellow PCV Jessica Moreno Teaching about Malaria
I may never know the exact impact of my one-day stint as a Malariabuster, but the enthusiasm and appreciation voiced by the villagers and my coworkers made the sweat and sore muscles all worth it. Like most development work, the reward is not in the paycheck or the immediate results….though how great would it be if both of those were possible!

No, the reward is what you are able to take away at the end of the day: the interaction with students excited to practice their English with an American; the laughter shared between sprayers as they competed for how many houses each could spray; the appreciative smiles from villagers seeing support from a foreigner. These are the rewards that will stay with me past the day when malaria is finally eradicated. 

Curious for more? Visit! Stomping Out Malaria in Africa was built on the vision that through strategic partnerships, targeted training and mobilization of Volunteers, intelligent use ofinformation technology, and radically efficient use of seed funding, Peace Corps will focus the efforts of over 3,000 Volunteers in sub-Saharan Africa to make an immediate and measurable impact in the fight against malaria.