April 25th is World Malaria Day. Over 450,000 people (mainly children) die each year from this preventable disease and millions (216,000,000) get really sick. Since many (90%) of these folks live in sub-Saharan Africa, malaria compounds an already challenging context of health-related and economic issues.
Go figure if half your country has malaria at some point during the year productivity will be low.
I knew a little something about malaria before moving to Tanzania in 2002 (a year of taking Lariam while globetrotting for a safe-water initiative definitely weirded me into a strong dislike of the disease.) Deciding that Lariam-induced weirdness was not an option, I purchased the suggested bed net and went into late night mosquito alert mode: splat, splat, DIE MOSQUITOES DIE.
In the first months while trying to learn the HIV/AIDS context I visited Kagera (in the northwest corner of Tanzania) for a few weeks to meet with our 600+ community volunteers there, community representatives, women’s groups, and AIDS patients.
Meeting with community groups to understand their concerns and priorities – “when you think of your children late at night, what keeps you awake?” – time & time again malaria came into the dialogue. I spoke with one mother who lost four children to the disease.
Heart-breaking to see her tears & hear her fears for her other children.
At that time in Tanzania, where malaria in many districts is endemic, (ie, you can catch it all year around), 70,000 children died each year from the disease.
After that Kagera visit I went back to our Dar office galvanized to do something more about malaria & began coordinating with our Programs Division to highlight this issue. We already wove simple malaria prevention into our long-term community development projects and had several special child-health programs that did extraordinary community health at the village level, but more was needed! So, we galvanized special projects from the Australia & New Zealand governments, UNICEF & generous donors.
Then, with CARE Tanzania, we co-founded TaNAAM (the Tanzanian NGO Alliance Against Malaria) with a cross section of NGOs, pharmaceuticals and major malaria stakeholders to coordinate national activities.
Partnering again with CARE TZ, we launched into the TNVS (an insecticide treated net voucher scheme) doing medical training, social marketing & awareness campaigns in every district of Tanzania. Using best practices from smaller projects in the project design, taking the project to scale required 8 promotion and training teams moving simultaneously in several districts at a time – no small challenge!
During evaluation visits ‘twas so exciting to see local performance groups communicating in local languages, tribal dances & skits demonstrating bed net prevention, diagnosis & treatment. In many of these places nets had never been available, but that’s why with this disease it takes lots of folks to make a difference.
Net manufacturers, distribution network builders, social marketing, health professionals, government health infrastructure, pharmaceutical companies – all working together.
Colleagues in our Arusha National Office began calling me the Malaria Queen, since our Dar division opened our doors to host this project and our Marketing Team designed the media campaigns, logos, events (& since their humble director – moi – backstopped the whole Promotion half, including rural BCC teams) of the multi-million dollar grant from the Global Fund for HIV/AIDS, TB & Malaria.
All this time I (somewhat zealously) used my bed net at home and while traveling. Our National Director, George, insisted each director visit every region at least once a year. Since we supported 126 projects in 12 regions that meant I traveled half of every month, mostly to rural areas and to our refugee programs in Kigoma.
I managed to avoid malaria for three years until traveling to Uganda for a regional conference. Asking the guesthouse desk clerk for a net, he said ‘you don’t need one here.’ Waking up at 3:00AM with mosquitoes all over the wall and bites all over my arm, needless to say the next night I insisted.
Two weeks later in Arusha for important international meetings, my temperature skyrocketed to 104 while my joints screamed with prickly pain. Did I mention being on crutches at the time? (click here to read more about that..)
That’s when I met malaria, up close & personal.
During this episode I learned more about the African lesson of ‘being with.’ My Leadership Team colleagues (all African) came to visit me (this, after being up all night, dazedly fevered, with my hair sticking out every which way.) But that is the African way!
‘Being with’ each other in painful times, showing you care by being there.
A hard lesson I had learned early on that also made childhood malaria deaths in Tanzania more than just statistics. After three miscarriages my vibrant assistant, Joylline, had a beautiful baby girl, Hope, my first year in Dar es Salaam. Little baby Hope became the darling of our Dar office. At 18 months Hope died from malaria and pneumonia.
A crushing death, as is the death of each and every child who dies from this disease.
During baby Hope’s first hospital stay (of many) I sent flowers and needed supplies. I didn’t want to intrude until I noticed our team members eying me askance. Finally, Happiness blurted out, “Madam you must visit, Joylline will think you don’t care!”
Yikes. I got it and visited right away. Then became first in line at every funeral, wedding, engagement because I did care and that is What You Do in Africa.
You show up. You share the pain, you share the joy. It’s that ‘being with’ thing.
Facing death, illness and tough times can be challenging, but what I love about the African way – you realize you are not alone as the pain is shared across family, friends and the community.
These years later many more children are alive because people around the world have joined their hands, hearts and pocketbooks to attack malaria with prevention, education campaigns and better treatment. There’s lots to celebrate – from 1 million annual malaria deaths to less than 500,000 per year – but there are still many little Hopes out there, who need us to show up.
Not just on World Malaria Day, but every day of the year!
Virginia : )
p.s. Buying a $10 net for a family really saves lives. Our project proved it, like so many others around the world.