Background
Malaria is a killer disease, affecting tropical regions in Asia, Africa, South and Central America. Young children and pregnant women are particularly vulnerable, and it is estimated that one child dies from it every 30 seconds in Africa.
The vector is the female anopheles mosquito, which transfers the infection from someone who has malaria to someone else. It does this by having a blood meal from the former usually in the hours of darkness, when it also ingests the infecting organism (plasmodium).This then undergoes maturation within the mosquito and migrates to the salivary glands. When it has its next meal , it injects plasmodium into the blood stream of its victim, who will develop signs of infection after an incubation period of 6 to 14 days i.e. fever headache vomiting , diarrhoea, sweating, dehydration, convulsions, even death.
There are several ways to reduce the incidence of malaria transmission, but the use of insecticide impregnated mosquito nets is one of the most important. The loss of 2 good friends from this infection in 2008 was an important stimulus in starting this project.
Funding
A substantial donation was received from my rotary club, Horbury and Ossett Phoenix (www.phoenixrotary.co.uk), which , together with other smaller donations, came to a total of £1000, to be spent on nets.
Sourcing Nets
Advice was sought from the local Rotary Club in Kenya , and after much wheeling and dealing in the back streets of Mombasa, nets were obtained at the best price possible. The nets were subsequently impregnated with permethrin, an insecticide. The net therefore acts not only as a physical barrier to the passage of mosquitos, but also acts as a vehicle for the insecticide. The presence of one single net in a house therefore is of benefit as mosquitos will be killed or repelled by it, even though some beds will be unprotected. Rectangular nets 6ft x 4 ft were chosen as this size enables a small double bed to be enclosed, under which 4 family members may sleep. These nets have 8 fixing points, which makes fixing to the ceiling time consuming , but this maintains the rectangular shape. Nets with circular supports have only 1 fixing point , and are therefore much easier to fix, but are much less suitable when beds have several occupants, which is the norm.
Identifying Recipients
KAG school now has 320 pupils in the kindergarten and primary, of whom 60 are sponsored by UK residents. They are amongst the poorest and most deprived children in the area. Many are orphans and are being brought up by relatives, eg grandparents or aunts. The domestic circumstances of these children are well known to the head teacher. In addition, we have been involved for some time in the leprosy settlement called Tumbe (this means ‘despised people’),where the only source of income is begging. It was felt, therefore, that it would be reasonable to start with these children and their families/carers . 220 nets were therefore distributed, which also included some to non- sponsored children and neighbours who were considered to be in serious need.
Method
Malaria awareness sessions were held by us in school over 2 days. These dealt with symptoms, signs of disease, mosquito life cycle, methods of prevention etc. Nets were demonstrated and erected in the classroom setting, and advice given regarding effective use.
The nets were fitted over 4 days, with the help of teachers. Fitting was difficult, as most people live in what could be termed a ‘mud hut’, very cramped, dark, dirty, humid with mud floors. The ceilings are made of mangrove poles with mud packed between to fill the gaps. Finding 8 suitable points to attach the nets was time consuming.
It was felt necessary to spend considerable time installing and demonstrating correct use.
Future
The project was very well received and it is to be hoped there may be a chance to expand distribution in the future, subject to adequate funding. In Tanzania, distribution of nets is done by a rotary charity REMIT(Rotary eliminating malaria in Tanzania). A huge reduction in malaria has been reported in the areas so far covered.
Jim Donnan