Saturday, July 13, 2013

Malaria in Mbakaou, Cameroon

Malaria pisses me off.  It pisses me off for a number of reasons, but the main one has to be the fact that it is entirely conquerable.  We used to have malaria in America, but we destroyed it.  We did it in a very American fashion by killing every mosquito we could find.  This included the use of everything from now banned chemicals to literally covering ponds or other sources of standing water with oil (I saw a great PSA recommending this; someone should find it and post it).  Given there are still mosquitoes in the States, these last efforts weren't the real source of victory, but massive roll outs of bed nets, screening houses, and actually taking drugs did.

Malaria kills untold millions of people across the world and particularly in Africa.  The devil in me says that we have a population problem anyway so who cares But wait there is more!  It doesn't kill most people, it just makes them reoccurringly sick.  To ask someone in Cameroon if they have every had Malaria is a ridiculous question; I have simply never met anyone who could answer "no" to that question (maybe a child young enough, but then I'd have to talk to children).  So malaria just kicks you on your ass, making you unproductive while you recover and brings down the productivity of whoever is taking care of you.  I often recommend that if a family has somehow managed to obtain a bed-net that they let the children sleep under it; they are more likely to die than adults who have survived malaria before.  It's often pointed out to me that if pappa gets sick no one works the fields and no one puts food on the tableEveryone suffers.  I can make no argument against that logic.

There are two things needed to get rid of malaria here.  Number one: sleep under mosquito nets.  The mosquitoes that can give you malaria only come out at certain times of the night.  Yea, you'll be exposed when meeting, greeting, and cooking outside, but at least the majority of the night you'll be protected.  Ideally houses should be screened, but based on the inability to provide mosquito nets I feel that is too crazy a dream to bother mentioning.  Number two: take your damn medicine.  If you are sick, go and take meds as quick as possible.  The main problem here I see is that meds cost money (and often aren't even in supply).  If you know you can possibly recover on your own and have in the past, then it is cheaper to not go to the clinic.  Again logic I understand.  Course, you still have malaria and every mosquito that bites you can now give to everyone else.  My normal lesson here is "don't be a dick".

Cameroon and the organizations here to help have simply failed.  Supposedly meds are free to kids five and under.  If you can find them.  And only if it isn't complicated, meaning you aren't too sick and vomiting up the drugs.  If they have to give you an IV, you'll pay plenty.  I like the strategy to get people to go to the clinic earlier (less time to transmit), but it's not working.  You want to get rid of malaria, everyone has to be able to get treatment.  As far as mosquito bed-nets go, the distribution failed.  They attempted to give one net for every two people under the assumption folks would bunk up (never mind that culturally most husbands don't even share the bed with their wives where I am).  Here at least, they did a crap job of telling anyone they would be giving away nets, so very few were given out to begin with.  What else did they drop the ball on?  I ask people everywhere if they know how you get malaria.  They don't know that it comes from mosquitoes.  No one mentioned this to them.  Thus no connection between mosquito nets and malaria was made.  Instead the few who did get nets had to decide between sleeping under a hot net and not getting bitten when you were probably sleeping fine before or using this nifty new net to do something else like fish or catch termites.  Eat more or sleep under a hot net: easy choice.  Oh and because the nets were given away for free and might be again (though no one knows when), no sensible businessman will sell them.  And no clinic wants to either or else be accused of hording the free ones to see for their own profit.  So if you want a net, good luck finding one.

Maybe this is just a simple case study of Mbakaou, the town lost off in the wilderness, but I keep hearing similar stories from everywhere else.