Malaria is a tricky disease. People get it from the Anopheles mosquito, who originally got it from another person. Seems simple enough, right? Turns out, that’s a pretty tough disease vector (fancy name for disease transmission method) to understand without a microscope, an education, and a lot of time for dedicated research. These are qualities and tools that are, unfortunately, hard to come by in the Zambian bush village. So, like all societies, Zambians have explained malaria transmission through a variety of other means. These explanations, while generally inaccurate, are based in the reality of village life.
If you ask a Zambian where malaria comes form, they might say one of the following:
– Getting wet in the rain
– Eating sugarcane
– Eating green (unripe) mangoes
– Eating leftovers
– It comes from the sun; “sun disease”
– Drinking contaminated water
– All mosquito bites
– Juju (witchcraft) can give you malaria
– Rest alone can cure malaria
– You can get malaria at any time of the day; sleeping under a bednet doesn’t have a purpose
– Bednets can make you sick
– All flu-like symptoms are believed to be from malaria
Does some of these sound totally crazy to you? Like, “How in the world could someone possibly think that?” – crazy? Don’t worry, they sounded totally crazy to me, too.
But, if you think about the village scene – low levels of education, few outside resources, and long traditions of oral history – some of them start to make sense.
Take, for example, the idea that eating an unripe mango can give you malaria. Malaria infections in Zambia reach their peak during the rainy season, which typically runs from around mid-November to mid-April. November and December also happen to be when mango tress begin to fruit, and little green mangoes are everywhere. Lots of people like to munch on the unripe mangoes, and if you didn’t know much about how malaria was transmitted, would it make sense to correlate the appearance of green mangoes with the spike in sick people?
Or, take for example the idea that the rain causes malaria. Seems reasonable if malaria spikes during rainy season, right?
Or what about drinking contaminated water? Stagnant water often hosts hordes of insect larvae (including mosquitoes). A person could take one look at that and think, “If I drink this, it will get me sick.” Since most Zambians have been informed through health outreach programs that malaria is carried by mosquitoes, it would be an easy jump to think that drinking the water that once housed mosquitoes could make you just as sick as a bite.
When you think about it that way – without Wikipedia or anything to help you make connections – it begins to make sense why people believe what they do about malaria and malaria transmission. But, even if their original ideas make sense in rural Africa, they are a major impediment to changing people’s understanding and behavior when it comes to malaria.
Peace Corps Zambia has recently put together a committee of volunteers dedicated to promoting malaria projects amongst volunteers (of which I am now a part). In 2013, less than 1/2 of of volunteers serving in African malaria-endemic countries did a malaria intervention project. Before joining this committee and learning more about malaria, I was like, “So, what’s the big deal? I’m not a health volunteer. Why should I care about doing malaria work?” Now, post-committee and some really excellent training, I realize that malaria (along with HIV/AIDS) is one of the few things that volunteers can really make a serious impact in stopping. We reach communities where NGOs don’t dare to venture; we speak enough local language to give malaria education to non-English speakers; we serve for 24 months in our communities – plenty of time to understand how malaria affects our area and how we can intervene effectively. Now, I look at that statistic and think, “It’s frankly kind of embarrassing that so few volunteers are doing anything to help prevent and eradicate malaria.”
So, we’re trying something new. Instead of trying to get all volunteers to learn health curriculum, we’re going to try to involve malaria interventions into their already existing program framework. We’re going to start doing things that Zambians actually care about (like beautifying bed-nets and presenting materials in local languages and through art) to encourage the use of prevention methods. We’re going to reach out to each and every volunteer in Zambia and figure out what keeps them from doing malaria interventions. Then, we’re going to remove the roadblocks.
In the meantime, we’re going to keep stomping out malaria by dispelling myths and bringing malaria to the forefront of Peace Corps. After all, malaria isn’t just a disease; it’s a disease we could eradicate within our lifetime. Want to support our efforts? Check out our Facebook page and stay tuned for more ways to defeat malaria.