Recently, TheNew York Times published an interesting article titled “Meant to Keep Malaria Out, Mosquito Nets Are Used to Haul Fish In”. The article focuses on the challenge posed by people using mosquito nets as fishing nets, and reminds us that the choice between hunger and health is real and pressing for many. This is not a new problem in the fight against malaria, but the article brings it to a new light. The ELCA Malaria Campaign would like to take this opportunity to share about how Lutheran malaria programs in Africa are already responding to this challenge.
Every net that is distributed through the Lutheran malaria program is accompanied by educational programming about how to properly use the net, how to hang the net, and what benefits (health and otherwise) can be realized from appropriate net use. The Lutheran malaria programs which are supported by the ELCA Malaria Campaign are comprehensive, which means that programming is more than just nets (although nets are an important piece). The programs operate under four pillars: prevention, education, treatment and sustainable livelihoods. Nets fall under the “prevention” pillar, but only when joined with content from the “education” pillar.
To address misuse of nets, the staff and volunteers of the Lutheran malaria programs work to customize communication messages accompanying nets to encourage proper use. In communities near bodies of water, messages related to discouraging the use of nets for fishing are especially emphasized.
According to the President’s Malaria Initiative, based on the data that is available to date, the overall misuse of mosquito nets for fishing appears limited. The examples tend to be anecdotal, and are specific to communities along lakes and rivers. While limited, the misuses are real and often driven by economics and food security concerns within these communities.
The Lutheran malaria programs attempt to offset the economics and food security concerns by offering sustainable livelihoods programming. This involves microfinance projects, seed money for small businesses, financial literacy courses, training in bookkeeping and loan programs. If people are given an opportunity to participate in other income generating activities (and therefore be able to earn money for food), one goal is that they will not rush to the seashore to fish with mosquito nets.
In Malawi, there is even a sustainable livelihoods project that has purchased fishing nets to prevent the use of mosquito nets for fishing. For example, a member of a Village Savings and Loans group in Salima, near Lake Malawi, used his profits to purchase a fishing net, which he uses to fish in order that his family can properly sleep under their mosquito net.
Fishing with mosquito nets is a topic that has come up before in conversations with leaders of the Lutheran malaria programs. Before the Lutheran malaria programs, people noted that nets were misused. The program brought essential education to the communities to inform them that using the nets properly was in their best interest.
Mr. Njiji Desiree is governor of the Cankuzo province in Burundi, East Africa. He has observed the work of the Lutheran World Federation (LWF) malaria program in his region and says, “I recognize the good cooperation with Lutheran World Federation, and appreciate the activities of LWF. LWF is very valuable in this community. They bring more sensitization sessions. For example, [before the LWF program] mosquito nets were being misused, for fishing, or for protecting crops or rice.” He affirms, “there is good work happening. LWF intervention will help the government reach more people, more effectively, with the malaria program.”
Another testimonial comes from Zambia, which is one of the countries mentioned in TheNew York Times article. Pastor Knox serves a congregation in rural Northwest Zambia. “Before the malaria program came to our village,” says Pastor Knox, “people had been using nets in the wrong way – for fishing, or as sleeping mats. This was a big problem.” He went on to say, “Through the malaria program, we learned how to use the nets properly.”
Finally, it is worth sharing some good news from the World Health Organization (WHO) to remind us that, despite some hurdles related to net use, the positive impact of malaria programming in Africa is measurable and real.
- According to WHO’s most recent malaria report (2014), an estimated 4.3 million lives have been saved as a result of the scale-up of malaria interventions, including mosquito nets, since 2000. Worldwide, the mortality rate from malaria fell by 47 percent between 2000 and 2013, and by 54 percent in Africa, where about 90 percent of malaria deaths occur. There was an almost 60 percent decline in malaria deaths in children under age five during this time, with most of that improvement occurring since 2007.
- Ten years ago in sub-Saharan Africa countries, household ownership of at least 1 net was very low (<10% in most countries) and net use was even lower. In recent years, national-level household surveys across Africa have documented dramatic increases in household ownership and use of nets. The malaria community has robust evidence that these nets are inside homes and being slept under.
While The New York Times article was just published, this is by no means a new problem. Misuse of nets has been a challenge of public health workers in malaria-prone areas for many years, and nobody is more concerned with the proper usage of nets in the field than our Lutheran health care professionals who are implementing these programs and working faithfully on net distribution campaigns.