To most of us in the United States, mosquitoes are nothing more than a pest. But in many places around the world, just one bite from an infected mosquito could transmit malaria. Every two minutes, a child dies from malaria – a preventable and curable disease. In a recent report, the World Health Organization warned that progress against malaria has stalled. World Malaria Day is a special time to remember our neighbors at heightened risk for this disease – and the ways God is working through and with them to reduce risk and build resilience.

More research needs to be done to help describe the relationship between hunger and malaria, but what we do know is that ending hunger means helping communities find ways to stay healthy. When malaria affects young children, costs for medicine, doctor visits, and transportation to health facilities can quickly add up. If an adult contracts the disease, it can mean time away from work, which makes it harder for their families to meet their needs.

But even seemingly simple interventions can make a big difference. One study from Zambia found that providing farmers with bed nets to prevent mosquito bites contributed to an increased output from their farms of more than 14 percent. A bigger harvest means more crops, more money, and less risk of hunger or poverty for a family. The interconnections between hunger and malaria – and the intertwined solutions to both – are one reason ELCA World Hunger continues to support efforts to address malaria.

Strategies for preventing malaria are just some of the ways the ELCA’s companion churches are accompanying neighbors in their communities. Though the ELCA’s Malaria Campaign officially ended in 2015, this important work continues in several countries.

Incidences of malaria can affect a family’s income, but the reverse is true, too. Increases in household income can reduce the likelihood of contracting malaria and make it easier for a family to afford treatment if someone gets sick. Building resilience by increasing opportunities for income generation is at the heart of the Evangelical Lutheran Church in Zimbabwe’s (ELCZ) savings and lending projects in Zimbabwe. Here, the ELCZ helps community members form village savings and loan groups (VSLAs) and provides training to strengthen existing skills in tasks such as bookkeeping.

In the Hwange District, Bulowe Nyoni was responsible for getting a water well built that now serves as a source of drinking water for most of her neighbors. From her savings, she also started an organic garden near the well. As a volunteer in the project, Bulowe received two goats, which have now multiplied to over 30, thirteen of which she sold to buy a cart that allows her to fetch firewood and other items. In addition, Bulowe also works as a volunteer in health clinic where she conducts health talks for patients. Because of her efforts, her community has access to clean water, patients in the clinic receive the support and information they need, and Bulowe is able to earn and save the income that builds resilience to both malaria and hunger for her household.

Memory Hove, popularly known as Mai Mdlungu, is a member of a savings and loan group in the district of Gokwe North. She and a group of 25 other women started the group in 2015. Initially, her husband was opposed to the idea. But Mai Mdlungu was determined, and she started raising money by baking and selling buns in her community and used part of the money to save with the other women. By the end of the first cycle of the savings and lending group, she received goats that she has been raising and breeding. These goats now help her pay for her children’s school fees. In 2016, she used her share of savings from the group to buy a cow, which has since given birth to a calf.

Seeing Mai Mdlungu succeed challenged her husband’s first impressions of the group. “I got married to an industrious woman,” he says, “and she has just woken me up from my deep slumber.” Mai Mdlungu’s husband joined the group and, at the end of the 2018 cycle, used his savings to purchase maize seed and fertilizer. Other couples are following their example, with men joining the savings and loan groups alongside women. This helps to strengthen the relationships within the family and, in Mai Mdlungu’s case, provide the opportunity for women to be part of the decision-making processes in their families.

These kinds of projects address the deep problem of malaria in holistic and transformative ways by building resilience and reducing risk. Because of the skills, talents, and hard work of community members like Bulowe and Mai Mdlungu, these projects are changing the lives of members of their communities and families. This work helps their families be less likely to contract malaria, less likely to face hunger and poverty, and more likely to be able to weather an illness if someone gets sick. And their efforts are helping to “wake up” others to the hope for a future free of malaria and hunger.

To support this ongoing work through ELCA World Hunger, please visit https://community.elca.org/good-gifts-2017/health.

From 2011 to 2015, the ELCA Malaria Campaign raised both awareness about malaria and gifts to support companion churches and partners in fourteen countries to combat this disease. These gifts continue to support projects in countries faced with the daunting challenges posed by malaria. This World Malaria Day, we celebrate this important work that continues through the ELCA’s companion churches. As we commemorate World Malaria Day this year, we do so with firm resolve to keep up this important work. According to the World Health Organization, there were 216 million estimated cases of malaria in 2016 (the most recent year data is available.) This is a significant decrease from the 237 million cases WHO estimated for 2010, which enlivens hope that we can reduce vulnerability to this disease. Yet, we also know that progress has slowed. The 2016 estimates represent an increase from 2015, when WHO reported 211 million cases.

 Clearly, there is more to be done. But ELCA World Hunger, our partners, and our companions also celebrate the progress that has been made and the impact this work has had in communities. Below are updates from some of the countries where malaria work continues. For more on the malaria programs in Zimbabwe from ELCA staffmember David Mills, see this post.

Malawi

Income generation and savings is a key part of the Evangelical Lutheran Church in Malawi’s work, as well. In 2017, their village savings and loan programs reached more than 2,100 members, who collectively saved nearly $167,000 dollars. These savings have helped the participants—88 percent of whom are women—gain increased access to health services, loans, and education while improving the overall food security of their households. The members were also able to make improvements to their homes and purchase assets that will help them generate income. All of these results will help them be more resilient to malaria outbreaks.

Namibia

Community members clear tall grass at Engela Hospital.

To reduce the population of mosquitos that carry the malaria parasite, removing brush and tall grasses that would allow standing water to collect near homes is critical. In Ruacana, 349 people from seven villages came together with the Evangelical Lutheran Church in Namibia (ELCIN) to implement a major cleaning campaign to reduce the risk of malaria. The Regional Councillors’ office helped by providing transportation for the large group. More than 100 participants joined in two other cleaning campaigns in Okongo and Engela districts, especially targeting the area around the hospitals in those communities.

Education about spraying continues to be a key priority for the ELCIN. When participants in their malaria program in Zambezi reported that many people refused to allow sprayer operators into their homes, the church began an intensive awareness campaign and hosted workshops with community leaders. With the knowledge they gained and the trust that was built in the workshops, the community leaders became active advocates for indoor spraying, assisting the program leads and offering support to sprayer operators. The ELCIN now reports that 89% of the homes in Zambezi have participated in indoor spraying, a key best practice in reducing the risk of malaria.

Zimbabwe

Malaria is a disease of poverty. On the one hand, the disease itself contributes to high rates of poverty because of lost productivity, lost wages due to illness or death, lower school attendance, and increased health care costs. On the other hand, poverty can also make a community more vulnerable to malaria by decreasing the availability of social services, including health care and prevention education.

This is why income-generating activities are a key part of the Evangelical Lutheran Church in Zimbabwe’s (ELCZ) response to malaria. In Hwange and Gokwe districts, community members took time to celebrate the hard work of people involved in the ELCZ’s livelihoods projects. In Gokwe, groups participated in field days at a local level, showcasing a variety of products, including organic honey, organic milled small grains, protein-rich nuts, sun-dried vegetables, and soups. Some of the products were collected and exhibited at a district-wide field day. The exhibit of products won an award for best exhibit in the social services category. More than just celebrating the work of the groups, the exhibits gave them an important opportunity for feedback on product quality and branding.

In Hwange, the ELCZ held a field day where groups could come together and share experiences and best practices. Groups also had the chance to showcase the products they had developed. The group members helped make the field day a successful celebration, mobilizing resources for food and prizes for the presenters.

The ELCZ’s work has made a tremendous impact on individuals and communities. Gogo Lucy Mloyi, a 60-year-old widow in Mfelandawonye, has been a member of a village savings and loan group since 2013. The group has been a blessing for Gogo Mloyi as she works to raise chickens for eggs and meat. Through her hard work and the support she has, Gogo Mloyi was able to build a six-room house, with rooms to rent for added income. She was also able to get electricity in her house to run a deep freezer where she keeps her chickens before they are sold. With the support from the village savings and loan group, Gogo Mloyi is able to meet her needs in her new home.

Gogo Lucy Mloyi

It is easy to think of malaria prevention as simply providing mosquito nets for prevention and medicine to those who have fallen ill. I have to confess, I’ve lived in Africa and had malaria on three different occasions, and frankly, my thinking about how to effectively combat the parasite is still so often stuck in this familiar pattern.

And then I visited Burure, Zimbabwe.

Burure is located in the Gokwe Region of Zimbabwe, bordered by rivers which are notoriously difficult to cross during the rainy season. It is an area that has been plagued by outbreaks of malaria in the past. It is, without question, one of the most remote areas served by the Evangelical Lutheran Church in Zimbabwe (ELCZ).

Jairos Charedzera

During my visit, I had the opportunity to visit the ELCA World Hunger-supported and ELCZ-operated Burure Primary and Secondary Schools and the Burure Gokwe Clinic – institutions which provide the opportunity for education and health care to a catchment area of approximately 10,000 people. I also had the privilege of meeting with Jairos Charedzera, a Village Health Worker supported by the ELCA Malaria Campaign.  With a contagiously enthusiastic and upbeat demeanor (even in the hottest part of the day), Jairos explained to me how he teaches malaria prevention and control in Burure and the surrounding villages and acts as a “trainer of trainers” for income-generating savings groups in each of these villages. Before introducing me to the savings groups, Jairos began his presentation with this simple yet profound truth:

“Health and income that reduces poverty must never be separated. When a household’s income rises, so does the likelihood of good health.”

Each of the village savings and loan groups greeted us with their own unique song and dance before telling us how their group works and displaying the fruits of their labor. In each of the groups, the members (all women) contribute a certain amount of money each month. That money is pooled together to invest in income-generating activities. The profits of these activities are then used to provide things like goats, hens, pots, pans, mosquito nets or other necessities for each member of the group and their households.

The group in this photo consisted of seven women who pooled their resources together to plant and nurture a nutritional garden, growing squashes, groundnuts, greens, and spices. They also harvested honey from beehives they had built and maintained.

After the group gave their presentation (and, being most persuasive in their sales pitch, successfully sold us nearly all of the produce pictured), I asked the leader of the group about the meaning of the song they had greeted us with. Her answer:

“Our song says that we will put into practice what we learn from one another.”

I learned anew in Burure that there is a more powerful method for undoing the devastating effects of malaria in communities than simply distributing mosquito nets and medicine – that method is giving the power back to the women.

Strong women are directly at the center of Burure’s journey toward a future of hope and possibility, freed from the shackles of preventable diseases like malaria. When women gain access to income, the whole community benefits. The profits go toward household necessities that make the cooking of nutritional food easier and to needs like mosquito nets (which they can purchase with pride and at a fairer price because they negotiate as a group), school fees for their children, and paying for medical care that mitigates the impact of easily treatable diseases like malaria. All are cared for, and no one is left behind.

Leaving Burure, we travelled hundreds of miles to visit four different hospitals in Zimbabwe. At each one, we left them with a gift of produce we received from the savings and loan group in Burure. The produce that was grown and harvested by these resilient women was used to feed sick people across their country.

When women are given power, the blessings cannot be contained, traversing mountains, valleys, and every barrier. When women are given power, malaria doesn’t stand a chance.

David Mills is the program director for budget and operations for the Diakonia team in ELCA’s Global Mission unit. Diakonia works with the ELCA’s companion churches and international partners with projects supported by ELCA World Hunger and Lutheran Disaster Response.

As we celebrate World Malaria Day, I cannot forget the words of Ryunosuke Satoro who said, “Individually we are one drop. Together we are an ocean” Together we can end malaria for good.

-Yeukai Muzezewa (Evangelical Lutheran Church in Zimbabwe, Malaria Project coordinator)

From 2011 to 2015, the ELCA Malaria Campaign raised both awareness about malaria and gifts to support companion churches and partners in fourteen countries to combat this disease. These gifts continue to support projects in countries faced with the daunting challenges posed by malaria. This World Malaria Day, we celebrate this important work that continues through the ELCA’s companion churches. We especially give thanks for Shoni Ngobeni, the Malaria Coordinator for the Lutheran Communion in Southern Africa (LUCSA), who compiled this post from reports from LUCSA member churches.

Since 2011, the ELCA has been accompanying six member churches of the Lutheran Communion in Southern Africa (LUCSA) as they respond to malaria in Angola, Malawi, Mozambique, Namibia, Zambia, and Zimbabwe. Since 2011, there has been a remarkable decline in morbidity and mortality related to malaria, particularly in these six countries.

The churches of LUCSA have played a role in that decline, and the work supported by the ELCA Malaria Campaign continues.

Yet, malaria continues to affect household livelihoods and education, especially because working adults and schoolchildren affected by malaria are often absent from work or school. In Malawi, malaria is still one of the major causes of morbidity and mortality, especially in children under five years of age, pregnant women and people living with HIV. There are approximately six million suspected cases treated annually, and malaria is responsible for 40% of all the hospitalizations of children under five years old and 34% of all outpatient visits across all ages.

Much work remains, but the success of LUCSA’s malaria programs so far is encouraging.

Strategies employed to achieve the success thus far include:

• Institutional Capacity Building
• Malaria Prevention and Control
• Malaria Case Management
• Sustainable Livelihood

The committed staff at the LUCSA secretariat office and of the member churches worked hard to build the capacity of the churches, congregations and surrounding communities through basic malaria awareness and education. This has enabled participants to take charge of their own health by preventing themselves from contracting malaria. The gap in knowledge was addressed, myths about malaria were dispelled, attitudes and behavior were remarkably changed, and participants laid the foundation for sustainable livelihoods to protect against future risk. Below are reflections and updates from two LUCSA member churches – the Evangelical Lutheran Church in Zimbabwe (ELCZ) and the Evangelical Lutheran Church in Malawi (ELCM).

Yeukai Muzezewa, ELCZ Malaria Program Coordinator:

The ELCZ cannot fold its hands and retreat from fighting malaria; I also cannot do that, when outbreaks are reported every rainy season, when children under five years are still suffering bouts of convulsions, when communities are not able to plow their fields because of sickness due to malaria. It is not over until we completely eradicate malaria. The ELCZ malaria project has declared war against the malaria-causing mosquito, and our weapons are mosquito nets, awareness-raising, indoor residual spraying and early treatment options.

For a number of years now, the project has been working with more than 45,000 households in two dioceses. The project has been divided into four strategic pillars: institutional capacity building, malaria prevention and control, treatment, and sustainable livelihoods.

The first strategic pillar is based on the realization that communities are able to solve their own problems. It, therefore, aims at working with church and community structures to build their capacity to prevent and control malaria as well as reduce its effects. The project works with schools, churches, community volunteers, community leaders, health facilities and other community organizations.

A vegetable garden initiated by Burure community to improve food security and household income.

A Village Health Worker demonstrating how to hang a net on a reed mat.

Mr and Mrs Tazviona from Gokwe joyfully receiving their share amount from their saving group.

Judith Jere, ELCM Malaria Coordinator:

With support from the ELCA, the ELCM Malaria Program contributed to the reduction of morbidity and mortality due to malaria, particularly among pregnant women and children under five years old, as well as among particularly vulnerable population groups. Congregations and surrounding communities are empowered to reduce the risk and vulnerability to malaria infection and to alleviate the impact of the disease on the affected households, with a strong focus on children under five years, pregnant women and disadvantaged people from the hard-to-reach areas, based on the four strategic pillars (see above.)

Major achievements from the program include:

• Behavior change: Many achievements have been recorded from the community in terms of increased knowledge, changes in behavior, and an awareness of the myths and misconceptions about the diseases.
• Net distribution: Use of nets for children has increased from 55.1% in 2011 to 88% in 2015, and from 33% in 2011 to 84% in 2014 for the general population.
• Treatment support: The proportion of pregnant women who received two or more doses of intermittent preventive treatment has increased from 41% in 2011 to 73% in 2014, indicating that more pregnant women are protected from malaria during pregnancy.
• Advocacy: When the program started, the government had not yet rolled out Rapid Diagnostic Tests (MRDTs) in the village clinics because Health Surveillance Assistants (HSAs), who are in charge of these clinics, had not yet been trained. Following a solidarity walk by the ELCM to advocate for training and use of MRDTs, it is pleasing to note that more than 80% of the HSAs are now able to diagnose malaria using the MRDT and are no longer treating malaria patients based solely on clinical symptoms. This was a great experience of effective advocacy creating meaningful change!

The introduction of the fourth strategy, the sustainable livelihood pillar of the malaria program, has brought a remarkable change to the income status and livelihood of the Lutheran congregants and surrounding communities. It improved the capacity of people in poverty to earn and save income.

Christina M’bwana, a participant in the Mwaiwathu Village Savings and Loan Association (Malawi), stands with her goats. “I am very happy that through my membership in the savings group, my family has attained our long-term goal,” she says. “These goats will help my family in very critical situations, such as hunger, illness and school fees for children.”

Conclusion: Shoni Ngobeni LUCSA Malaria Coordinator:

Looking back at where the journey started, LUCSA and the member churches really appreciate the financial support and the technical support offered by our faithful and committed partners at the ELCA. We would really appreciate more support in the form of funds and accompaniment as we harness the lessons learned and build our capacity to raise funds locally to continue with the journey towards the elimination of malaria. The Communion Office of LUCSA continues to facilitate the member churches to further invest in the strengthening of community support structures and organizations as part of the transition from the campaign phase.

ELCA World Hunger thanks Judith, Yeukai, and Shoni for sharing their hard work with us for this blog post. Photos are courtesy of ELCZ (credit: M. Ndlovu) and ELCM.

World Health Day, sponsored by the World Health Organization, is an opportunity to raise awareness of global health issues. It is celebrated every April 7. This year, we are pleased to have a guest post from Katy Ajer. Katy program director of health and sustainable development for the ELCA’s Global Mission unit.

“Why should health be a priority within ELCA World Hunger programs?”

This was a question raised during the interview process for the position I currently hold as Program Director of Health and Sustainable Development within ELCA Global Mission. However, as we celebrate World Health Day – acknowledging all the efforts that are made throughout the world to improve the health of individuals and communities and the work that still needs to be done – I think the more important question is HOW are we a church called to respond to health inequalities in the United States and around the world.

We are called as a church to respond to health inequalities because those health inequalities are frequently not the result of biological chance but the result of other systemic injustices and power dynamics. We know that health is not in a silo but is deeply interconnected with hunger and poverty. The graphic below provides a visual of all the aspects of our lives that affect our health.

We know that health injustice is in direct relation to economic justice. We know that those who are poorest are least likely to be able to access health services, medicine, or even the clean water and nutritional food that would help prevent some of the diseases. We know that they oftentimes have a cyclical relationship – once sick, people miss work, resulting in less money for the necessary treatment and continued worsening health.

All of which brings us back to the question above: HOW are we as a church called to respond to health inequalities in the United States and around the world. When looking at the graphic to the right and all the areas that influence our health, it can often be overwhelming to decide where and how to start implementing efforts to improve health. In my short time at the ELCA, I’ve had the pleasure of learning how many of our companions around the world, with support from ELCA World Hunger, work to alleviate the short-term suffering of individuals while taking multi-pronged approaches to improve the long-term health of the communities. Below are some examples of this important work.

Educación Popular en Salud (EPES)

EPES in Chile provides nutritional courses with a twist through its Promotion of Nutrition project. It looks at the issue with a focus on rights and with attention to gender, in addition to nutrition value. What this means in practice is that in addition to education about nutritional foods and recipes, they examine the food production chain and how that can affect the nutrition of the food and the health of the surrounding environment, which in turn affects the health of the people. The participants then decide on actions to take to share this information and encourage healthy food choices and changes in food production or availability so that all may have access to nutritious food. Most recently, they have created a cookbook filled with nutritious recipes as well as a mural on a street advocating for decreased production pollution that can impact the ability to cultivate crops and the quality of the food.

Artists with EPES celebrate in front of the completed mural

Lutheran Communion in Southern Africa (LUCSA)

LUCSA InfoHuts projects in Namibia, Zimbabwe, and Malawi work to contribute to a generation free of HIV and AIDS by combining life skills and sexual and reproductive health education with computer use training. At first it may seem like an odd mixture of topics for a project; however, as with many of the projects that combine health education with livelihood training, students leave more knowledgeable about how to prevent and/or treat HIV and AIDS and have a new employable skill that allows them to earn money for nutritious food, medications and other needs to maintain good health or treat any future health concerns early on. By addressing both health and poverty, the impact is often greater and more transformative.

Students learn computer maintenance at the Vashandiri InfoHut Zimbabwe

A life skills facilitator teaches students in Zimbabwe.

Lutheran Health Care Bangladesh (LHCB)

LHCB provides quality clinic care as a hospital and mobile clinic but also operates activities focusing on other aspects that impact the health of their patients and community. They provide livelihood training in agriculture development, vegetable gardening, poultry and livestock, and tree planting. They organize the installation of safer stoves that are less harmful for the lungs of the women who cook over them. LHCB also works on raising awareness and mobilizing their community through workshops on gender and human rights, advocacy meetings, and community dialogues. Recently, they arranged a space in the hospital for breastfeeding to encourage the practice while providing mothers with privacy should they desire.

How are we as a church called to respond to health inequalities in the United States and around the world this World Health Day?

I had been in this position for little over a month when we recognized World HIV Day here. One of the most impactful parts of the day was a reflection read aloud by Kim Serry, who attended the US Conference on AIDS in 2016 with a delegation from the ELCA. Throughout the reflection, she came back time and again to the proclamation of African theologians, “The Body of Christ has AIDS.” She also paraphrased Melissa Harris Perry who made a similar claim:

“Our collective HIV status matters. It is not to say that our individual status does not matter, it certainly does. It means that our communal life suffers when individuals in our community suffer. It means that our communities are gravely sick when power and privilege determine who is shielded from harm and who will suffer it… and a pharmaceutical will not fix that.”

An aspect that is present within each of these projects that positively impacts health (although we often don’t think about it in these terms) is the sense of community that arises. These and many other ELCA World Hunger-supported projects work with groups over time, and these groups become social support systems that can help participants maintain good health physically, emotional, and spiritually. This support can arise through sharing knowledge between neighbors, helping one another recognize health symptoms that may not be noticed otherwise, lending money through Village Savings and Loan Groups for medication or transportation to a hospital, and, importantly, listening to one another and praying together during difficult times.

We are part of that Body of Christ. While some of us receive the burden of poor health unfairly, we all suffer. We are part of the social support system that is so important in creating equality that all may have the best health possible – that there is justice in who has access to health care and medication, to clean water and nutritious foods, to environments free from violence, and to opportunities to learn.

So, this World Health Day I give thanks to our partners, companions, and missionaries around the world and in the United States, striving to alleviate short-term pains and illnesses and to address root causes of health inequalities to ensure that all can live a healthy and joyful life. Thank you for your work and thank you for teaching us how to address health injustices with a Christian heart.

Photos above are courtesy of: EPES (Chile), Evangelical Lutheran Church in Zimbabwe, and Lutheran Health Care Bangladesh.

It is easy and effective to be an e-advocate. When it comes to voicing concern for our neighbors in Zimbabwe, e-advocacy is also urgently needed. Visit http://tinyurl.com/ZimbabweAdvocacy to find suggested text to e-mail to your senators and representatives. Don’t know who they are? Don’t worry. All you need to know is your home address!

One Evangelical Lutheran Church in Zimbabwe pastor told an ELCA colleague “I thought we had hit bottom, so it couldn’t get worse; but it seems a hole can be dug in the bottom.”

Don’t be tempted to put this off. What else can you do in the next five minutes that will be as important? E-advocate for our neighbors in Zimbabwe and urge at least one other to do the same.

Questions? Visit www.elca.org/advocacy , www.elca.org/disaster, or contact Jodi Deike, Director for Grassroots Advocacy and Communication, ELCA Washington Office.

Advocating blessings,
Sue-s