After eventually making it across the river and the day-long trip to the large up-country town of Basse Santa Su, we rendezvoused with the 800 bednets that had a long journey from Vietnam, where they are made, to the Senegalese Capital Dakar and finally to The Gambia. On Christmas Eve we hired a large truck to transport the bednets across the river and over the rough 25 km path from Basse to Barrow Kunda. The reception Michelle and I received from old friends in Barrow Kunda was simply incredible. At left is a picture of the hundreds of people that lined the road to the village to welcome us back to Barrow Kunda.
We spent the better part of December 24th and 25th attending village wide celebrations to welcome us back, and much more importantly, to promote malaria awareness and the basic steps that can be taken to protect families from the mosquito-borne disease. During my trip to The Gambia I was taking a malaria prophylaxis that is extremely effective in preventing infection. Unfortunately, in a country where the average working age adult makes less than $1 per day, malaria prophylaxis is simply out of financial reach (and even if prophylaxis was affordable, the wisdom of putting a person on years-long treatment is questionable). What is not questionable is the effectiveness of insecticide treated bednets in preventing malaria.
The village organizations, particularly the woman’s group, did an amazing job at using traditional forms of communication to promote the anti-malarial education that was a critical part of of this bednet distribution. Over the course of several community programs, the woman’s group and others used song, dance and plays to transmit basic but essential knowledge about the necessity of using a treated bednet every night, the importance of reducing standing water and other essential components of malaria education. Below is a short video snippet of a song the women of Barrow Kunda composed and sang about the catastrophic effect malaria has had on the community and the ways the village can use bed nets and other basic resources to prevent future infections.
December 26th was the big day, the date of the actual distribution of nets. Personally, there was a lot of excitement, but also anxiety about this day. We had worked for a year to lead up to this moment. This would be the first of many bednet distributions and it was important that we start out this project with a competent, organized distribution with enthusiasm from the villagers. It turned out my anxiousness was unwarranted, as the distribution was a complete success. The leadership shown by the village heads was exceptional. Michelle, myself and the current Peace Corps Volunteer serving in Barrow Kunda (Brendan Loula) intentionally played a backseat, logistical role so that the villagers would take ownership of this project and its long-term implications.
Over the course of a 5 hour period our team of village leaders distributed 680 bednets to 75 compounds. This was neither easy nor simple. In Gambian society it is acceptable for a male to marry up to 4 wives. There were instances of one wife collecting nets for an entire family, and not sharing with the other wives and her children. Also, there are “mega compounds” where up to 4 men and their many wives live as a collective unit. The individual family units that make up these compounds often feud, which resulted in some families not initially receiving their fair share of nets. Luckily, the exceptional leaders of Barrow Kunda were able to mediate these disputes where necessary so that each citizen of the village was guaranteed the protection of a long lasting insecticidal treated bednet. It is also important to note here that some people in the village already slept under a quality, treated bednet. With the help of the community health nurse, we were able to take a bednet census so that nets would only be distributed to people that needed a new net.
Below is a video of the entire process of nets being distributed for a single compound. First, we look at the census to see how many nets a particular family is entitled to. We then go to collect the nets from the young men that ensure the security of the nets. The appropriate number of nets are then marked with the name of the compound using a permanent marker (this helps to fight sale of nets on the black market). Finally, the nets are distributed to a representative of the family, along with a reminder about the proper use and upkeep of the nets. This final educational component is particularly important and supplements the many other educational messages about proper net use that we had propagated throughout the campaign.