Converting a rectangle into a cone…bed net that is!

Botswana’s National Malaria Program’s goal is to have zero new malaria infections by 2015. In efforts to eliminate malaria in Botswana, the Ministry of Health (MoH) has distributed tens of thousands of Long Lasting Insecticide Nets (LLIN) over the past 5 years. Most recently, the MoH distributed 40,000 LLINs in high endemic areas of Botswana. Community volunteers went door to door collecting household data on bed net use and gave the head of the house hold a voucher to collect the appropriate amount of bed nets per household at the nearest health post, clinic, or hospital. The head of the household would then collect the LLINs the following day.

Following the most recent distribution, I have asked people if they have been sleeping under their bed nets every night. Some say “yes” and some say “no”. For the people that say no, I ask why? It was a free bed net that they wanted, so why not use it. The most common answer to this question is it is a rectangular bed net. Many people say the rectangular bed nets are too hard to hang up or they make them feel claustrophobic. They would prefer to have conical bed net. An easy solution to this problem is to convert their rectangle net to a conical net.     

I decided to show people how to convert their nets for little or no cost. I bought a couple meters of irrigation pipe for about BWP 10 (~$1), electrical tape for about BWP 5, and used some plastic-zip ties I found laying around for this project. If these supplies are not available, pliable sticks (with all sharp points removed) and string can be used. I took all the supplies to my clinic and sat down with a handful of clinic staff. Step-by-step we went through the process of bending the tube into a circle, taping it together, and then connecting it to the bed net. In less than 15 minutes and for less than a couple dollars, a rectangular bed net was converted into a conical bed net!

I used the newly adapted bed net at a recent health expo and around the clinic people. People were excited to see it and wanted to know how to do it themselves. I will host some simple workshops/trainings on how to do the conversion and develop a step-by-step educational leaflet to distribute at events.

Photo - Mphande, Shakawe Clinic Health Education Assistant, holding the final product of a conical LLIN bed net.

 

Educating the public about Malaria

Botswana’s Ministry of Health and National Malaria program are taking great strides to eliminate malaria in Botswana. One of their key strategies in meeting their goal of zero local transmissions by 2015 is to provide education, information, communication and advocacy to community members. To help them with their goals, I am conducting health talks and attending health expos with Celia, the Health Education Technician and Mphande, the Health Education Assistant at Shakawe Clinic.

Using materials provided by the Botswana Ministry of Health and materials our team has created, we are educating people at government offices, NGOs, schools, and other venues. We personalize the health talks based on who we are talking with. For example, if we are giving a health talk to mothers with children under 5 years old who are attending the Child Welfare Clinic, we will explain how children under 5 are the most vulnerable and susceptible to malaria. Another example is if we give a talk to the Veterinary Department, we highlight that when they are working in the bush they are at a high risk for contracting malaria and should bring their bed nets with them.

Here’s a general outline a health talk about malaria:

• First, define what malaria is, and explain the signs and symptoms of complicated and uncomplicated malaria. While defining what malaria is, try to get as much audience interaction as possible. Additionally highlight that children under 5 years old, pregnant women, and people living with HIV/AIDS are at the highest risk.
• Second, have the audience list the signs and symptoms of malaria, if appropriate. Once the majority of the signs and symptoms are listed, go over them in detail. Encourage anyone who has these symptoms to go to the nearest clinic to get a rapid diagnostic test and a blood smear test.
• Third, discuss preventative measures making sure you put a lot of emphasis on using a bed net. When talking about using a bed net, bring a rectangular net that has been converted into a conical bed net (preferred by Batswana).  Demonstrate how to convert, use, repair, wash the bed net properly. Use the phrase, “Hang it up, Keep it up, Tuck it in.” Other preventative measures to discuss are Indoor Residual Spraying (IRS), personal protection, and vector control. 
• Lastly, end the health talk with questions, answers, and comments.

 

Malaria health talk given at Shakawe Clinic led by Mphande (HEA), Celia (HET), and Matthew (PCV)

  

The Adventures of "Flat Addison"

Our niece, Addison, is a 5-year old kindergartener. Her class read Flat Stanley, a book about a little boy who becomes flat. This allows him to travel anywhere in the world by sending himself in an envelope. A few weeks ago, we received a large envelope with a flat kindergartener that our niece made. We spent a week taking our “Flat Addison” wherever we went. This blog post is all about the adventures “Flat Addison” went on while in Botswana. 

“Flat Addison” visited Shakawe, Botswana a village in the Okavango Delta. The Okavango Delta is the biggest inland delta in the world and is home to many animals. Some of the animals that live in our area are elephants, hippos, crocodiles, leopards, lots of antelope and lots of birds.  

On Monday, she spent time at the Shakawe Clinic. She helped out with baby-weighing. Parents bring their small children once a month to see if they are growing well. They use a hanging scale to weigh the children ages 0-5 years old. After their weight is marked on their chart, they get free food. This food is either beans, oil or sorghum meal with vitamins. 

After saying goodbye to the nice people at the clinic, “Flat Addison” went shopping for baskets. Baskets are made from palms that grow in the area. The different colors in the baskets are made from local plants too. The baskets in this area are some of the best in all of Africa. There are also other crafts such as beaded jewelry and leather bags.

On Tuesday, “Flat Addison” went to the Botswana-Namibia border with Aunt Bridgette. Namibia is very close to Shakawe, so it was a fast trip. She saw more of the Okavango River and took a picture next to the sign for Botswana. She also visited the local baobab (bay-oh-bob) tree. Baobob trees can get very big and they have a very nice fruit that tastes like yogurt. The baobab tree in Shakawe is quite small compared to others. Baobob trunks can be up to 36 feet in diameter!

On Wednesday, she walked all around the village. Aunt Bridgette needed to talk with several schools and the new library about an Earth Day event. At the library, she met some pre-school kids and some boys who were reading. The library was very nice. She also saw a traditional house made of mud with a grass roof. It’s amazing what can be built with local things!

 

Thursday was full of farm work. Aunt Bridgette and Uncle Matt work at a garden and farm that teaches people to grow organic food. To get to the garden, she had to walk in the “bush” for 1 mile off of the main road. It was very sandy, but very pretty. 

At the garden, she saw some of the greens they were growing. The most interesting was the native greens that grow really tall. Greens are called  morogo (more-oh-hoh) in Setswana, the official language of Botswana.

“Flat Addison” also helped put up a new shade net with Uncle Matt and his friends.
 

She also visited the farm where they grow food in a more eco-friendly way. Sadly, this area had a very bad drought. Many people’s crops have not grown well. This is bad because most people only eat the food they grow, they cannot go to a grocery store.

 

After getting her feet dirty at the farm, “Flat Addison” visited the nearby crocodile farm. Crocodiles are big reptiles that live in the Okavango River. They are very powerful predators.

 

The end of the week was spent hanging out near the Okavango River. It is very pretty and filled with papyrus, the plant that was used for the first paper. She also saw a mokoro, a traditional dug out canoe. Many people still use mokoros to travel and fish.

 

“Flat Addison” had quite an adventure in Botswana. She enjoyed seeing the Okavango region of Botswana. It was very quite and peaceful. She is being sent back to Mrs. Tammy’s kindergarten class with items from her travels including a small basket, jewelry and the Botswana flag.