You know how when you’re in a pool in the middle of the summertime and it’s just about to start pouring, you can tell because you can see the drops making circles in the water? I used to love those minutes in between when the rain would start and the lifeguards would blow their whistles for us to leave the pool because if you swam to the bottom and looked up, the sky looked like a dalmatian.
Every day at about 5:00, we see those spots on the water by our cottage. After the first few days, though, we realized that it wasn’t drizzling– the spots were bugs hitting the water. Today in the late afternoon, we went out in canoes on the dam and I realized just how thick the air really is with bugs at that time of day. No one here seems to think twice about it, though, even in the dry season.*
Malaria, HIV/AIDS, and Yellow Fever are so common here that most people laugh to see how afraid we are of them. Every bed at the hospital has a malaria net, but they’re commonly misused because malaria is seen as such a minor issue. In the village, malaria nets are more useful as a makeshift garden fence to keep the animals out, because a full course of malaria medication is only 150 kwacha ($0.44) at Jey Jey, right behind the register next to the razors and super glue.
Millions of dollars a year go to distributing those malaria nets; technically, it’s punishable by Malawian law to misuse them. Yet people who have them often don’t use them because they know that malaria causes minimal damage if it’s treated early, and that they can easily obtain the treatment. That attitude unfortunately leaves children at risk, because for them it’s more dangerous and less easy to diagnose early. Reportedly, during the wet season the pediatric wards are full to the hallways of malaria patients. Overall, though, the attitude we see is that people who live here can recognize and self-treat malaria more efficiently than nets or prophylaxis can stop it.
On the other hand, we see Oral Rehydration Therapy (ORT) integrated into the local culture as something mothers standardly buy for their children when they’re sick, even though we tried some and it tastes absolutely awful. Advertisements on buildings show the packets and they’re available cheaply at the local market.
Giving people things doesn’t seem to work nearly as seamlessly as making it an option for them. Without end-user adoption, we can throw all the money in the world at getting people to use malaria nets and young people with HIV to use condoms and still not do much good. If the people here don’t think it’s an issue, aid-givers in the proverbial there can’t do much to solve things. Either we all, local institutions and global ones, have to intelligently enough educate the people on the benefits of a technology to change their attitudes, or we have to adapt the technology together to better fit the environment.
The mosquitos are swarming, but at the end of the day Malawians don’t need more malaria nets. They need people to listen to them.
*Disclaimer: while we were on the water we were wearing a heavy perfume of bug spray and we’re faithfully taking our prophylaxis every day before we go to sleep under our appropriately-used untorn mosquito nets.