STOMP LOG 4: What is a Hero?

The WHO estimates that in 2015 there were 214 million new cases of malaria resulting in 438,000 deaths. Others have estimated the number of cases at between 350 and 550 million for falciparum malaria. The majority of cases (65%) occur in children under 15 years old. (See full report)

Solving this threat to children and families in Sub-Saharan Africa requires heroes.

Part of my job is to speak out when I see these heroes in action. 

Joseph is a hero.

He may not realize to what level he is a champion of this community, but the more I work with him, the more I see the hope of malaria eradication in this community becoming a reality.

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Joseph is a community Health Worker in his village, near the Kigoma Washing Station where many of the surrounding coffee farmers work and where we have been building capacity through house visits, community groups, and trainings. 

In our second visit to Joseph’s house, we sat down over some non-alchoholic sorghum beer (Ikigagi) to talk more about his impactful role in this initiative.

Joseph has always been a leader in our community group, and he brings that leadership back to his role as a community health worker. After some small talk and time visiting, we asked Joseph some questions. 

Andrew asked Joseph about net distribution, and Joseph told us some excellent news. In one of the cells (collections of villages), nets have been distributed, post census. This is huge. In the words of Joseph,

“If 50% of people in the community have nets, and 50% are using them, then if we get nets to everyone, we already have a dramatic increase in malaria prevention.”

Now that 100% of the community has nets, Joseph believes we must capitalize.

The number one challenge of behavior change and malaria eradication is resources, and I’m grateful that Rwanda is doing so much to get those resources where they need to go.

However, some areas still don’t have these distributions yet, and net repair is a key area we must focus on, even if nets have the smallest tears or holes. Mosquitoes carrying malaria (female Anopheles mosquito) are most active between 8pm and 2am, and they are smart. When hitting a barrier of a net they dive bomb like fighter jets, looking for a hole in the net. Using the most informal and unscientific analogy of all time, it reminds me of the death star—we think we have an impenetrable protection barrier with a decent net, but all it takes is a small entry place/rip, to leave a child/family unprotected.

Joseph’s opinion: Interventions make a difference, and adding more resources will make a dramatic difference in the villages in this area, if combined with consistent interventions and accountability in the community.

Joseph told us he is thankful for the extra support from the STOMP team, and that he sees tangible differences in how people in the village talk about malaria/carry out prevention.

Joseph has five adorable kids, and the eldest kept popping into our visit keenly listening to our conversations. I told her we are coming to her school in two weeks to train students in malaria prevention activities. These activities will give students a chance to take ownership in the fight against malaria within their community through net checks and a day for net repair once a month. She has the chance to follow in her father’s footsteps as another leader of behavior change at the village level. 

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I asked Joseph if we could use his photo and his story, and he was 100% on board. Change and eradication of malaria starts with community health workers like Joseph who are engaged with their village communities on a daily basis, and can truly lead an initiative with authority and positive cultural receptivity. I hope we continue to find more Josephs in this community, because as we do, Kigoma has the potential to become a model for community based interventions protecting these families from malaria.

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I’m excited to document more of this project soon. I feel very honored to work with Community Health Workers like Joseph. There are many challenges mucyaro (in the countryside), but Joseph knows how to kwirwanaho (to improvise and work with limited resources.) This is just the beginning!

Cheers!

Ryan