Man made Malaria (6)
--------------------
Many thanks for the responses (both privately and openly) to my con-
tribution on community participation though I am not sure if it is a
compliment or not to have my methods compared with those of Moa Tse
Tung.
I think perhaps that I misrepresented myself somewhat in some areas.
Firstly I am not saying that source reduction is any better or any
worse than any other type of control - I am also involved in two mos-
quito net projects, one with PSI (Population Services International)
and another one distributing impregnated nets by Mail Order. Basi-
cally I believe in hitting malaria with every thing in the book where
resources allow including high tech stuff like anti-gametocyte vac-
cines.
Secondly, community control by its very nature is a haphazard form of
control - for every success we have had, we have had many failures,
and even the "sustainability part" mentioned by Ron Marchland in
terms of continued community participation is problematic though not
necessarily insurmountable - I am also on a learning curve and we
learn from our successes as well as our failures - what I do know is
that some individuals are superb at community mobilisation while oth-
ers fail dismally and we are studying what are the essential ingredi-
ents to make it all work. More importantly it is a learning process
for the communities involved - it is true that they relax after ini-
tial successes, but when the mosquitoes return in avenge, it has a
very powerful effect on the appreciation of "cause and effect" of
their actions.
Perhaps the most important aspect of community control is that it
costs little - in many parts of Africa people suffer in ignorance,
and because large funding agencies don't come around, nothing gets
done - the important thing is that malaria can be dealt with "each
according to his need and his pocket" and community based source re-
duction offers something where nothing else exists.
Lastly, I would like to say that from a community point of view lar-
viciding and environmental control are easily accepted. Unlike adul-
ticiding where the effects of the insecticide are rarely visible,
once people recognise mosquito larvae for what they are, there is a
great deal of satisfaction see them die before your eyes. More impor-
tantly, in areas of high mosquito densities, once source reduction is
properly carried out, within a few weeks, mosquito populations drop
dramatically so that the whole community is aware that something has
occurred.
As stated in my last contribution, source reduction and community
participation do not offer a fast or complete answer to malaria con-
trol - I see it as a developmental process. However, I believe, with
continuing diminishing resources, it is necessary to empower communi-
ties to take charge of their own lives and not wait the whims of gov-
ernments and NGO's. I have no problem with people suffering from ma-
laria when they are fully aware of what could be done and they have-
n't done it - what I do have a problem with is people suffering in
ignorance, especially when there is something around the corner which
could be done by themselves.
Tim Freeman
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Tim Freeman
Malaria Specialist
Save the Children Fund (UK)
P.O.Box 4689, Harare, Zimbabwe
Tel: (Bus) +263-4-793198/9
(Res) +263-4-301525
Fax: (Save the Children Fund) +263-4-727508
mailto:freeman@healthnet.zw
--
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