Apparently, malaria is the major disease burden in Kyangwali refugee settlement accounting for close to 50% of the morbidity. There have been various preventive and curative interventions that are widely implemented by Action Africa Help and other implementing partners- something that really raises hopes among health workers, sympathizers and some of the residents.
However, the reality is a bitter one that nearly rubbishes the efforts and time spent in the preventive approaches, specifically the supply of Insecticide treated mosquito bed nets. One of the facts that the refugees have come to learn with time is the “insect-cidal” effect of the chemicals these nets are treated with. As opposed to utilizing this “insect-cidal” effect by sleeping under them for the control of mosquito infestation, majority have adamantly used the mosquito nets as termite resistant building materials. The closer one gets to most of the grass thatched houses in the settlement, you notice strips of blue or white thick netted thread joining up reeds or sticks used for the superstructure and as well firmly fixing the grass thatched conical roof tops. As though this is not enough, I saw animals tethered by twisted but netted blue and white ropes that clearly turned out to be mosquito nets. I was exasperated and sick of this unhealthy practice among people who indeed are in dire need of rescue for their lives. They are causing a great disservice to themselves, health service providers plus inhabiting and surrounding communities by averting the efforts towards a malaria free community. My worst scene had not come yet until I coincidently moved to the back yard of one of the houses that we visited during the intensive nutrition assessment exercise for the refugee settlement. A brand new mosquito bed net, without a single puncture was hanging over firmly fixed sticks forming a chicken pen that restrained 2 cocks and a hen just like one would use a wire mesh!
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| Chicken restrained by a mosquito net as a chicken house |
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| Mosquito net used as building material |
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| A grass thatched roof fixed with strips of mosquito nets |
As I reflect on these observations that seem to be happening in many homes in the refugee settlement, I can’t stop asking myself what exactly the missing link is. Why would a pregnant mother, a recovered client or a vulnerable person who has received instructions and sensitizations on the value and usage of such an effective item go back home only to use it as a chicken house or a tether rope? Could it be that the health communication is not effective or that the paradigms in behavior change among such populations are rather complex?
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