Hello all! We write from Betampona, in the deep bush. So far, as we go further along the Nosivolo, the villages get more simple and the toilets more adventurous. Betampona defies this trend, with its concrete town hall, blasting speakers and even the occasional shop. Walking into Betampona we were greeted by a chorus of singing children, who clapped our way into camp. There were lots of familiar faces among the crowd and warm greetings all around.
After settling in and establishing base, we met the chiefs of the town. One of our priorities this year has been to expand schistosomiasis education. First a bit of background. Schistosomiasis is normally found in slow moving bodies of water, such as the Nosivolo River, but rarely in fast moving water such as streams and water pumps. When people stand in the river, microscopic schistosomiasis parasites swim into their skin; the longer you spend in the river, the more parasites you pick up. The more parasites a person has, the sicker they will be. We have previously found that many of the children have high numbers of parasites in their body.
The problem with the Marolambo district is that people depend almost entirely on the Nosivolo river to live. People use the Nosivolo daily to wash themselves, plates and clothes. Furthermore, villagers spend half the year panning for gold in the river, wading in chest deep for a whole day. To make matters worse, parents will bring their children in with them, often from as young as 6 years old. While many villages do have a central pump with fresh water, the flow is quite slow and many houses are far away.
Local understanding of schistosomiasis is limited, particularly in its transmission. Most adults do not understand that the parasite is found only in the river, not in the taps or streams. This is where our education fits in. We realise that the population cannot avoid using the river completely. However, by regularly educating adults and children about schistosomiasis and encouraging use of taps and streams over the river, the level of parasite in the body may be reduced. In combination with yearly treatment, education has been effective in other areas around the world.
Unfortunately, we can only run schistosomiasis education for each village for one day. So our question this year has been: how can we encourage the villagers to keep up education throughout the year? To tackle this problem, we have been running focus groups with the chiefs in each village. After thorough education, the group is asked a series of questions, such as “How can we discourage children from playing in the river?” or “How can you promote maximum use of the water pumps and the streams”. The main aim is to start a discussion between the Madex team and the village leaders, so that our work is carried on after we leave.
It was quickly clear that Betampona was a diamond in the rough. The leaders of the village were well educated and practical about combatting schistosomiasis. They were committed to running both adult and children education. To demonstrate effective schistosomiasis teaching, we invited them to come watch our child education session. This program, designed by Kate and Jemima and delivered by our Malagasy team members Manu, Gina and Aryon, is fantastic. Using a mixture of games, songs, story books and pictures, the children are taught about how to catch schistosomiasis, its symptoms and its treatment. We wanted the education to be fun and memorable. I certainly wont forget Manu running around with a shark hat on pretending to be “Scolly the Schisto”, listening to children sing “Pass the Praziquantel” in Malagasy and the ridiculous drawing of a stickman using a latrine with a huge smile on its face.
Altogether, Betampona was a huge success. Not all the villages have been as enthusiastic or receptive as Betampona, but its really nice to see the outcomes when everything comes together. In the ideal world, the teachers and chiefs in every village would continue our schistosomiasis education regularly throughout the year. At the very least we hope that the information we have left will diffuse throughout the year and that maybe some people will change their behaviour as a result. As it was pointed out by a village elder, all it takes is one family to adapt their behaviour and hopefully their improvement in health can be an example to others.