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News for 2009, January - Show latest items

Why bednets?

One of the questions we often get asked is why the focus on bednets and also the claim that you can link provision of bednets to lives saved.

It is true, bednets are not the only weapon available in the fight against malaria.  Education is important as are initiatives to remove pools of stagnant water.  Drugs also have a role as does (more controversially) spraying of insecticide.  However, the evidence shows that providing long-lasing insecticidal bednets is probably the single most important and effective thing that can be done.  The reason for this is as follows.

The malaria-carrying mosquitoes are typically the female Anopheles mosquito that bites between 10pm and 2am when seeking a blood-meal from a human. Hence nets work as they protect over the specific time when the relevant mosquitoes are biting. Of course someone could get up in the middle of the night and potentially be exposed but as you can imagine, protection while sleeping reduces hugely the chances of being bitten.  Where possible, a 'blanket' coverage of all sleeping spaces in a village or community is carried out as this effectively wipes out -or close to it - a mosquito population as the mosquitoes are literally starved of a blood-meal, as well as the mass 'killing effect' insecticidal nets have when the mosquitoes land on them.  Where it is not possible to achieve a complete coverage of all sleeping space, those most vulnerable, pregnant women and children under five years old, are given priority.

An example might help. In a recent distribution in Uganda, the clinic covering 9 villages reported 257 cases of malaria, and three deaths, in a one month period shortly before a net distribution. In the one month period, two months after the distribution, the number of cases of malaria was seven and no deaths. A fundamental, dramatic impact.

As already mentioned, malaria education is an important element in a bednet distribution which is why it is a condition of all of our distributions that they must have a malaria education component. This typically involves explaining how malaria is transmitted, proper use and care of the net, a bednet hanging demonstration and how to identify the signs of someone suffering from malaria. This helps people understand why sleeping under a net at night can protect from malaria-carrying mosquitoes. A simple play or 'skit', performed in front of the village, is often part of getting the message across. Adopting a light-hearted storytelling approach to explaining how nets protect people and kill mosquitoes is highly effective. It is explained that nets are for their use and, with comments from the village chiefs and community leaders about how these nets must be used properly, proper use of the nets is encouraged.

We also use the education component of bednet distribution to talk about the importance of removing areas of stagnant water, thus also addressing this issue.

Prevention is better than treatment but malaria can be treated if caught early and drugs are administered. Helping people recognise the signs of malaria, explaining that treatment is possible and encouraging them to take someone suspected of malaria to a clinic are all important education elements.  However, drugs are not always available through lack of funds in a country and the very poor often have no money to pay for them.

The amount of money required to provide all the nets needed and all the drugs needed is large by your and my standards - about $3.5 billion per year each year for 10 years. We focus on the nets and education part because of the reasons explained above but also because it gives us something simple and tangible we can use to engage people in the fight against malaria.  We have established a system that allows 100 percent of any money raised purchase nets as well as being able to show exactly where all the nets go.  We think this is incredibly important in motivating people to join the fight, not just in terms of raising money but also in sending a message to governments. In national budget terms the sums required are small and over ten years would help save between 10-30 million lives, yet they are still not allocated. http://www.againstmalaria.com/Why.aspx

If we were to use the funds we raise for nets and drugs and all sorts of other things the message about defeating malaria would be a more complicated one to get across. As it is, we are able to focus on the simple message that 100 per cent of the money buys nets, they end up over heads and beds and we demonstrate that has happened. Other organisations focus on things such as drugs and the logistics of distributing them. This illustrates how many groups, with their own clear objectives, communicating well and acting as a large team, can defeat malaria.




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