Our net distribution efforts have gained for us seriously good credibility as an aid organization in the Gaoua area where the Loropéni and Kampti districts are located.  The earlier post about the mayor of the Djibge district coming to ask us to distribute there is one illustration of that.  We have a reputation for being thorough, fair, transparent, and tough in how we go about distributing nets.   We visit every village several times.  We follow up on the distributions to make sure people are using their nets.  We gather accurate data on our work and can trace every net we’ve given out (well, maybe just 99% of them).  We work with local and regional public health authorities and keep them informed of our progress.  When we go out to the villages we see other health issues first hand that the local health officials in the clinics in the towns never see.  As we have launched into distributing in the Kampti district since June we have seen this reputation become established again. 

In the town of Kampti some disputes arose over the completeness of our original census of the need for nets, with people claiming that they had never been counted and thus would not get a free net.  They called and complained to their mayor.  He showed up one day to observe the distribution, and we welcomed his presence.  We showed him all we did to try and figure out how many  nets were needed in any locale.  We showed him who was responsible for doing those censuses.  We showed him our distribution method and our method of gathering data from each person who received a net.  We talked about our plans for follow-up visits in the future.

In the end the mayor was very impressed with our work and through investigating the complaints, found that only three households in that locale had been left out of the original census.  We corrected that quickly, and everyone but the guys who were trying to scam us out of more nets went home happy.

As we cross the half-way point for finishing the distribution in the Kampti district, and as the government starts making more moves to begin their own distributions nationwide, we are starting to explore how we can take this great cred we have in the region and put it to work in other areas of improving public health, especially children’s health.

In 2009 the Burkina Faso government launched a nationwide campaign to distribute long-lasting insecticide-treated nets (LLINs) to the entire country.  Their goal is to give one net to every two people in the country.  When they launched the national campaign, they didn’t actually launch it everywhere, just in one provincial capital and surrounding villages.  They hadn’t received enough nets in the country yet to do it nationwide.  Back in January of this year I met with the national director of the anti-malaria campaign to find out how their distribution plans were progressing.  If they were moving ahead with their plans, we would wind up our own distribution program and back out and shift to other projects.  However, the national director told me that they hadn’t even ordered the 8 million nets they needed to distribute throughout the country, and were actually having a hard time finding that many available.  So it would be a while before they got to actually distributing.  He urged us to move forward with our own distribution plans in the Kampti district and not wait for the government program to get there.  Who knows how long it would take.

So we ordered 20,000 more nets and began distributing in early June.

This spring I was running through my head some summary statistics for our distributions in the Loropéni district (comprised of 6 health zones), which we finished up in February.  From the end of April 2008 to the end of February 2010, we distributed about 23,000 LLINs in the district.  According to the 2006 population census, there are about 45,000 residents in the Loropéni district.  Thus, statistically at least, we have met and exceeded the government’s goal of getting one net to every two people!  And this, not by making that our goal per se, but by fixing our goal as getting a net in use in every room where people sleep in every village.  Some members of our distribution team have expressed skepticism over how the Burkina Faso government will actually go about achieving their goal of one net for every two people, and whether they do or not, and how exactly, remains to be seen.  Yet, by coming at it in a different way (one that we believe is more practical and born out of the reality on the ground), we seem to have already met the one-for-every-two-people goal, at least statistically.

Raphael and Togo are busy distributing nets in villages in the Kampti district, a large area to the south of Loropéni with a population about the size of the Loropéni district (both about 46,000 inhabitants).  One of the villages they went to recently has the Lobi name Gbankhoura, which loosely translated means “Mosquitoes, they’re eating us alive.”  Really.  (For the gearheads reading this, the name parses like this:  gba- ‘mosquitoes’ –n- ‘they’ –khoura ‘eat [us] ravenously’).  When Raphael and Togo arrived to distribute the insecticide-treated nets that effectively kill mosquitoes in large numbers, they remarked in the education and training phase that if everyone in the village uses their nets properly, they will be able to change the name of the village to Gbankhiira, “Mosquitoes, they’re all dead.”  That got a laugh and a lot of nodding heads.  Togo has spoken with someone from that village recently and he said that, true enough, the mosquito population in the village has been decimated.  Whether they will actually change the name of the village or not is yet to be seen.

Adama in Ouaga emailed me today to say that the new shipment of 20,000 nets has arrived in Ouagadougou.  Adama will work to get them out of the customs depot in just a few days.  Can we start the distribution by the first of June?

The nets were ordered in February from a factory in Thailand, through BestNet Europe.  Annette Braae was very helpful in processing the order and setting the process in motion.  However, we’re disappointed in how long it took for the nets to get to Ouaga – about 3 months.  Our team on the ground has been anxious to begin distributing.  The rains in SW Burkina Faso have been coming early this year, and there are a lot of isolated villages in the Kampti region that are hard enough to get to in the dry season, and may be nearly impossible in the rainy season.  But our local team is dedicated to getting the nets out, and we’ll use every means at our disposal to get them to the villages.

I’ll try to post tomorrow with some photos of how we’ve gotten the nets out to the villages in the past.

Got an email today saying that the next shipment of nets will leave Tema, the port in Ghana, in the next few days.  Let’s hope and pray that the nets arrive in Ouaga before the end of the week.

The name of the town means “white water” and it is pronounced something like "jeeg-BAY”.  It is one of the southernmost prefectures in Burkina Faso, and one of the most isolated.

The mayor of Djigbe had a long talk with Togo asking him if we could distribute nets in their health zone as well.  They are not confident that the government will get to them any time soon, so they would rather we did the distribution.  We had to tell them that for now, we just had funding to cover the Kampti health zone with over 100 villages, but that if more funding comes in, we would seriously consider covering their zone as well. 

ChildAlive has earned a reputation in the Gaoua area for careful, serious work against malaria.  This is another example of local leaders coming to us to ask us to intervene in their regions.  We’re happy to do it, we just need the resources. 

Togo went back to Gbatounona to take pictures of the improvised stands for the mosquito nets.  He took a young med school graduate with him and a video camera as well. The recorded a meeting with the women of the village who not only thanked the Foundation for the gift of the mosquito nets, but also begged us to help them dig a well.  The village is well out into the bush and uses nearby creeks for water.  Half the year, the creeks are dry, so they dig shallow wells in the low-lying areas for brackish water.

We’ll start looking into the process of getting well dug in Gbatounona.  Togo will get an estimate on the costs, and we’ll develop a plan for village participation and contribution. 

One of the things we’re discovering is that by following our policy of distributing in every village of a region, we visit villages that have never received a visit by development agents, either from the government or from  private NGOs.  The people of these remote villages really appreciate the effort we make to get to them, and I think it engages them more in carrying out their responsibilities.  This is one reason we’ve have a good compliance rate for net usage after the distribution.

Got a text message from Togo Palé last week, so I called him back via Skype.  He was outside a small, remote village called Gbatounona, in the southernmost reaches of the Lokosso health district.  He was doing a follow-up survey to see if the nets we distributed in that village last fall were being used correctly.  He had to leave the village and climb a low hill to get enough cell phone signal to send the message, but in spite of the remoteness, we were able to talk for several minutes. 

The people of Gbatounona had taken the net distribution to heart and had been using them correctly since the distribution.  Togo reported that over 90% of those who got nets had them hung up properly in their bedrooms.  What pleased Togo the most, however, was that several people had made special stands to allow them to take their nets outside or up on the flat roofs of their houses to continue using the nets in the hot season.  From March through June in Burkina Faso, daily temperatures in the sun can go above 50 degrees centigrade (122 deg Fahrenheit).  At night it may cool down to 80 or 85 F outside, but it remains oppressively hot inside the houses, so many people sleep outside during that time. The photo below shows a traditional mud house built by the Lobi people with a flat roof.  Notice the traditional ladders carved out of a log.

What the people of Gbatounona had done was make a solid mud base in which they stuck rods cut from tree branches.  The placed four of these outside or on the house roof and then draped the mosquito net over the rods.  This gave them the protection they needed while sleeping outside.

Togo liked this idea so much that he wants to incorporate it in the training we do before each net distribution event.  He also reported that the villagers expressed deep gratitude for the net distribution.  In such an isolated village they rarely see any development or health agent make the effort to come to visit them.  It has become a signature element of our net distribution campaign, that we visit every village we distribute to several times, first to distribute, then to follow-up (at least two follow-up visits) to make sure nets are being used properly.  This has given us consistently a 90% compliance rate in the adoption of this new technology to prevent malaria, and it has translated into a dramatic reduction in the incidence of malaria in the region.

I hope to have some solid statistics on that issue soon.  Raphael just emailed me the malaria data from the Loropéni clinic from 2007 to 2009.  I’m anxious to see what the numbers tell us.

We’re now going on three weeks from the great flood of 2009 here in Ouagadougou, Burkina Faso.

On that day, more than 12 inches (~260mm) of rain fell in less than 12 hours on the city, causing flooding and destruction of houses and property unlike anything ever seen by anyone alive here.  The three main dams running through the center of town overflowed, flooding the hospital and one of the nicest hotels in the city.  As bad as it was for the hospital, which is now closed indefinitely, it was far worse for as many as 150,000 people who lost their mud-brick houses to the torrent.

For detailed information, first-hand accounts, and photos of the flooding, see my family web-page: www.showalterfamily.net, and click on the “News” section.

ChildAlive is contributing to the health needs of the flood refugees through an organization in Ouagadougou called Paam Laafi.  This is a name from the local Mooré language which means simply “Get healthy!”

More on Paam Laafi in another post.

No Internet for the last two days out here, so no posts.  However, Togo and I did some great interviews over the weekend with people who had asked if they could give a testimony to how the mosquito nets had improved their lives. We shot some video of these testimonies and will post them when we get them processed and when I get to some fast enough Internet access.

What did people say?  Basically, that not only are the nets protecting them from malaria, but they are also sleeping better than they ever have before, and they have more energy to work, and they are no longer spending money each day on mosqito coils, small coils of incense that keeps the mosquitoes away. One women said she had enough strength this year to plant a rice field to provide for her family.