I started this blog with the hope of sparking meaningful
discussions that could move us towards more efficient and effective development
agendas. I write with no intent to
personally belittle or ridicule the work of current or past development
programs, but to simply point out some contradictions that I’ve witnessed as a “beneficiary”
of these programs and how these contradictions inform my current work in the
development of my country. That being
said, I would like to discuss what I feel is a fairly rampant misuse of
resources by multiple development agencies in Ghana, and I suspect in other
countries: mosquito net distribution.
I do not deny the existence of malaria in Ghana; however, I
do question its supposed prevalence. My
suspicions are primarily founded in the fact that I have been diagnosed with
malaria seven times throughout my life.
Never once have I been tested.
Every single one of my friends and family members has shares a similar
experience. In fact, I know many people
who visited the hospital and complained of headache, weakness, and nausea just
to get a prescription for Artesunate-Amodioquine on behalf of a friend or
family member who may actually be suffering from the sickness.
Stories such as these make it difficult for me to accept many
of the published malaria statistics. These
statistics, however, are often used as the basis for mosquito net distribution
and result in subsequent floods of nets to community health offices. They are often given to the community nurses or
health volunteers with some sort of qualifier. For example, one agency may say, “Distribute
these nets to all the pregnant women every three months.” The next will say, “Give these nets to each
child under the age of five,” or “Provide nets to each household in accordance
with its size.” They will be given at
the clinics, again at infant weighings, and again during house-to-house
distribution. Before you know it, a
family of five that typically sleeps in one room under one net (if they choose
to sleep under their nets at all) will have upwards of eight mosquito nets;
and, in a couple of months, nets will be distributed again.
Moreover very little, if any, follow-up is done to verify
that these nets are actually being used.
If it was, development workers would find their nets in use at the
rivers for catching fish, at farms for packaging and carrying produce, and in
homes two wrap and protect personal belongings.
They would most likely find many nets years old and still in their
original packaging unused and forgotten.
So, what is it with mosquito nets?
Why such an obsession with their distribution? And, why not try re-allocating these
resources to an area that is more meaningful, effective, and better received?
Are you a native English speaker?
ReplyDeleteWhy do you ask?
DeleteExcellent blog, Mankama. You raise important questions about the efficacy of development aid, as witnessed from the beneficiary end of the global enterprise. When you look at all the media hype and fancy hand waving on display by NGOs and contractors, you might be forgiven for getting the impression that the problem of poverty has been solved, or that it's in serious remission because of their actions. Some of these organizations no doubt have done good, in certain circumstances, but what long-term influence have they had? We are never informed about the follow up five or ten years down the road...a story I'd like to hear. Your blog is a good start. As for the mosquito nets, I would take one if living in an open screened house regardless of the prevalence of mosquito borne diseases. Mosquitoes if nothing else are a nuisance, and I cannot sleep within earshot of their buzzing. Malaria statistics are another story. Not sure how they are compiled, but one would assume they are based on confirmed cases, not undiagnosed symptoms (which as you say could be anything).
ReplyDeleteYou pose very good questions. In looking at malaria statistics, you should go to the source and see how they defined a case ("case definition")or how they got the estimates. It can be a complicated process, especially in countries who don't have a good health information systems.
ReplyDeleteMore to the point is your discussion of nets going to waste meaning wasted money and wasted resources. I think to solve this problem, NGOs and governments need to coordinate to make sure they are not duplicating efforts and are complimenting each others programs. Additionally, you just can't hand someone a net and expect that they'll use it. You have to create a culture of people sleeping under nets through education, reinforced, behavior, etc. That in itself is a complicated issue to address. Again, as Mr. Walters said, follow-up is important and not always being done. Are these people using the nets? If not, why? In areas where people are using nets, are rates of malaria going down (this I think has been studied and there was a positive effect on malaria rates with mosquito net use)?