Tuesday, April 6, 2010

Rural Health

The backbone of the Malaria Control program is the nationwide survey that informs donors and the government about what is going on at the household level. You can distribute bednets and drugs and paper the countryside with brochures and posters but unless people sleep under the bednets, take the medicine, understand the brochures your efforts are for naught. April 2010 is survey month and the third such survey done in Zambia (2006, 2008). Some 150 survey technicians are trained and sent out with the goal of interviewing 6500 representative households about their habits, knowledge and health. It's a massive undertaking and a logistical fete. These photos are from a training trip to Chongwe rural health district, about 45 minutes from Lusaka by car.

Chongwe gets it fair share of visitors b/c it is so close to Lusaka and is very easy to get to -- the roads are paved (tarred) until the last 20km and there is rarely an issue with flooding or access. Many parts of Zambia are in accessible for much of the year because of the poor conditions of the roads in the far-flung corners and because of the rains.

The survey questions include topics from how many are in your family? how many chickens do you have? do you listen to local radio programs? what color and style mosquito do you prefer? as well as collecting a health 'snapshot' for the household.

Surveyors headed out.

This surveyor hitches a ride....another NGO (http://www.worldbicyclerelief.org/) recently distributed bicycles in this area. It's great to see them being put to use.

The data is collected on hand-held computers; the information is geo-coded.

The village school. The school day is split into morning and afternoon sessions to accommodate all the students.

This is a concrete house typical of this village. They have appliances like TV, radio, DVD player, cell phones, etc, but no electricity. Always with corn/maize.

They have a small bit of space where they planted vegetables and a handful of chickens running around. The chickens get counted in the survey (as would any cows, horses or goats if they had them) but the dog does not.

The house has a pit toilet a short walk away from the house.

This is the kitchen boma/insaka in the backyard -- the family does all their cooking with a small charcoal brazier.

Part of the training the surveyors undertake is how to administer and report malaria tests. They collect some blood for RDT (rapid diagnostic testing) and also a slide for later analysis.

Moses had a negative malaria test this time. (The stick that looks like a pregnancy test stick is the malaria RDT.) From the oral survey, the team finds out that the family has bed nets that they got a few years ago that have recently been re-treated with insecticide but they are not using them currently. There is a 'transmission season' where infection rates are high but malaria is a problem year-round. The parents report that they have used the nets in the past. The family has 4 children living in the house. The surveyors are also trained in public education and have 'permission' to advise the family about measures they can take to prevent malaria - including sleeping under bednets every night all-year round.

As a random aside, I love that while the surveyors are out in their bright orange shirts and caps these bright orange flowers are also in bloom everywhere.

Moses (aka MoziGator), feeling better. He's deep in thought, plotting how he is going to get a hold of that hand-held computer and use it for a teether -- which he did. Victory!

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