Public Health or Poverty Alleviation? What are Mosquito Nets for?

A total of 21.5 and 27 million nets were distributed in Uganda in 2013/14 and 2017/18 respectively, and this yielded reduced malaria cases in the country. However, despite good government intentions, a number of Insecticide-Treated nets have not been used for their intended purpose and many are using them as fishing nets, wedding veils, ropes and for ant collection. It’s therefore important that government incorporates and ensures implementation of a proper malaria communication strategy

 

By Gertrude Masembe*

Kampala , Uganda

Public Health or Poverty Alleviation?

What are Mosquito Nets for? 

 

Mosquito nets of varying types and sizes have over the years been used as a prevention strategy against Malaria in the world and this is no exception for my country Uganda. Uganda was once in 2017 cited as having the highest malaria incidence rate of 478 per 1000 people per year. To curb the deaths and escalating Out Patient Visits (OPD) at health centers government came up with a Universal coverage program which would help address this seemingly indomitable but preventable disease.

According to the National Malaria Control Program Report (2018), a total of 21.5 and 27 million nets were distributed in 2013/14 and 2017/18 respectively, under this arrangement and this, according to reports, yielded reduced malaria cases in the country.

However, despite good government intentions, many of the ITNs (Insecticide-Treated nets) have not been used for their intended purpose. According to the Uganda Demographic Household Survey 2016, 65% of household populations had access to ITNS and percentage is lower in special areas like island and mountain districts where access stands at 48% and 59% respectively.  To prevent malaria, people must own mosquito nests and must use them whereby use is assessed through having slept under the mosquito net the previous night. A study undertaken in Uganda showed a reduction in LLIN (Long Lasting Insecticide Net) ownership at 65% of sampled household (in 2018) down from 94% in 2018 favoring wealthier households. Only 17.9% had adequate LLIN coverage favoring households with fewer residents and wealthier households but only 39.5% had used a LLIN the previous night.

A number of theories can be advanced to explain this but one reason we can’t run away from is the fact that a number of ITNS have not been used for their intended purpose. ITNs have been repurposed to serve other uses and many are using them as fishing nets, wedding veils, ropes and for ant collection. I have had chance to transverse various parts of the country during which time I have fed my eyes on outcomes of new innovations by communities as they seek to generate income using the free government goodies. One adventure that has stuck with me though was use of ITNs to trap ants intended for human consumption!

Of course, trapping white ants using government donated nets is no new story but the way of doing it is what caught my attention during my adventure. As I made my way towards the eastern part of the country I came across a stretch of land all lined up with white funnel shaped images along the main road.

I requested the driver to stop by so I could chat to the ladies nearby. After the usual greeting, I requested them to allow me take some pictures. They were at first hesitant for fear of being penalized by government but after back and forth negotiations I emerged winner and strolled towards the harvesting point.  My eyes immediately caught sight of the additional items used in trapping the white ants and couldn’t contemplate the level of hygiene!!! There, before me, was a very old and dirty kettle all stained with soil that appeared to be in piles. The white net now turned brown and with numerous holes due to continuous stretching was a sight to behold.

However, the ladies were all happy to have me take the pictures as long as no one was captured in the background. They also let me into their small secret. “Mosquitoes nets are now part of our money-making resource. After all we didn’t ask government for nets. Instead of giving us things we need they choose what they think is best for us” one lady commented while others agreed in unison

After a few minutes, a ten-year-old emerged with a sizeable saucepan and a plastic cover but the level of dirt on the utensils this time sent me packing.

“Aren’t you taking some white ants for people back home?” they beckoned as I sped off to the car

“Thank you very much for your kindness, but my team says I have over stayed my leave” I replied in a loud voice.

This clearly indicates that government is probably under performing in terms of awareness regarding malaria and its adverse effects on the human population or people don’t have mosquitoes nets as a priority need. It’s therefore important that government incorporates and ensures implementation of a proper malaria communication strategy while my individual advise to travellers remains summarized in one statement

Next time you think of buying white ants along the road, think twice before you munch on the crunchy treats!!

—————————————

*  Gertrude Masembe is an Executive leader with proven management background; effective problem-solving skills with demonstrated ability to work in rapidly changing environments. She has demonstrated expertise in strategic planning, organizational development, project management and business intelligence across diverse spaces in the development sector. She attended Makerere University and specialized in Social Sector Planning and Management. Her passion is community development which cuts across various sectors like health, education and economic empowerment

E-mail: trudymasembe@hotmail.com