Yes, they say that all good things do come to an end. I guess all things come to an end; be it good or bad. After 10 weeks of activity on the ground (and obviously many more before arriving) in Sahn Malen, our 2010 distribution has come to an end. And I choose to think that it was good. I know, I know, this is only a continuation of the fight against malaria that has battalions of private and public organizations involved and it is a wonderful pleasure to be a part of that brigade.

We distributed 10,560 nets to finish covering all of Malen Chiefdom and 4 sections in the neighboring Kpanga Kabondeh Chiefdom. On average, we spent about $0.20 to distribute each net. Our team included over 20 students from Njala University and various high schools, multiple locals and 6 international students. Mathias Esmann from Denmark, Sarah VanHorn, Luke Dryban, Ablorde Ashigbi and Sam Slaughter all from the United States.

In addition to the above troopers, we partnered with UNICEF, the National Malaria Control Program, the Pujehun District Health Management Team, the Red Cross and the Against Malaria Foundation. We would now like to thank everyone who made this possible. The donors, the GMin team who could not travel with us but who were eagerly following us via this blog and YOU. Thank you. Once a final report is ready, we’ll post that on our website. Also, watch out for our Fall Newsletter. If you’re not subscribed, please sign up on our website.

- David

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On our very last day in Sierra Leone, hours before we left on a plane, GMin gave a presentation to all the key stakeholders in malaria control in the country. It was the monthly Roll Back Malaria meeting, and in the audience were representatives from the National Malaria Control Program (NMCP), the Red Cross, the World Bank, UNICEF, the United Methodist Church, and the WHO. They all wanted to learn from our small distribution in Pujehun.

The reason for their interest is that the NMCP is planning a weeklong campaign to distribute 2 million nets in November to finally achieve the full mosquito net coverage they pledged under the Abuja declaration. We were given 10 minutes, and we did our best to demonstrate how education has been a key component of our success; spending 5 minutes extra on making sure that the net is used properly makes a big difference on usage in the long run. We think such education is best achieved by going house-to-house, and hopefully the NMCP will be able to combine our distribution model with the voucher system they want to put in place.

The best part was when they presented the budget and the major donors. It read: Global Fund, Red Cross, DFID, GMin! Our 10,560 nets are being counted, which guarantees that nets won’t be wasted on the already saturated Malen chiefdom. In all, our work has made life a little easier for the big guys, and even more people will receive mosquito nets. After a quick Q&A about our work, we hurried to the ferry to cross the bay to the airport, and our work this summer was done.

- Mathias

G-Day is not short for “Great Day”. I mean it might as well be called that but this is short for “GMin Day”. A simply amazing day. Over 200 people gathered in Sahn. 60 + chiefs. Health officials and local councilors included. The representatives of the Honorable Minister of Political Affairs- the Permanent Secretary, the Director and the Public Relations rep. Why was everyone from all the different sectors gathered here in Sahn Malen town? Well, we were celebrating as one. We were celebrating GMin’s accomplishments. We were celebrating that everyone in Malen Chiefdom now sleeps under a mosquito net. It was the beginning of something that should happen through out the country. We were celebrating that we had covered 4 sections in the neighboring Chiefdom. It was also a celebration for the people as well because this was their project as much as it was ours.

After about an hour of speeches from the UNICEF representative, Anthony Lebbie and a re-declaration of the government’s commitment to provide LLINs to cover every sleeping space in the country by the end of 2010, dancing and eating commenced. The invited guests all gathered round to eat as local dancers showed us just how is done in Sahn.

In the evening, as the older ones went to bed (frankly I don’t think they slept early with the music playing so loudly), the younger ones got ready to drop it low at the dance party. We all danced late into the night- GMin members and locals together. There was a reason to celebrate and we did not disappoint in this field. I guess all we were missing was Clem Wrights’ incredible dancing skills.

- David

During this distribution, our data shows that there are 25% of under-fives in all of Malen Chiefdom and the sections of Kabondeh in which we worked. Most of these children either have mothers that were either below 18 years old or parents who were on their 6th pregnancy.

Parents hardly seem to understand that the fewer children they gave birth to, the more disposable income they had access to. They would have fewer medical bills to pay, fewer mouths to feed and fewer sleeping spaces to worry about covering with LLINs.

However, on the other hand, it is more like parents are hedging their bets against the inevitably high infant mortality rate here.

Unfortunately, this also means the worst chances of maternal mortality in the world for these mothers. Do they know this? Maybe they see lots of pregnant women dying but I am not sure there is a connection between the state of pregnancy and morbidity.

The situation is not made any better by men who continue to refuse the use of condoms or who prevent their wives from actively engaging in birth control (thanks to Marie Stopes – an NGO actively promoting this). Certainly, they do not have to worry about any stage of pregnancy and even when the baby is sick, it’ll be sleeping by its mother while the father is making more babies with his 5th wife.

A major reason for all of this is the incredibly high illiteracy rates in the country. 70% of Sierra Leoneans are illiterate and trying to explain the above issues on billboards posted by Marie Stopes and other NGOs might not be the most effective approach. If Sierra Leone is to stay on the path of ‘development’ maybe we should take a much closer look at the high rates of people who cannot read their malaria prescriptions. And perhaps our men should not show their vitality by how many wives and consequently how many children, who eventually die in drones, are acquired.

- David

Not the alcoholic influence in case you were considering to ban your under aged children from spending time on our blog. Rather, I am writing under the influence of plasmodium falciparum. For some, it wont make any sense since they have never seen what a malaria patient is like. For others, you realize that it means my temperature is 103F on day 2 of my malaria episode. Yes, of course I took a drug today but I will have to settle in my present state of being hot, yet cold whilst shivering. In mende, malaria is very appropriately called “being hot while cold.”

How in the world would I have malaria if my whole summer is spent trying to prevent this disease from attacking and taking the lives of young children and pregnant women in particular? Well, mosquitoes bite in the early evenings, they might bite whilst I am in the toilet or just outside talking to the guys. In fact, during this trip, about 4 people from our team got sick from malaria, including 2 of my brothers. Lucky for us, we had access to drugs. We could survive.

So, imagine a kid who is in some far away village like Komende who gets malaria. Day 1, the parents notice that his temperature is getting high but it could be anything- like headache. Day 2, his temperature goes down in the morning just so that the mother takes her attention from it (this is when the parasites are in the blood cells reproducing) and somewhere around night or Day 3, these monsters all break open into this kids body while rupturing the blood cells. The kid who is probably already malnourished is severely anemic at this stage and by night of Day 3, just as the parents are thinking of bringing this kid to a health center 4 miles away, he enters into a coma and by the time they arrive to the next village, he’s gone.

Why then do we waste our time with the distribution of long lasting insecticide treated nets? Well, mosquitoes mostly bite while people are fast asleep. Also, an LLIN could technically kill a mosquito that is in the same room as the net thus protecting the kids even when they are not asleep. We help reduce the opportunities an infected mosquito has for biting someone. Furthermore, if we try really hard, we might just control malaria in these regions.

Just this spring, Sam Slaughter who had been working in Kenya also got malaria. He got the vivax strain, which is much harder to cure. He had access to a good health care facility back in Connecticut where he was diagnosed after getting fevers as high as 105F. Not everyone gets that lucky and he realizes this, which is why he still works with us. Check out our website, make a donation, send us ideas and comments and you might actually be saving a life.

- David

When Mathias Esmann packed his bags to SL this time, there were two essential items that he knew he would not forget. Those were his two helmets; a silver one and a black one. I quickly took control of the black one that was way too sophisticated for me. I guess complexity meant it was pretty safe in case I had a fall. No one plans to fall down whilst riding a motorbike but I hear it is the ultimate mark of proficiency. I had been riding the Honda XL bike for a while now and I guess I did not really know how to ride too well yet since I had not fallen.

So, I set out to pick up Sam Slaughter who was joining us on what would be our last day of LLIN distribution. He had to make it. After riding for about 10 miles, I finally met up with Sam who was trekking on the road (as I had told him to get off his vehicle.) Shoot! I forgot to bring another helmet but then pointed to him the beauty of mine. We joked around and spoke about all the good things great friends talked about.

As we cruised towards our destination 20 minutes later, I saw a bumpy patch on the road. I did not like it and so I decided to make a quick cross over to the other side of the road. It felt like the switch took a whole decade and when we had arrived on the other side (or did we?), I was on the ground, not really sure what had happened and Sam was up on his feet checking out his nose. We had fallen down- nothing major and we got a few scratches here and there. Phew, his nose was not broken either. We got back on the bike and went on to meet the rest of the team with bloody hands and hips.

Sam definitely participated in the final distribution and there was one thing that was clear- I was now proficient at riding a motorbike after the fall. I rode with Sam for another 30 miles that night from Mandeima to Sahn Malen town and we arrived at least 20 minutes before the poda poda got back and I’m sure they were relieved to find out that we were both alive since it had been raining cats and dogs and it was already dark.

- David

This was probably one of the days when anyone doing the kind of work we do had nightmares about. Why? Gbondapi has the biggest weekly trade fair in the country. More than 3,000 people usually congregate there on Tuesday and Wednesday to buy and sell all kinds of items including mosquito nets often provided by NGOs. I put on my cautious goggles and told Mary- one of our volunteers from Njala University, during the meeting that we should definitely not cover floor spaces in this village if we do not want to run out of all our nets.

This was when I finally realized that GMin’s message was well understood by our volunteers and those who we work with. Mary reminded me that she knows that it would be harder for us but if we had the policy to not cover floor-sleeping spaces, we would be missing the children- the group we wanted to cover the most. Damn! How did I forget that? Oh well, I was excited that we worked together as a team and the “no Boss” policy had saved many more lives.

After a day’s work, we had distributed 2,000 nets to Gbondapi and it’s nearby villages. It was much tougher and we had to really squeeze the correct answers from people who tried to get extra nets for whatever purposes. But again, one cannot really visit the trade fair if they were not ready to bargain. At the end of the day, I was positive we had every sleeping space covered.

On the way back, I rode Ibrahim’s bike ahead and met with the Chief of Benga Junction- a place that was originally not on our list but very close to the villages we had covered. 15 minutes later, the guys on the poda-poda arrived and we had the town meeting and distributed in Benga Junction before heading back home in the rain. Indeed, a very fulfilling day.

- David