Archive - January, 2015

Campaign anticipates misuse of bed nets

Teresa Ad‹o Jo‹o (second from right) receives instructions about the proper use of her new mosquito net from Ilda Nanjembe during a 2012 distribution by The United Methodist Church's Imagine No Malaria campaign in Bom Jesus, Angola. A UMNS photo by Mike DuBose.

Teresa Ad‹o Jo‹o (second from right) learns about proper use of a bed net from Ilda Nanjembe during a 2012 distribution by The United Methodist Church’s Imagine No Malaria campaign in Bom Jesus, Angola. UMNS photo by Mike DuBose.

Bed nets intended to prevent malaria are used in fishing communities in Zambia to fish for food, which is sold in the local market, according to a report in the New York Times. The nets also trap fingerlings necessary for future stock. This decimates stocks and causes environmental harm.

The issue highlights an unintended consequence of the global effort to combat malaria, an effort that has reduced the death toll by half in the past decade.

The net distributions I have seen by the Imagine No Malaria campaign anticipated the problem of net misuse.

Before a distribution, community health workers and volunteers were identified and trained. During a pre-distribution education period, they learned how to prevent malaria, request permission to enter homes to hang nets, and explain proper use and care of nets.

Media campaigns, community meetings, fliers and word-of-mouth alerted local people to the future distribution. Communities were prepared in advance to welcome health workers and volunteers into homes. The trained volunteers hung nets and demonstrated how to use them.

As followup, health workers were assigned for six months to sectors to monitor net use and record the use rate. This identified issues for future distributions and reinforced behavior change practices that are critical for regular net usage.  For 9 to 12 months after a net distribution, there are regular check-ups to ensure proper use and care of the nets.

In the Bo District of Sierra Leone, for example, health workers determined 98 percent of the nets were in use six months after installation. In addition, Imagine No Malaria nets were not distributed around fishing communities. The use of nets for fishing is likely localized to those communities.

In the past, nets distributed without such precautions sometimes appeared in local markets and were used for many unintended purposes. But net providers learned and adapted.

Underlying problems

Secondary uses of netting, as with many other items, are common in many communities lacking resources.

While this doesn’t mitigate the environmental harm, it does emphasize that people are using nets to get food and fish for sale. The root of the problem is food self-sufficiency and a healthy local economy.

It’s compounded by lack of awareness of the harm done to fish stocks.

The story also points to the need for alternatives to nets where practical and for more education.

A greater emphasis on screens and doors in living quarters is proposed. Due to construction practices and cost, this is more practical in some areas than others.

Indoor residual spraying is practical and safe, and it is used in some regions.

Responding to the challenge

Media campaigns can encourage proper use of nets and point out the harm done by this particular secondary use. Local leaders can speak against harmful fishing and build community support for prevention.

Addressing the diseases of poverty is a complex challenge. Solving one problem can lead to others. Unintended consequences reveal themselves.

Disease, poverty, education, food sufficiency and environmental stewardship are interrelated, complex human concerns. We are challenged by them to find life-enhancing solutions.

The story points to the need for thoughtful, comprehensive development to address these interrelated issues of life and death.

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This post was edited to remove a sentence that said the NY Times article did not refer to new nets. The article quotes a fisherman who says new nets are better because they don’t have holes.

Ecumenical partners brought healing after Khmer Rouge’s ‘hell on earth’

 

A worker cultivates rice on a collective farm in 1980s Cambodia. Photo by Larry Hollon.

A worker cultivates rice on a collective farm in 1980s Cambodia. Photo by Larry Hollon.

Today is the 36th anniversary of the fall of the Khmer Rouge in Kampuchea, known more commonly today as Cambodia.

Shortly after the fall, and after Vietnam occupied Cambodia, I went to the country to produce a film on reconstruction. Cuban hydrologists and Polish veterinarians went into Cambodia under an ecumenical partnership brokered by ecumenical leaders including Paul McCleary, head of Church World Service.

The people were still reeling from the trauma. It’s estimated that up to one-quarter of the population died in the genocide. Led by Pol Pot, the revolutionaries attempted to create an agrarian, collectivist society.

Instead, they created hell on earth.

The killing fields

At first dissidents were killed. But the attacks enlarged to include the educated and even those who wore glasses because they might be intellectuals. Teachers, lawyers and professors risked identification as part of the anti-revolutionary elite.

Under coercion, neighbors, family members and even children reported on those presumed guilty of anti-revolutionary acts or thoughts. Families were divided. People were uprooted and forced to labor in collectives. Mass murders were common.

This was the time of the killing fields.

The country’s infrastructure was dismantled. Telephone lines were torn down. The electric grid was destroyed. Modern technologies were counter to the idealized rural society the revolutionaries envisioned.

The teams put in place by the ecumenical coalition helped to restore the national cattle herd and reconstruct destroyed canals in the Mekong Delta. The canals irrigated rice paddies, which were the basic food source for the region.

U.S. carpet bombing during the war with Vietnam had caused massive destruction to the countryside. The Khmer Rouge made it worse.

Mass graves

The 1978 invasion by Vietnam had freed the country of Pol Pot but added to the damage. But for the Vietnamese administrators, Cambodia was a non-functioning country, driven backward into pre-modern status.

Land mines, laid during the war with Vietnam, were still in the ground, causing injuries and death. A grim census was underway exhuming bodies from mass graves.

Tensions between the occupiers and the Khmer were subtle but strong. Trust was broken. Hatred for the U.S. government was mitigated only by a more intense hatred for the Khmer Rouge and Pol Pot.

We traveled the country, under a curfew and tight regulation. We went to killing fields. In one particularly disturbing visit, we watched a worker exhume skulls and other bones. The odor of decay made the scene all the more horrific.

At a city hospital in the south, a modern stainless steel sterilizer for medical equipment sat upended on three rocks. Now it served as a boiling pot above a wood fire in a former operating room.

The building was a skeleton of its former self.

Sensitive work

The work of the ecumenical coalition was controversial at the time. Healing after the war between Vietnam and the U.S. was still in the future. But the ecumenical team was doing pure humanitarian work. It was the work of reconciliation and healing.

As in all wars, the suffering is not limited to the combatants. Those caught between the guns bear a tragic burden as well. This was especially true of the Cambodian people.

To enter Cambodia we had to pass through Vietnam. Vietnamese officials were suspicious of our film crew, but the Vietnamese people were hospitable and gracious.

The Cambodians were fearful we would make a misstep and cause problems for them with the Vietnamese occupiers.

U.S. authorities had sanctions against both countries. They required special approval for licenses and visas. And they confiscated and held my film for a brief time upon our return.

Eventually, however, the State Department purchased copies to place in libraries around the world as an example of the humanitarianism of the U.S.

Vision for a different world

Imagine how different the region is now. Cambodia is recovering from near-Stone Age conditions that prevailed only 36 years ago.

Vietnam is becoming an economic success story.

Thailand, despite disruptive political divisions, is a strong economic power and a tourist destination.

And Laos continues its reconstruction.

On this anniversary, I’m grateful for the courage of the ecumenical partners who carried out this humanitarian work of reconciliation and healing. People are slowly coming back to more peaceful times and have changed from worrying about killings and casualty to more mundane and safe things. Things like where to send their kids to school, what the best home odor eliminator could be, what to eat for supper etc. I’m especially grateful for leaders who had the vision, perseverance and commitment to see the world differently, through a lens of compassion and reconciliation, and to carry out the vision.