Of the askari and my mosquito net

For the last three years I have lived on this side of town – Kicukiro to be precise – where I have grown accustomed to knocks on my house door, especially over the weekends.

Monday, November 25, 2013
Paul Ntambara

For the last three years I have lived on this side of town – Kicukiro to be precise – where I have grown accustomed to knocks on my house door, especially over the weekends.If it is not the garbage collector demanding for pay, it is the village official telling me about the venue for the next Umuganda (community work).  A recent addition is the irksome fruits lady, who despite making it clear to her that I have another supply source, keeps popping up and her excuse; ‘I was just checking.’But last weekend’s knock was a different one. It was my askari (watchman). He couldn’t have been a harbinger of bad news because he was the usual jolly old man.His message was simple, authorities at the cell office had requested for my national identity card number.The logical question I put to him was, why? "There is a mosquito net for you, boss; it is a donation from government,” he said with a heavy accent.  I obliged and a few minutes later, a treated mosquito net was delivered at my doorstep.A cursory research on the issue revealed that over 600,000 other people in the City of Kigali and some districts of the Southern Province, like me, had been beneficiaries of these free mosquito nets distributed by the Ministry of Health through a campaign to eradicate Malaria that started last year.It is very hard to find anyone in Rwanda who has not suffered a bout of malaria. For those that have been lucky, it is highly probable that they have endured doses of preventive medication.And this is not just a Rwandan problem. According to the World Health Organisation 2012 World Malaria report, there were 219 million cases of Malaria in 2010 and an estimated 660,000 deaths. About 90 per cent of the deaths occurred in Africa.As if this is not bad enough, WHO estimates that every minute, a child dies of malaria in Africa.Interventions by government to contain the disease are worth noting, especially with reports that global funding for malaria prevention and control levelled off between 2010 and 2012, according to WHO.The report notes: "The number of long-lasting insecticidal nets (LLINs) delivered to endemic countries in sub-Saharan Africa dropped from a peak of 145 million in 2010 to an estimated 66 million in 2012.”Rwanda has made big strides in reducing the incidence of malaria over the last ten years. The intervention has been a cocktail of prevention and treatment measures that seem to be paying off.According to the Ministry of Health, in 2005, malaria was the number one killer of children under five years. In 2008, it had dropped to third and eleventh in 2011.This success is attributed to a number of interventions like indoor residual spraying and the distribution of Lasting Insecticidal Nets. It is on the latter intervention that government seems to have put much emphasis with resounding success.Government, through the Ministry of Health, has distributed more than 1.7 million mosquito nets for children under five countrywide early this year. It has also been considered as a rule of the thumb for every pregnant mother to be given a mosquito net on her first antenatal screening. Mosquito nets have also been given to all under five years children upon completion of vaccination.As a result of these efforts, the 2011 national health management information system shows that only about 200,000 malaria cases were reported compared to 700,000 cases in 2008.Enviable results you may say, but it is worth noting that Malaria has not gone anywhere. These efforts that have paid off handsomely need to be sustained to prevent a resurgence, especially given the fact that Malaria incidence in some neighbouring countries like the Democratic Republic of Congo indicate that they are among the most affected in Sub Saharan Africa.Replacing old nets will also be vital. Another measure that is at an individual level is a mindset change. Many people have nets but never use them. Some people that I have interacted with claim that sleeping under a mosquito net is uncomfortable. Brazen excuse especially if you come to think of the alternative. This should be the next battle line.