To live is to change, to acquire the words of a story.
--Barbara Kingsolover, The Poisonwood Bible

Saturday, November 9, 2013

The Rihannas of Seasonal Malaria Chemoprophylaxis

"Sadio, you tricked me!" my host sister Diabou announced as she approached me with both narrowed eyes and a smile.

"What?"

"You didn't tell me that my picture was going to be everywhere!  Everywhere I go people are telling me that my children and I are on their pamphlets.  Even in the village where I grew up!  Even in Sanela!"

"I did too tell you that!  When my friend who speaks Pulaar came with her fancy camera, I explained that I had been asked by people in Dakar to take pictures to help with their malaria prevention campaign. I told you that the pictures would be all over Senegal."

"Well I forgot.  And you said about the poster, but I or really understand that every person was going to see it.  People from Kondokhou  and even Sanela have told me that they saw my picture. I would have tied my headscarf better and made myself pretty."

"Diabou, you look beautiful in the pictures.  And you look like a good mom because it shows you giving your kids the medicines to prevent malaria.  Be excited!  You just became a celebrity!"

"A what?"

"Basically, you're Rihanna."  With that, the narrowed eyes disappeared, and she ducked, laughing, back into the cooking hut.
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In May I had the fortunate to be asked to attend a workshop with the National Malaria Control Program and other partners to plan for the roll out of a Seasonal Malaria Chemoprophylaxis (SMC) program in the 4 regions of Senegal where malaria is the most prevalent.  I learned an amazing amount participating in this national planning process, and this month, I finally got to see the intermediate and final planning steps as well as the actual launch of the program.  I supervised the training of the community health workers in one health post and then supervised the implementation in several villages.  Seeing a project from start to finish was really interesting, and I think will be extremely valuable in future global health work endeavors.

SMC distribution in action
Yummm Amodiaquine!
SMC is the administration of preventive medicine for malaria in areas where malaria has seasonal peaks during the months of those peaks.  The World Health Organization estimates that SMC can reduce the incidence of malaria within the target age group by 75%. Community health workers go house to house to administer the first dose of the medicine to all children under ten.  The mother is instructed how to give the necessary doses for the second and third day. The medicines protect the child for one month, after which the cycle was repeated.  This was supposed to roll out in July, but due to problems with the medication  manufacturing, it had to be delayed until November.

Maybe it was the delay that made Diabou forget about the pictures.  At the national meeting, I was on the communications committee, and I was commissioned to take a series of photos to be used for the campaign, since I actually live in the setting where the program is taking place and apparently could more easily capture the village scene.  We needed photos for a poster and for a reminder booklet for the health workers who would be implementing the distribution.  I asked my friend Ashleigh who had a sweet camera and takes great pictures to come help.  She recently left us for Amerik and then Cameroon, so I'm grateful to have had the photo shoot adventure.

There is a community health worker who lives with my host family, so he got to play the part of the health worker.  He even changed into his World Malaria Day t-shirt for the occasion.I didn't give Diabou much advance notice of the exact timing of the shoot precisely because I didn't want her to go put on a bunch of makeup and become a scary clown (as she tends to do for holidays)--they wanted a realistic scene.  

Let's be honest.  The primary goal of this blog post is to showcase the modelling talent of my host family.  They are basically Rhianna.



There they are! SMC Campaign poster at the Saraya Health Center.  Slogan: Let's protect our children from malaria.

Brochure to be left with each mother to explain the campaign and how to administer the meds, and the guide for the health worker

Dosage differs by age group, so photos of Mamadou, Oumou, and Sambaly served as reminders of what children of the different age groups look like--people rarely know exactly how old their kids are. 

We took headshots of all the kids that were around that day. They didn't all make the cut since there are just three different age groups, but the photos are so great that I wanted to post them here anyway. Here's Kounadi. 

Samouro is thrilled to see her face all over town on the poster and pamphlets.
Kharifa!

Step by step guide: Identify the children under 10, get clean water, make sure the child has eaten, crush the pill for kids who can't chew, leave the meds for days 2 and 3 with the mother, mother administers remaining meds

More step by step guidance.

This is my favorite picture that was taken that day.  The English translation of Toumany's shirt is: Defeat malaria.  SMC is definitely a tool that can lead to the eventual accomplishment of that goal, and it has been exciting to be a part of it.