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Archive for the ‘Zambia’ Category

Posted by Ahna Machan, Rotary Member

Our group of Zambian and U.S. Rotarians met with Dr. Mulakwa Kamuliwo (the acting coordinator of Zambia’s National Malaria Control Centre (NMCC)—and his team at NMCC.  There, we learned more about Zambia’s approach to malaria control:  one country-wide strategy, one coordinating body, and one monitoring and evaluation system.  This sounds so simple and so logical, but simple does not always mean easy—I knew that it was what made Zambia stand out among so many malaria-endemic countries and was likely the key to Zambia’s successes.  I also was reminded of the recent travails in the US in trying to pass health legislation reform that would make it easier for everyone to have access to health care. 

But at the NMCC, there seemed to be a real sense of teamwork as each person described their role, successes, and challenges.  Their collaboration and commitment stretched beyond a conference room in the capital of Lusaka into rural, malaria-endemic communities – those very vulnerable, high risk regions.  Several of the Zambian Rotarians asked questions about specific problems and possible interventions, such as using insecticide-treated bednets (ITNs) versus spraying and citing stagnant water pools they had noticed in their regions. 

The NMCC told us how they work in accordance with WHO guidelines and trained 600 community health workers (CHWs) who actively visit each home in these malaria-endemic villages.  Zambian Rotarians nodded as they had firsthand knowledge of working with these invaluable CHWs, particularly in the Copperbelt region. Several days earlier around World Malaria Day, the Zambian and Seattle (US) Rotarians had worked side by side with the CHWs, delivering ITNs and educating families about malaria. The community health workers explain how malaria is transmitted (by the anopheles mosquito), conduct rapid diagnostic tests to detect the presence of malaria (especially for pregnant women and children under five), prescribe appropriate treatment, and ensure that each home has at least one insecticide-treated bednet and knows how to use it to prevent malaria.  The NMCC hopes to train more health workers when they are able to attain more funding—and it was great to hear one of our Zambian Rotarians ask if they could be trained to become a CHW or if they could support more training for them! Dr. Kamuliwo welcomed this offer and encouraged them to keep in touch to develop a working relationship with the NMCC to become part of the team and help to carry out Zambia’s quest to roll back malaria by 2014. 

Zambia’s approach, including involving the participation of civil society, is becoming a model for other African countries.  So far, they have made great strides:  62% of the households have at least one bednet.  Yet, there is much more to be accomplished and Rotarians are joining forces across continents to help build public education, knowledge, and awareness of malaria in communities throughout Zambia.

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Posted by Roy Mann, Rotary Member

Yesterday we traveled for five hours from Kitwe in the north to Lusaka in south-central Zambia. On board were Ben and Gena from PATH/MACEPA, my companions Jim and John from the Seattle Rotary delegation, and our nine new Zambian friends: Ndala and Varian from the Mongu club in Western Province; Webster from the Chipata club in Eastern Province; Fides, Rose, Akapelwa, and Bwembya from the Choma club in Southern Province; and David and Penias from the Livingston club also in Southern Province. Hard to believe we met only four days ago here in Lusaka, as strangers.

Along the way, bonds of friendship formed. We were entertained by a number of things: Ndala’s multitasking with not one but two cell phones, Akapelwa’s distinctive “Guinea fowl” ring tone, Varian’s infectious smile, Jim’s ready-print color photos, and Ben’s hearty laugh. We grew familiar with one another, even to the point of making coordinated “nature” breaks in the tall African grass next to the roadside. As Fides put it, “Rotary is friendship with a purpose”.

This same level of familiarity and trust makes Rotary a powerful force for change in the broader effort to achieve a malaria-free Zambia. Of the nine Zambian Rotarians on our bus, for example, seven tribal languages were represented—Lamba, Nyanja, Lozi, Lunda, Luvale, Bemba, and Tonga. Their knowledge of the village and community level uniquely positions them to assess local needs. Acting in partnership with the National Malaria Control Centre and MACEPA, Rotarians like these can increase access to treatment with the help of local community health workers and volunteers.

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Posted by Jim Moore, Rotary Member

On Sunday night we held a working dinner with representatives from nine Rotary Clubs.  Besides traditional Rotary fellowship, the main purpose of the dinner was to begin to specify the next steps that should be taken in implementing the Second Century Malaria Control and Eradication Project.  Though the hour was late and almost everyone had participated in a full schedule of events over the weekend, our fellow Rotarians got down to work—all of them.

Jim speaking at World Malaria Day in Mpongwe, Zambia

Rotary Club members, their skills, their connections, and their dedication to service are the key resource that would be brought to bear on the fight against malaria.  To be effective and have a sustained impact on malaria, Copperbelt-based Rotarians recognized that their projects must fit into the overall anti-malaria plan at the district and local levels.  Consequently, they should start with a cooperative session with District Health Management Teams aimed at identifying the gaps and local needs in the DHMT’s annual plan that can be filled by Rotarians.  Implicit in this concept of “gaps and needs” were villages units and entities such as schools and orphanages.  A Rotary Club could adopt one or more villages and/or entities for sustained anti-malaria actions including distributing insecticide treated nets, environmental management (draining stagnant water sources, cleaning water channels to promote flow, etc.), malaria education campaigns (media and curriculum delivery), diagnostic testing through community health workers, and indoor residual spraying—singly or in combination.

Pregnant mothers with bednets at Mpongwe Mission Hospital

It was more than heartening to hear the clarity and passion expressed by Zambian Rotarians about their roles in the fight to eliminate malaria.  At the end of the evening, Modestine Kaoma of the Mufulira Rotary Club rose to give visiting Rotarians and MACEPA/PATH staff a warm and emotional thank you.  “There are no words to adequately express how much we appreciate your leaving your homes in Seattle to come this long way to work with us and make our battle against malaria your battle too.  You have deeply touched our hearts.”

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Posted by John Adams, Rotary Member

Seattle Rotary #4 was active with the Rotary Malaria Control Project on World Malaria Day today, with a team on the ground in Zambia.  Jim Moore, Roy Mann and John Adams all attended several events related to malaria eradication. 

We joined with members of the Seattle PATH team in Zambia working on the MACEPA program, including Ben Cheng and Gena Morgan, and Mshuka Kamwela, who is based in MACEPA’s Lusaka office. We first visited with the District Commissioner of Health in Mpongwe.  There we presented three wheelchairs donated by our Rotary Club for the use of local children.

Donating a wheelchair in Mpongwe

The District Commissioner of Health, Ms. Minivan Mutes, gave us a briefing on the local malaria situation.  She gave an impassioned speech at the official launch of World Malaria day about community involvement in malaria eradication. 

We learned from Dr. Frederick Kaoma, from the Rotary Club of Mufulira, that many cases of cerebral palsy here in Zambia are caused by malaria, when pregnant mothers cannot provide adequate oxygen to their babies at birth because of malaria-induced anemia.  These children often require wheelchairs for life to assist with mobility.

During our discussion with the District Commissioner of Health, she asked if she could join Rotary!  The Rotarians present said they would be sure to sponsor her.  Modestine Kaoma, a local Rotarian, explained the four-way-test to her with such passion we all applauded.  We then all joined and sang ‘happy birthday’ and gave a wheelchair to a boy on his 15th birthday.

Community health workers in Ibenge

The next stop was the Ibenge Clinic.  Here we observed community health workers giving new insecticide-treated bednets (ITNs) to pregnant mothers and young women.  These bednets can protect expectant mothers from the common miscarriages that can result from malaria infection. 

There were several dozen young mothers who received free bednets and they were highly appreciative.  Children ages one to five years are particularly vulnerable to malaria.  For each mother, the chance of having her children live a normal lifespan is very personal and her highest priority.

Distributing nets to pregnant women and young children in Ibenge

In Zambia, the volunteer community health workers, such as those we saw providing bednets at the Ibenge clinic, are in the front lines, helping the local community health departments to implement malaria control interventions prescribed by the National Malaria Control Centre.  MACEPA and the local Rotary teams work with these volunteers in the national effort to eliminate malaria.

We stopped at an outdoor market on the way home, and the young women at the fish stalls were drumming, singing and dancing with joy in the early sunset.  It was infectious in the best sense, and was a happy and fitting end to our afternoon of Rotary service projects.

In the evening, we had a formal dinner with the members of eight local rotary clubs. Jim Moore led a discussion of “The Way Forward”, which helped each of the eight clubs to plan how to work towards elimination of malaria in Zambia.  The structured workshop helped each club to identify club personnel resources, the malaria control components of their current Rotary projects, their relationships with the local District Health commissioners and a section on planning for partnering strategies.

Jim asked two key questions:  “What are the next steps for your club?” and “What can we do for you at Seattle 4 and Rotary International?”  There were many resolutions about projects the eight clubs want to implement and useful recommendations that we will bring back with us to share with Rotary Club #4 on how we may help these clubs.

PATH and the MACEPA program were the facilitators for all of these meetings, and have provided a combination of inspiration, vision, and flawless execution of logistics and scheduling.  We are convinced that Rotary #4, working with Rotary International and local clubs in communities in Zambia, can take simple and effective steps that will help prevent malaria in the region and ultimately save thousands of lives.

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Posted by Todd Jennings, MACEPA Communications Officer 

Pre-match greetings

Football (soccer) is a living, breathing force on this continent.  Mobile phones buzz with match day updates and the final whistle releases a rain of text messages on opposing fans.  From the playground to the pub, you can ignite a heated discussion by claiming the brilliance of Messi bests that of Rooney or Ronaldo.  In Zambia, the loudest political headlines is an analogy from the beautiful game: for example, a Catholic priest has begun a movement to show a red card to the government.  Just as a red card ejects a footballer from the pitch, this effort—which includes the now illegal act of flashing red cards during public rallies—encourages voters to remove the current government in the next election.

Zambian Minister of Health Simbao, wearing a World Malaria Day t-shirt

That’s why tapping a force like football makes so much sense.  The United Against Malaria campaign seeks to fight the fever of malaria with the fever of football.  Today we saw that in action as the Minister of Health, Kapembwa Simbao, captained a soccer team against a mighty opponent: former stars from the national team, the Chipolopolo Boys.  Zambia did not qualify for the World Cup in South Africa but Simbao rallied his squad, saying today’s match was “our World Cup”.  His halftime speech—to a team of business leaders, musicians and partners including USAID and UNICEF—was persuasive but it wasn’t enough to overcome quality football by the Chipolopolo Boys.  Minister Simbao did lead by example, however, converting a penalty kick with a cracking shot into the back of the net.  Why did the referee award a kick from the spot?  Because of a penalty that resulted in a red card.  

Little girls holding United Against Malaria soccer balls

A former star was sent off the pitch and while the crowd laughed at the connection to the political debate, it wasn’t hard to take the analogy one step further. From inspiring political leadership to inspiring families to make sure their children sleep under a bednet at night, Zambia is united against malaria—and the country is working together to show malaria a red card.

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Posted by Roy Mann, Rotary Member

Today was another active day in Zambia’s Copperbelt. Our Rotary delegation went in two different directions, one to Luanshya and another to Mufulira—almost on the border with the Democratic Republic of Congo.

Buchi Clinic Kitwe

I was in the latter group that began with a visit to Kitwe’s Buchi clinic. There we encountered palpable suffering – pregnant women with malaria, and a long dark corridor filled with people waiting to be screened for malaria and other illnesses. The maternity ward did not have insecticide-treated bednets and there was a stagnant pool of water right outside of the window. Pregnant women are particularly vulnerable to malaria as pregnancy reduces a woman’s immunity to malaria and increases the risk of spontaneous abortion and stillbirths.

There was quite a contrast between the Buchi public clinic in Kitwe and the privately operated Malcolm Watson Hospital run by the Mopani Copper mines where we met Rotarian Dr. Frederick Kaoma. This facility is open to all Mopani mines staff and their families and also available to the general public if they can pay for their services.

ITN hand over, mufulira

Rotarians delivering bednets in Mufulira

Dr. Frederick led us to an orphanage supported by the Mufulira Rotary Club that cares for some 150 children. We delivered a new soccer ball and some bed nets. We also handed bed nets to young mothers at the Rotary funded Murunu Health Center. . . I’m inspired by my new Rotarian friends from Zambia who, along with the PATH-MACEPA folks, embody a common principle that motivates us all – Service Above Self!

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Posted by Jim Moore, Seattle Rotary

Malaria test

Jim gets tested for malaria during Zambia's World Malaria Day celebration

After 30 plus hours of traveling, John Adams, Roy Mann, and I finally arrived in Lusaka last night. Unfortunately our luggage didn’t make it with us, but we’ve since learned that it arrived in Lusaka this afternoon and we may have clean clothes later tonight. We set off at 6 a.m. this morning to Mpongwe for the World Malaria Day (WMD) event. Traveling with us on the bus were Rotarians from the Chipata, Livingstone, Mongu, and Chongwe clubs and we will be joined tonight by Rotarians from Kabwe, Kalulushi, Kasama, Kitwe, Luanshya, Mufulira, and Ndola. Many of them were at the WMD event in Mpongwe when we arrived.

One of the things that really impressed me during WMD was Zambians getting tested for malaria infection. The Malaria Consortium had set up a tent and invited everyone to be tested. I was particularly moved watching the mothers. The Mpongwe mothers were among the first to line up to get tested. They sat stoically getting their fingers pricked and blood tested, often nursing their young infants at the same time. Then they would promptly prepare their infants’ fingers to get their blood sampled, too. Many babies wailed in anticipation, others sat quiety. After 15 minutes of patiently waiting, the moms and babes got their test results back. If their results were positive, they would receive malaria medicine to treat the infection. Mothers in Zambia are like mothers around the world—they want the very best for their children and will do whatever they can to make it possible. Though not a mom, I, too, was tested, and am happy to report that the results were negative!

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