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Under the Malaria Safety Net in Niger

By Lane Hartill

It's been more than eight years, but even now, surrounded by her seven children, Hawa still thinks about Maria.

Hawa with her children

Hawa lost her first child to malaria. But since CRS distributed insecticide-treated mosquito nets in her village, she and her children sleep under the net every night and none of her children have gotten malaria. Photo by Lane Hartill/CRS

Maria was her first child; she had her when she was just a teenager. In those first months of motherhood, Hawa would strap Maria on her back in the evening when the heat of the day had lifted and they would walk out into the village, sit with other mothers and take in the cool air. They stayed out late—sometimes until 11 p.m.—chatting about children and farming and life.

But at 4 months, Maria started losing weight. Hawa didn't know what was wrong with her, so she took her to Zinder, the nearest big city. They gave her a shot in the arm. Hawa didn't know what they were giving her, she just hoped it worked. Then they gave Maria more shots. When that didn't work, they gave her oral rehydration salts. Nothing seemed to work. Malaria, it turns out, had an iron grip on her system and wasn't letting go.

After eight days at the clinic, with Maria ever more listless, they told Hawa to take her home.

A week later, Maria died.

Hawa was crushed. For two weeks, she thought about nothing else. When could her firstborn have caught malaria? She racked her brains, and only later realized that during those long chats at night, when she was busy showing off Maria, the mosquitoes, which are attracted to carbon dioxide and body heat, had found her daughter.

Malaria was always a fact of life when Hawa was growing up, but few people owned mosquito nets. The only way to prevent getting bit was to build a fire in the middle of the compound and drag your sleeping mat near it, hoping the heat and the smoke would keep the mosquitoes away. When you did come down with the weakness and malaise, you drank a tea made from kinkeleba leaves. It was only when she was 16 that she had abandoned the traditional cure and started taking paracetamol, a general pain reliever and fever reducer taken by many Nigeriens for malaria.

In April 2009, Catholic Relief Services and our partners helped deliver close to 3 million insecticide-treated bed nets across Niger. This project was made possible with a generous grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria. Along with the nets came village talks led by people like Abdou. He's a CRS outreach worker who works his way through local villages, flip chart and megaphone in hand, teaching people about malaria and how to prevent it.

When asked why they don't or won't sleep under mosquito nets, men and women here say what any parent strapped for cash would say: Mosquito nets cost too much. Or they'll tell you it's already hot enough, why would they want to crawl inside a hot mesh box that blocks the evening breeze? Occasionally, some people even say the nets are a refuge for spirits, or they cause sterility.

But Abdou's job is to debunk these myths, to tell the women that it protects their children, which means no trips to the health clinic, and they won't have to miss days of work in the field.

His talks seem to be working. The community health center in Sabonkafi where Hawa lives has seen a drop in malaria cases since Abdou's talks started and CRS delivered the bed nets. But officials admit the drop in cases may be attributed partly to a drier-than-normal rainy season.

In a study completed last year, CRS found that in Niger only 36 percent of pregnant women and 44 percent of households with children younger than 5 have an insecticide-treated mosquito net. The study also found that malaria is the principal cause of death of pregnant women in Zinder.

But you don't need fancy statistics to impress Hawa. She's a mosquito net convert now. After Maria died, she was willing to try anything if it would protect her children. Now every night she hangs up the huge blue net outside under a thatch awning. Then she herds the kids under it and climbs in after them. She then tucks the net under the mat where they will all sleep (her husband sleeps in their two-room mud house) making sure there are no cracks where the mosquitoes can enter.

They all know their places: The 8-year-old twins, Ousseina and Hassan, sleep next to one another; then comes Issia, 6, who has a hard time settling down at night; next is Ayuba; then the second set of twins, Rabiou and Hamissou; and finally Mahman, who is 3 months old and sleeps next to Hawa.

Once they are lined up, Hawa tries to get them to wind down. Sometimes she tells them bedtime stories, like the one about the tree and the donuts, or the one about the louse and the dancing village chief. They like the part where she starts to sing, pretending to be the insect, luring the villagers in. And before you know it, the kids are dozing off.

Soon, there is only the snuffling of Rabiou, and the gurgling of Mahman. Hawa will drift off knowing that her children are by her side and nothing can touch them. Not even a single mosquito.

Lane Hartill is the western and central Africa regional information officer for Catholic Relief Services. He is based in Dakar, Senegal.

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