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Battling Malaria in Senegal

By Lane Hartill

You find them where you least expect it.

Abou wades through a swollen stream to reach a village.

Abou Deme visits villages and treats people who have malaria. During the rainy season, he has to wade through swollen streams to reach villages. Photo by Lane Hartill/CRS

The professor in a Darfur refugee camp reading a dog-eared macro economics book; the Afghan, starving for news from the outside world, who buys bananas for the newspaper they're wrapped in; the African living in a forgotten town, asking foreign visitors if they have any literature they could spare.

They're the developing world's intellectuals, sucked into the vortex of war or poverty. They wash up in backwater villages, quietly enduring a life they hadn't planned. They seek solace in Shakespeare; turn to Locke and Rousseau for comfort, and pine for the classroom and thoughtful debate.

On the rare occasion, though, you'll find someone who has chosen to go back, someone who has willingly left the world of wifi and paved roads, for the heat and dust of the village.

Abou Deme is one such man.

Dreams Cut Short

Every morning, he rises at 4:30 a.m. to catch the world news in English from the BBC. He runs down the day's headlines for me: Obama's speech at the United Nations; the arrest of suspects in the Uganda World Cup bombings; and more fighting in Somalia.

He's eager to speak English; it's rare he has the chance. He machine guns questions faster than I can answer them: What is Kigali like? What are my thoughts on former U.S. Defense Secretary Donald Rumsfeld versus current secretary Robert Gates? Is the band Kool and the Gang still together?

He's toying with the idea of writing a book, tentatively called "The Life of Abou Deme." He's a fan of Chinua Achebe, the famous Nigerian author, whose book, "Things Fall Apart," he can relate to.

Born in Senegal, Abou moved to The Gambia as a child to live with his mother. He studied at St. George's Primary School in Mansajang, one of the oldest schools in the country. His teachers came from Ireland, Nigeria and Ghana. He was consistently at the top of his class.

His dream of becoming a journalist was cut short by the death of his father 7 years ago. His death prompted him to go back to his home village in Senegal to care for his 4 brothers.

Now, his hair is sprinkled with strands of silver. He has 6 children. He farms corn and peanuts to make ends meet. A few weeks ago, as if life wasn't hard enough, he dropped his cell phone in a stream, soaking it beyond repair.

A man with Abou's hungry intellect needs an outlet, a cause he can throw himself into to keep his mind sharp. And he's found it in the form of a parasite. Abou's new mission: Stamp out malaria in his corner of Senegal.

Abou draws blood from a baby to determine if he has malaria

Abou Deme draws blood from a baby to determine if he has malaria. If malaria is detected, he distributes free medicine on the spot. Photo by Lane Hartill/CRS

"We are living in a very miserable situation here," Abou says. "I'm here to help my people."

Malaria on the Rise?

As a home healthcare volunteer, Abou visits nearby villages and treats simple cases of malaria (he's not authorized or trained to diagnose other diseases). He's part of a 5-year nationwide effort by the President's Malaria Initiative, a program set up by the United States government to combat malaria in 15 countries.

The project in Senegal is managed by the U.S. Agency for International Development in conjunction with the government of Senegal. CRS and its partner Caritas are working in eastern Senegal to oversee outreach workers like Abou who teach villagers how to protect themselves against the parasite. He's one of hundreds of volunteers spread out across the country who have helped reduce malaria nationwide.

In Abou's area, malaria is a serious problem, and local health workers believe it's on the rise. It's a surprising fact given the frontal assault on the disease by the government and humanitarian groups: Nets have been delivered. Homes have been sprayed with insecticide. People have been taught what causes the disease. And there are more than 30 outreach workers like Abou crisscrossing the countryside near his village of Sinthou Fulbé, treating people who have contracted the disease and teaching them how to prevent it.

Abou says Mother Nature has a lot to do with the problem. It seems she turned up the thermostat in this region then walked away. It's oppressively hot here, routinely over 110 degrees Fahrenheit. Abou claims birds die from the heat and fall out of trees, goats miscarry, and water comes out of the tap so hot that it needs no boiling for tea.

The heat means people stay outside late at night, hoping to catch a breeze. While they drink tea and chat, mosquitoes dine on them. By the time people crawl under their nets for the night, the damage has been done.

Misconceptions About Malaria

Another complicating factor: access. There are no roads here, only sand tracks interrupted by puddles the size of a Motel 6 swimming pool. When people fall sick from malaria, it's not easy to reach the nearest health center. So horses are bridled and carts are attached and, when a stream is reached, people carry the sick across the water, piggyback style.

The biggest hurdle Abou faces are the misconceptions about how people contract malaria.

"Before (the project), people thought milk caused malaria," says Abou. It's somewhat understandable, he says, because animals tend to give birth—and therefore produce milk—during the rainy season, which coincides with people falling sick with malaria.

On a recent hike to a neighboring village, Abou, slippery with sweat, rolls up his pants and confronts a puddle the length of a football field. He jokes about contracting bilharzia (also called schistosomiasis), a waterborne parasite common in the area, as he wades through water, the color of coffee with heavy cream. Boys swim around him, disappearing under the milky water.

After walking a few miles through millet fields and forest, he arrives at Sinthou Mamadou Ciré, a village that has never had a foreign visitor. A European hunter was spotted in the distance 10 years ago, hunting warthogs, but he didn't bother to stop by.

Abou talks to the chief of Sanghadji.

Abou Deme talks to the chief of Sandhadji, a village of 200 people in eastern Senegal. Photo by Lane Hartill/CRS

Abou gets right to work. A father presents his 7-year-old son, Samba, who, he says, has a "hot body." Abou feels his forehead, looks in his eyes, and sticks a thermometer under his arm. Anything over 100 degrees Fahrenheit, raises a red flag.

Samba has a fever. So Abou pulls out his malaria rapid test kit. He pricks Samba's finger, draws a few drops of blood and mixes it with a solution. In 10 minutes, Abou's hunch is confirmed: Samba has malaria.

'Not Just Talking'

Abou gives him 3 days worth of malaria pills. And he's on to the next child. Pretty soon, a line forms. Everyone, it seems, wants to see Abou.

The next day, Abou and I are scheduled to go to another village. This time we can drive; a luxury for Abou. As the sky darkens and rumbles with thunder, we jump in the bed of the Toyota and jounce over the ruts. We're slapped in the face from low wet leaves. It becomes a game of duck and cover.

As we churn through the puddles, the conversation shifts. Abou wants to talk about corruption in Africa, which he sees as a big hurdle to development. The second hurdle, which he's seen firsthand, is neglect.

"When I was in school, I was not seeing any (humanitarian agency) come and rescue our population from the suffering," he says, a slight British lilt to his voice.

"Now the NGOs (nongovernmental organizations) are coming, like you the CRS, and we are seeing it with our eyes; they're not just talking."

Prayers for the Program

Abou often reflects on his lot in life, how he got an education. Still, his respect for his fellow villagers has never wavered. "I'm not better than those people inside the villages," he says. "I'm a human being like them."

We bounce along. Abou is lost in his thoughts.

"People like me should stay and help people in the communities," he says, "because we have been forgotten by the authorities."

We roll up to the village of Sangadji. The chief, El Hadji Mohammad Sylla, who is in remarkably good health, welcomes us.

He says malaria has long been a problem. But he's thrilled with the malaria project and CRS' involvement in it. No foreign humanitarian organization has ever come to the village; CRS and Caritas are the first.

And with that, Chief Sylla asks for a ride to the nearest village where there was a mosque. This 86-year-old Muslim, wanted to say a few prayers for Catholic Relief Services and its malaria program.

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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