The Zambia Ministry of Health and The National Malaria Control Center in partnership with Akros have been conducting Community Malaria Surveillance in selected parts of Zambia including Lusaka where the malaria prevalence rate is low. This is in an attempt to eliminate malaria as stipulated in the Zambia National Malaria Strategic Plan (2011-2016) that calls for the creation of five malaria-free zones by 2015.
Akros recently hosted 14 undergraduate Montana State University (MSU) students in Zambia from May 14 to June 11, 2015. The students were enrolled in a course titled “Zambia: Community and Family Health,” taught by Professor Wendy Bianchini Morrison of the Health and Human Development department at MSU.
“I approached Akros management a year and a half ago with the idea for this course,” said Morrison. “I wanted to bring MSU students to Zambia to expose them to international community health work. Akros management was very open to the idea and expressed interest in collaborating on the course.” She reported that Akros was appealing because it is an established organization in Zambia that has strong relationships with the government, local ministries and communities across the country, and implements public health initiatives that use data and research to increase the efficacy of their interventions.
The three stories below were written by students from Montana State University during their time in Zambia.
The Katete district office, in the Eastern Province, had just the little spark that caught my eye. This spark embodied a central point of international development and the key to Akros’ success: the people. Government Officials, Environmental Health Technicians, Community Champions, and the village locals themselves. They are the ones who represent the Community-Led Total Sanitation program to make it successful and sustainable from the beginning. Akros supports the Zambian community in a way that utilizes the needs specifically for each Province and District. If there is an area that demands more, there will be more time and efforts put towards it. But the only way to determine those needs and demands is by truly understanding what is going on in the local communities. This is why the district assessments are so important.
Exhilda Daka is the Senior Administrative Officer for the Council of Chinsali, Muchinga Province of Zambia. In her work for the council of Chinsali, Mrs. Daka is in the Human Resources department. She handles all issues among staff in the District Council. Being in that position she has a great understanding of most if not all programs in the district as well as the challenges of their implementation. Her training is mainly in Environmental health, managing the council assets, such as land and environmental management. Her specialty with Environmental Health has lead her into involvement with Akros Global Health in Community Led Total Sanitation (CLTS.)
Mrs. Daka’s main role in CLTS is district training. She trains District Water, Sanitation and Hygiene Education Committee (D-WASHE) members, Chiefs, Environmental Health Technicians (EHT), and Community Champions (CCs) on CLTS practices. Through her time working with CLTS, Mrs. Daka has learned that CLTS is attainable she believes that “mindsets are starting to change” and that in some villages Open Defecation Free (ODF) is possible. Mrs. Daka stated that in a few years, if key changes and support are available, ODF can be accomplished district wide. Though she recognizes that some CLTS practices such as triggering are incredibly effective, she also knows that the reason ODF has not been reached in the district is due to some key challenges. Mrs. Daka spoke freely about changes that need to be made in her district and has some great ideas to overcome the challenges that are inhibiting ODF. The first issue Mrs. Daka pointed out was the Chief involvement. In her opinion the Chiefs and Village headman are not participating in CLTS to their fullest ability.
After an exhausting 10-hour drive from the Akros offices in Lusaka, two students from Montana State University, the Akros Surveillance Officer, Sanford Cheelo, our driver, Jackson Zulu and I arrived in Chinsali, Muchinga Province. Almost immediately we were greeted by the friendly face and warm handshake of Dominic Mushashu. Aside from working for the Zambia Ministry of Local Government and Housing (MLGH) as an Environmental Engineer, he is married with a 3-month-old child, and he works extremely hard to make the Community Led Total Sanitation (CLTS) program possible in Chinsali.
“The environment is dear to me,” he says with a radiant smile. This is what initially led him to volunteering with Akros as a Water, Sanitation and Hygiene (WASH) Focal Point Person. Although he wasn’t aware of the time and energy commitment such a job would entail, he enjoys this work because he is eager to make a difference in his community; he welcomes any challenge with open arms.
When the fight against malaria is discussed and its fighters about to be awarded with medals, it is easy to look to health workers such as nurses, doctors, biomedical scientists and policy makers as the deserving recipients. Similarly, when interventions such as Indoor Residual Spraying (IRS) are discussed, it is easy to look at how effective the intervention has been in reducing the malaria burden without making mention of community based volunteers such as spray operators.
Jimmy Hachinyama, 27, has been working as a spray operator for more than three years in Kafue District. He was drawn to the position by his quest to know more about malaria and how the Zambia National Control Programme operates. “I was told by a friend that Kafue District Health Office was receiving applications for spray operator positions, I got interested and applied,” said Hachinyama. “After being shortlisted, I went for oral interviews and sat for an aptitude test which I managed to pass. I was also subjected to physical medical examinations aimed at checking my health status before being recruited” he further said.
Step D, also known as community surveillance, was introduced to Kazungula District in 2012 as a malaria elimination intervention after it experienced a significant decline in the incidence of malaria. The malaria incidence reduced from 150 per 1,000 in 2007 to 4 per 1,000 in 2011. Mambova is a community in Kazungula District with an approximate population of 4,715 yet only has one nearby health center. Headed by a nurse, Mambova Rural Health Center is charged with the responsibility of providing quality health care to this community.
“I work alone as a health worker with two other helpers, a cleaner and a watchman,” said Betty Masedza, Mambova Rural Health Center nurse in charge. “This is a great challenge on my part but the presence of community health workers (CHWs) has been of great assistance to my work,” she said.
Research is an important aspect of any organization that aims to enhance the quality of it work. Last year, the National Malaria Control Center (NMCC), with technical assistance from Akros, set up a pre-fab laboratory facility where cutting-edge DNA technologies are used to ‘fingerprint’ or barcode individual parasite infections. This enables the NMCC to link individual infections with the same fingerprint. This further ensures evidenced-based decision making with regard to malaria programming and the efficient use of resources.
Mulenga Mwenda is the Akros Lab Technologist. She holds a Bachelor of Science in Biology from the University of Zambia, and worked for NMCC’s Malaria Transmission Consortium as a Research Assistant from 2010 to 2013 before joining Akros later in 2013.
Mwenda describes her ability to work in the lab, carry out experiments and get desired results as the most fulfilling part of her job. Overall, she describes her role at Akros as the receipt of field samples, sorting them and assigning unique identification numbers, extracting of DNA and anti-bodies from samples from the Active Infection Detection field responses as well as other programmes such as the National Malaria Indicator survey and conducting scientific investigations (malaria research). Depending on the scientific question being answered, she carries out Polymerase Chain Reactions (PCRS) or Enzyme-linked Immunosorbent Assays (ELISAs).
LIVINGSTONE, ZAMBIA The Government of Zambia in collaboration with various stakeholders that included E8, WHO, Roll Back Malaria, Gates Foundation, MACEPA/ PATH and Akros gathered today in Kabuyu, Kazungula District to commemorate this year’s World Malaria Day under the theme “Invest in the future, eliminate malaria”.
“Kazungula District has recorded a decline in the incidence of malaria since 2005 from 150 per 1,000 to 4 per 1,000 in 2011,” said Dr. Phallon Mwaba, Kazungula District Medical Officer. “However, the incidence rose to 34 per 1,000 in 2014 due to the introduction of Active Surveillance programme in 2012 which collected data in the community and included it in our Health Management Information System (HMIS),” said Dr. Mwaba in his speech. “The above is a positive result to us as the 34 per 1,000 recorded in 2014 includes all cases in Kazungula District,” he added.
“We are having challenges in eliminating malaria in the area because of the imported cases we record from other districts,” said Lubinda Mushala, Kazungula District Malaria Focal Point Person. “In fact, the majority of the cases recorded are imported from other districts,” Mushala said.
[icon size=”16″]icon-camera[/icon] Anne Mutunda (far right) celebrates the 1 million new users of sanitation milestone with her W.A.S.H. colleagues at the Akros offices in November. Mutunda will present on her research at the 21st Biennial Conference of the Society for Menstrual Cycle Research in Boston this June.
World Health Day is celebrated on April 7 each year as a global health awareness day that also marks the anniversary of the World Health Organization, established in 1948. For the past two years, this day has also marked the start of World Health Worker Week, a weeklong celebration of the inspiring health workers who make health care possible. This is also a week to celebrate health workers who provide health care in the hardest to reach places, often compromising their own comfort for the sake of health equity.
Anne Mutunda, an Akros Water & Sanitation Health (WASH) Surveillance Officer, has been invited to make a presentation during the 21st Biennial Conference of the Society for Menstrual Cycle Research to be held at the Centre for Women’s Health and Human Rights at Suffolk University in Boston from June 4 – 6. “I am very happy to be invited to this conference, I feel delighted as this will make me known in the international research community as a subject-matter expert in the area of water, sanitation and hygiene,” said Mutunda.