Friday, May 16, 2014

Malaria Training in Fidel Castro

....Yes, that's the name of my friend's community located just north of Xai-Xai...
Welcome!
...and that is where we hosted a two-day malaria training last week. 

The group of community leaders and volunteers participating in our oral pre-test about malaria. Because we were not sure of the reading level of most, we did the test by a show of hands.
As part of transitioning into my new role as the Peace Corps National Malaria Activities Coordinator, I have been working with the current coordinator to learn all the in's and out's of my new position. As part of this handover, we hosted a malaria training of trainers in Fidel Castro with the Peace Corps Volunteer there, my friend, Dan Martin. Hannah and I planned out the training following models of trainings she had done in the past. We arrived in Fidel Castro early Wednesday morning and Dan's supervisor picked us up at the mini-bus stop. We then swung by Dan's house to pick him and all of the food and generator up before going to his organization. We arrived there just before 9 a.m., the exact time the training was supposed to start. But, it wasn't an issue as no one was there yet. And as we entered the building it became clear that the room we thought we would use was not in any way, state or form for a meeting. There was corn everywhere. Dan's supervisor tried to convince us that we could use one of the other smaller rooms, but we told him there was just not enough space. We then decided that we would set up outside.

We took the generator, the chairs and projector outside. The women cooking started setting up their kitchen. The kitchen being two fires and space for basins, water jugs, plates and all the ingredients including the chickens that would later become lunch. They were let to roam for just a little while longer. About 30 minutes later, our first participants started to arrive. It was not until about 10:30 a.m. that we realized we had better "tomar cha", serve our snack of tea and bread, as we continued to wait. It was not until 11 a.m. that we officially started our training with introductions and an ice breaker. Two hours late. But, so it goes. I have to admit, I wasn't stressed or even bothered by the fact that we were starting that late. I guess that's a sign I have adjusted to the Mozambican schedule.  Also, in typical fashion, Dan's supervisor, was there long enough to give a welcome and then he left. Chefes. So we were then left with our 10 participants. All of our participants were women, eight of them were volunteers from two different organizations that work in the community and two community leaders. We had a translator there as well to translate into Changana, the local language, and it ended up that he started participating more and forgetting to translate. After we went through our introductions, we did a pre-test orally and then started going through all of our themes for the day: transmission, prevention, symptoms and treatment. 

Hannah and I explaining the symptoms of malaria.
Throughout all of our sessions, we highlighted six essential actions:
1. Sleep under a mosquito net.
2. Allow PIDOM, the indoor spraying, into your home to spray for mosquitoes.
3. All pregnant women should take a prophylaxis called TIP.
4. Anyone showing symptoms of malaria should be taken to the hospital within 24 hours.
5. Do not leave stagnant water out in your yard or home.
6. When being treated for malaria, take all of the prescribed medication COARTEM.  
Hannah and some of the participants demonstrating how the parasite dies once Coartem, the treatment for malaria, starts working...
We finished the day with distributing manuals and storybooks, "Tatu, luta contra malaria". We told our participants that it was their homework to go home and read the books with someone. We then ate lunch of beans, rice, xima and chicken. From there, Hannah and I headed back to Chicumbane only to be back in Fidel Castro by 8:30 a.m. the next day. We told everyone that it was really important that we started on time the second day because we needed to finish early. We made up a rule together that if anyone arrives late, they would have to dance in front of the group. Also, if anyone's cell phone made noise, they too would have to dance. Throughout the two days we had a couple people dance. But, NO ONE had to dance that Thursday morning because they were late.

Reading story books about malaria. 
Some way, some how, everyone arrived before 9 a.m. and we started with tea and bread before starting our session at 9:30 a.m. Hannah and I were both amazed. That never happens. We started our session with reviewing the homework. And from there we did a little of Peace Corps Goal #2 and introduced them to Jeopardy reviewing all of the material from the previous day. They loved it.

In addition to training all of our participants about malaria, the second component of our two-day training was to write up an action plan to eradicate, or at least diminish, malaria in the community. We divided our participants into two groups and they had a serious brainstorm "chuva de ideias". We then wrote up a plan together and designated responsibilities. With the information they learned in the training, they said they would go to talk at churches every Sunday, give talks at the local schools and meet with the people responsible for the neighborhood wells in the community to ensure that each well has a good cover and everyone in their neighborhood understands the importance of covering it. (Stagnant water is where Anopheles mosquitoes, the ones that transmit malaria, breed.) 

At the end of the second day, after going over malaria prevention, treatment, symptoms, transmission and developing an action plan with the group, Hortencia led giving the post-test to all the participants. 
When I talked with Dan today, he said the group plans to meet on Wednesday to start putting their plan into action. Fingers crossed.

I am hopeful. The day after our two-day training I had a meeting at the EGPAF office in Xai-Xai. As I entered the room, Amelia, one of the volunteers I had just met in Fidel Castro, shouted out my name. I was so surprised to see her there. But then as I realized that the meeting was about how community organizations can work more with EGPAF at the hospitals, it was not such a surprise. I sat down next to Amelia and she told me how she "beep"ed me ("to beep" someone is to call that person only to have it ring long enough so they can see you called and then use their credit to call you back) last night with some questions she had.

"When does malaria become cerebral?"

That was her question.

I was impressed. And embarrassed. I had to admit, I did not know the answer. I told her, as I was still in the process of taking over the position, I am still learning. So I told her I would do my research and get back to her.    

Hannah and I were pleased with how the training went and hope to have similar trainings to this one throughout the country over the next year.  Stomp out Malaria.
Hannah, Dan and the group of newly trained malaria trainers!
Check out this music video of a group of teenagers who worked my friend Alden and Positivo, an organization that creates music with health messages, to write and create music about malaria.

Thursday, May 8, 2014

The Great Northern Adventure

Six cities in Mozambique (Pemba, Ilha de Mozambique, Nampula, Cuamba, Gurue, Quelimane)
Five different modes of transportation (Plane, train, car, bike, boat)
Four Peace Corps Volunteer houses along the way
Three friends out exploring
Two weeks of an exciting, yet relaxing vacation
ONE Great Northern Adventure.

Sunrise over Maputo the morning we flew out

Upon arrival in Pemba, the first stop along our tour.


The beach in Pemba, we happened to stumble upon a Vodacom dance party...
Ilha de Mozambique

Alden with all his new friends he made on our bike tour around the island.

Alden and Adela in front of the hospital on Ilha, just one of the many stops on our bike tour. 

The view from the Garden of Memories.
During the slave trade, most of the slaves exported from Mozambique left from this dock. 

Sunset over Ilha.

Sunrise on Ilha. 

The oldest building in the Southern Hemisphere (the white church above which was part of the Portuguese fort)  is located on Ilha.
Exploring the old Portuguese fort. 

We did an overnight camping trip to Island of the Snakes. This was our campsite. Yes, we saw snakes.  

Boarding the train from Nampula to Cuamba. It was an 11-hour ride. 

The view from the train. 

Moz 18 Reunion in Cuamba.

Colin and Alden outside Colin's organization where an old tank is left from the country's civil war. 

Hiking in Gurue!

Gurue in its glory!

An all-day hike to the waterfalls.

The tea plantations in Gurue

Just hanging in Gurue

The tea plantations in Gurue...

The bustling fish market at the beach just outside of Quelimane.