By Alex Wynter in Nigeria. Photos by Benoit Carpentier
The International Federation of Red Cross and Red Crescent Societies (IFRC) and the Nigerian Red Cross Society (NRCS) this week rolled out new cellphone surveys for malaria-prevention work in Nigeria. This is the last of three African countries where trials of the service are running with the help of Red Cross volunteers.
The new Management Survey Tool (MST) was launched in Malindi district on Kenya’s Indian Ocean coast earlier this year and has also been successfully tested in Namibia’s Caprivi Strip.
Volunteer interviewers working with the MST use mobile phones equipped with DataDyne EpiSurveyor software to gather, store and upload public-health information, which can then be quickly analysed.
This only recently became technically possible in Africa.
Dr Mac Otten, a paediatrician and epidemiologist who helped the IFRC set up the programme, says volunteers are doing more than sending emails or texts. “They’re uploading data using the second-generation networks that probably reached most towns in Africa only around two years ago,” he said.
The latest MST surveys from Nigeria’s Cross River State, are being used to evaluate the impact of a mass distribution and hang-up campaign by NRCS volunteers involving more than half a million long-lasting insecticide-treated nets, funded by USAID, with support from an IFRC team in the state capital, Calabar.
The exponential spread of ‘first-generation’ mobile telephony in Africa is already a development legend. Now BlackBerries, iPhones, tablets and the faster networks they depend on are also spreading rapidly.
“I use my personal mobile for accessing the internet now, not just making calls or sending texts,” says David Samuel Effiong, a 25-year-old NRCS volunteer and a member of one of the MST survey teams who were interviewing 300 households door-to-door across the state this week.
“The GPRS signal is everywhere,” adds Effiong, a cameraman by profession who has been volunteering for the NRCS for eight years and also donates his time by making free video-shorts for the Red Cross.
Surveys are regarded as vitally important for making informed decisions in public health. But doing them in what is rapidly becoming the old-fashioned way, with pencils and clipboards, is expensive and time-consuming.
Elder Bolagi Anani, chairman of the NRCS Cross River State branch, who believes there’s a long history in Nigeria of malaria being taken for granted, said the MST exercise had been a worthwhile job because it showed volunteers another dimension to humanitarian work. “The training has helped us build our capacities – no doubt – to the point where we feel we could conduct it ourselves in other Nigerian states,” he said.
Nigeria bears an estimated 25 per cent of the total sub-Saharan African malaria burden.
Jenny Cervinskas, an IFRC specialist who also helped manage the roll-out in the three countries and prepared training material for National Society staff and volunteers, describes MST as part of a “broader effort by the IFRC and its partners to develop approaches to evaluating health programmes that will enable decision-makers to carry out a survey and act on the results quickly.”
The MST malaria-surveys in the three African countries were carefully designed to be as representative as possible of entire communities, and timed so that target groups were not, for example, away working in their fields or attending religious festivals.
They are intended to highlight information about malaria prevention and treatment, as well as access to local health-care services, household income, and nightly net usage.
EpiSurveyor is now used by some 4,000 account-holders in at least 170 countries. Selanikio, DataDyne’s CEO, said its adoption for humanitarian work was just amazing. “People are collecting tens of thousands of records’ worth of data every month and 99 per cent of them are doing it for free,” he said. “Mobile computers are leapfrogging laptops in developing countries.”
When David Effiong and his NRCS volunteer colleague, Theresa Agba, this week reached the house of Agnes Modey, 32 – who remembers getting combined typhus and malaria when she was pregnant with her now three-year-old son, Thomas – their MST questions highlighted another common problem with nets: the ‘hang-up’ issue.
The Modeys’ house in Ogoja, northern Cross River State, is spacious, with solid concrete walls and ceilings and several large rooms; but there are no obvious points from which to hang a net.
Agnes improvised, hanging hers longitudinally over the main bed on a cord nailed to the walls.
The Red Cross information campaign that went in tandem with net distributions encouraged the proper hang-up of nets in households and nightly use to ensure maximum protection against malarial mosquitoes.
Thomas was ill recently with fever, but as far as they know he is clear of malaria. In any case, the whole family now sleeps under netting, so he should stay that way.