The drive for universal bed-net coverage in Cross River State, Nigeria

تم النشر: 24 أبريل 2012 15:25 CET

After the first flood of the summer rainy season, most of the roads become impassable for long periods of time. In Cross River State, the dirt road into Bazohure village seems hardly passable, but Awara Rekpene Sunday and his team of Red Cross volunteers are making their way up and down the treacherous road to bring in all the mosquito nets that they have been tasked to distribute to this village from the offices of the Local Government Area (LGA), where they were initially stored.

Just over 3,000 community-based volunteers from the Nigerian Red Cross Society (NRCS) were trained to conduct a door-to-door distribution and hang-up campaign of long-lasting insecticide treated nets (LLINs) in order to reach universal coverage in Cross River State.  The volunteers were also trained on how to convey key messages about net use and maintenance.

Awara and his team distributed and hung up nets during household visits, using nails, string and hammers procured for the project. Whilst hanging the nets, they came up against an important complicating factor: many houses are bamboo-frame and mud – there are no hard surfaces to take the nails from which the nets are strung. The solution the volunteers found was to gently probe the walls until they detected a bamboo upright buried in the dried mud, then hammer a nail in. Even that didn’t always work as some of the walls are very thick and the nails were not long enough; some nets had to be hung from cords nailed to roof joists. “It was stressful,” says Awara, a 29-year-old local teacher. “But we didn’t miss out a single house here because of its structure.”

Nigeria is Africa’s most populous nation. What may be less well-known is that the country’s 158 million people carry a disproportionate 25 per cent of sub-Saharan Africa’s entire burden of malaria. We will not have beaten malaria until and unless it is beaten in Nigeria. In Cross River State, the distribution of 1,159,061 LLINs offers hope and contributes to the national effort to curve the effects of this killer disease.

The Red Cross volunteers hung nets over all beds and “sleeping places” – in practice any floor-space where families put mats or foam mattresses that are stowed away during the day. It is hard work: the temperature inside Blessing Benard Omet’s tiny, windowless house is way above whatever it is outside, which is high enough. Now, with the rains, the air is grey with moisture; the humidity slows everyone to a crawl. Blessing is a 17-year-old new mum with a month-old baby living in a household of seven people. They got two nets from the Red Cross volunteers – the most it was possible to hang within the house. They arrange themselves at night so that everybody sleeps under a net, says Blessing, and she and her family are clear of malaria.

Mary James Egon, 62, has a little more space in her house – room to look after her granddaughter Lydia and one of the child’s friend’s. Now she has a new net for everyone to sleep under. With young children to care for, she says she finds the net immensely reassuring.

Reverend John supervised a team of 17 Red Cross volunteers in Biko-Biko ward of Ugep LGA. Between 21 May and 6 June 2011, his team distributed and hung no fewer than 5,000 nets – an average of more than 20 a day each, working six-day weeks. It’s an impressive total for one team in one ward.

Results of the Rapid Mobile Phone-based survey conducted by Nigeria Red Cross volunteers in June 2011 indicated that the LLIN hanging rate was as high as 84% following the first phase of the distribution: in practical terms, this has been largely the achievement of the Red Cross volunteers who live in the communities in which these nets have been hung.