Benin is a country in West Africa, situated between Nigeria, Niger, Burkina Faso, and Togo. Tabetha Miller is currently a Peace Corps Volunteer, serving in Djougou, Benin.
This is her story and community reflection on Malaria and Malaria Prevention.
The moment I stepped off the plane, I was swept into a room with the doctors holding out something called Doxyclycline, expressing that I needed to take 100mg a day. Coming to Benin has been my first experience living with the everyday possibility of catching malaria. What is malaria? Malaria is a disease that is transferred through mosquitoes and mosquito bites. Usually, when I am at my site in Benin, people ask if I must live with the possibility of malaria in the states and when I respond with “no”, the looks of surprise are priceless. The mosquitoes in Benin are infected with a parasite called Plasmodium and only the female mosquitoes can transfer it. This parasite is deadly and is known to be one of the leading causes of death in the West African country of Benin. Because of this, precautions need to be made and these precautions become an everyday part of life.
As a Wisconsin born American woman, coming to Benin, my knowledge of malaria prevention was non-existent and really revolved around what I had seen in movies, blogs, and random Google searches. I knew about the mosquito nets, but I had no idea how to use it. I knew that some people become sick with this little thing called “malaria”, but I had no idea what the symptoms were and how serious it could be. Now that I have spent six months in this country, I have become more educated about ways that I can prevent malaria within myself, how malaria affects my community that I currently live in, and the seriousness of the sickness.
My first three months in the country, I lived in Lokossa, a city in Southern Benin, during the rainy season. More rain equals more mosquitos and although I was taking my anti-malaria medication, sleeping under my mosquito net, and putting on mosquito spray day and night, the mosquitos still found a way to bite me and I was constantly in an itchy pain. Thankfully, my medication and prevention must have been doing something right because I never once caught malaria. My host mother, a woman in her late fifties had malaria during the first week that I met her. My reaction was very scared for her and I knew that she needed to rest to recover. My host mom, on the other hand, did not like the idea of staying still.
When a person catches malaria, the biggest symptoms are constant diarrhea, headaches, vomiting, muscle aches and pains, and weakness. All of these symptoms were affecting my Beninese host mother, but she did not feel it was necessary to rest. She took her required medication to counter the parasite and then she continued with her day to day life. This was my first encounter with Malaria and since then, I have found that so many other host country nationals have a similar outlook on the disease. For me as an American, Malaria is such a foreign disease that often gives off the impression that it will never happen in the states. When I see it first hand, I have a very strong impression on how serious this disease is. For Beninese nationals, this disease is common and while people do need to rest, many have the impression that it is a quick recovery.
Since being at my permanent site in Northern Benin, the number of mosquitoes has gone down, however, the level of Palus (malaria) has gone up. We are entering the season of Harmattan, a season where the dust from the Sahara Desert blows into West Africa and brings along a cooler temperature. This is a major blessing for me to live in a cooler temperature for a few months, but already, family members of my co-workers, mothers of my students, and my students themselves have had malaria and have missed work, school, and important meetings. I decided that I needed to talk with my counterparts and community about what they do to protect themselves from malaria and then what they do when they have malaria as well.
Living right next door to me in my concession is a family of six who came to Benin in 2013. Just this past week, their oldest daughter came up to me and said, “Tabby, j’ai la palus”. I looked at her once and by the looks of it, no one would be able to tell she had malaria, but she did. Her outlook on it was that her doctor could simply give her one pill and soon afterward, her malaria would be gone. I asked her mom what kind of prevention methods they use and of course, the first thing that came up was the beloved mosquito net. Using any type of bug spray, in particular, RAD is also the next step to keeping a family free of malaria. The last thing that the family does on a regular basis is taking Lariam, a preventive medicine that is taken once a week on the same day. This is more than I have heard from other families in Benin. When I was in training, during my first three months in the country, my host family took a medication once every two months. Medication, along with protection with mosquito nets and bug spray are the number one ways in the country to avoid catching malaria.
As a Peace Corps Volunteer, I can honestly say that I am constantly worried about catching malaria, not only because I live twelve hours from the doctor, but also because I am never ready for the symptoms like diarrhea, major migraines, dizziness, and more. Having to be on a bus to reach the doctor when I am feeling like complete crap does not sound appealing to me at all. Every day, I am sure to take my Doxycycline and even during those I have days where I am super sweaty and tired and too lazy to put down and tuck in my mosquito net, I still push myself to do it. The way I think about it is, if I really hate bugs (which I really do), then tucking in my mosquito net will not only protect me from mosquitoes but also those ugly scorpions and tiny insects that are all over the place.
The people of Benin may or may not have as much luck with finding ways to take care of malaria and to prevent it. I live in the third largest city in Benin, so I do not usually see many people who live in the tiny villages. People in the city have easy access to pharmacies and doctors who can prescribe medication, but for those in the villages, it may be incredibly difficult to find the help that they need and to find the transportation to get help. In addition to having less access to doctors and pharmacies, knowledge and understanding of mosquito nets may also go down. In some cases, where mosquito nets were given out to small villages for free by USAID, villagers won’t actually use them to sleep under. If one would take a long and large tour of Benin, they would see that the other use of mosquito nets in this country is to use them as garden nets. Because many people create their income from their crops, this use sometimes seems more practical, but maybe not in the long run.
To say that being aware of malaria in a country like Benin is easy would be a lie. There are a lot of things to know and remember. Thankfully, I have many people to talk to and have been sticking to my lovely bottle of anti-malaria medication to avoid the dreadful ride to the south. Along with my own protection against malaria, I have also stood as an example for my neighbors to protect themselves. Even my counterpart at my school will ask me for advice, along with my students. I don’t know everything, but I know more now than what I came into the Peace Corps knowing. Let’s just hope that I will not be one of the unlucky volunteers that have malaria by the end of my two years!