GUEST BLOGGER: Carolyn Windler
If I have learned one thing serving as a health volunteer in a developing country, it is that changing someone’s behavior long term is a nearly impossible task. As humans, we have an intrinsic drive to maintain habits and impeccable difficulty instilling new habits without substantive reward. In my work, this is particularly true with respect to malaria prevention.
Nearly 90% of cases at the local health clinic in my village are due to malaria, and that is not an uncommon rate. My job is to help educate and encourage the community to implement prevention methods. Of the primary ways to prevent malaria, increasing mosquito net usage, is a top priority for reducing its huge impact on West African communities. Yet people simply have no desire to do so.
Here in Togo, the Ministry of Health seeks to promote 80% mosquito net usage to prevent the spread of malaria. As use increases, disease rates exponentially decrease due to fewer mosquitoes acquiring and transmitting the infection. After months and months of trying and failing to convince members of my village to sleep under mosquito nets, I was feeling dejected. Despite being able to recite all the benefits, people still said they would not be likely to sleep under a net. Other times, when asked if a family slept under a net the response might be “yes,” but when a follow up question is asked regarding how many nets are owned, the response will often be “zero.” Well, that doesn’t quite fit…
Heat, rashes, inconvenience, and lack of availability are the most cited reasons why people don’t sleep under nets. In reality, malaria is such a rampant part of life that they believe it will affect them no matter what. Despite receiving new nets every two years from the Ministry of Health, people re-purpose or store them away never to be hung up.
The first thing I discovered was that just educating people on malaria, while important, is not enough to convince them that a net could truly prevent disease. Individuals themselves have to make the connection between the use of nets and reduction of disease. They have to want and enjoy a change in lifestyle, otherwise it will never last. Moreover, with slow, incremental efforts, often invisible to the agent herself, change is happening. Like primary care, education and aid are an essential first line of defense towards changing people’s lives. Behavior change might seem nearly impossible, but with strategic efforts and a willingness to keep trying, at least one person will avoid at least one perilous mosquito bite while sleeping under a net. That makes it all worth it.