And now to hang the nets…

Curious neighbors say hello during a home visit...

Volunteer Richard and a happy owner of a newly installed mosquito net.

Volunteer Abraham of Takorase after demonstrating the hanging of the mosquito net to the household.

As part of TAMTAM’s operational research, we are again testing the impact of using community health volunteers to hang mosquito nets for households on net usage. At the same time, we are also observing the rate at which households will install nets on their own and whether or not the nets make it home after a fixed point distribution. These questions were all suggested by malaria policymakers in Ghana. We hope to deliver useful findings for them through our work these past few months.

The community health workers are now visiting homes to install mosquito nets and collect other information. They have been trained to hang nets in different types of rooms, over beds and mats, and armed with supplies such as flashlights, nails, and hammers.

We look forward to hearing that households not only own but also use their mosquito nets to cover their entire family.

Nets are in the communities at Ghana site!

Happy kids with nets.

Meeting the local health officials before the net distribution.

Crowds waiting for nets at Adwenso.

Calling household names at Afuafie.

Assembly line to prepare nets for households.

Supply pack included with each net: strings, hooks, nails, and care instructions.

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Going home with baby and nets.

Managing the distribution table in Dzamam.

Going home...

After two action-packed days, nearly 2000 nets have been distributed for free to communities in Dzamam sub-district. Five separate distributions were supported by the community health volunteers, the local health clinic, KLO Drivers’ Alliance, and the TAMTAM team. The tro-tro van which carried our 2,000 nets and team members traveled many kilometers over challenging terrain to reach the communities. The distributions occurred at central community hubs: a health clinic, two churches, and two schools. Each distribution began with a malaria message to the gathered community by Mr. Sackitey Offei, the leader of KLO. The message covered basic malaria prevention information and proper care (mild soap, no sun exposure, minimal washing) and use of the mosquito nets including a hang-up demonstration. Following the message, household heads were called by name from the pre-registration list and given the mosquito nets allocated to their household. TAMTAM’s mosquito nets, WHO-certified Permanets manufactured by Vestergaard-Frandsen, were prepared by opening the package and cutting a hole in the tag to mark TAMTAM nets. Hooks, strings, and an instructional cartoon were included in the distributed packs. Nets were opened to ensure they could not be sold and so that households were know to use the nets immediately instead of saving them for the future. It was quite an assembly line with all hands on deck to assemble thousands of nets for distribution.

At the end of the distributions, we were satisfied to know that six communities, or 3,700 people in 585 households were protected by TAMTAM mosquito nets. It was especially rewarding to see mothers and small children and pregnant women taking home nets. Thank you to KLO Drivers Alliance for their preparation and facilitation of the entire project. The staff members of the Dzamam health clinic (Barbara, Wahab, Eudia, and Abigail) have been very helpful- from shuttling us to distant villages on their Ghana Health Service motor bikes, coordinating collection of data from volunteers, and storing our supplies. They are all nurses and technicians assigned to this rural site, far from their homes and where they must learn the new language of Krobo. Once again, we have been inspired by local partners and found their participation critical to the success of our work.

Photos from Pre-Registration in Dzamam

Father and son visited during a household pre-registration visit.

Volunteer Abraham checking one of the few existing mosquito nets. This household owns one but it is too old to have effective insecticide.

Grandma and baby while their house is visited by a volunteer

Volunteer Joseph registers a household in Adwenso

Training Volunteers in Ghana

Photos- Top: Volunteers, KLO, Dzamam clinic and TAMTAM teams after training; Middle: Volunteers ready for instructions; Bottom: Discussing details during training.

The community health volunteers for TAMTAM’s project in the Dzamam sub-district gathered at the church across from the health clinic. During the one day training, the volunteers learned how to pre-register their communities so that TAMTAM could distribute enough mosquito nets for universal coverage. As defined by the National Malaria Control Program’s standards, universal coverage for a household is one net for every two people, up to the number of sleeping spaces, and less the household’s current effective nets. Our volunteers went into their communities to return this information for each of their households. They were also prepared with tools such as clipboards, inkpads, pens, and flashlights to help them accurately obtain the data needed. During training, volunteers were able to practice administering the pre-registration survey. They problem solved potentially challenging situations through role playing and discussing together.

After training, the seven volunteers (Richard, Christian, Felix, Nicholas, Abraham, Joseph, and Joseph) conducted pre-registration in their respective communities of Brepaw, Dawatrim, Dzamam, Adwenso, Takorsae, and Afuafie. TAMTAM members were available to work with the volunteers during their first few household visits to ensure that there were no difficulties. In total, 3800 people in about 600 households were registered for TAMTAM’s project.

Ghana Field Site: Dzamam

Dzamam is a sub-district of Upper Manya Krobo District. The district was formed just two years ago, after Manya Krobo became too large to adequately distribute resources. The new district is working to develop its own systems and leadership. Its capital is Asesewa, which is about one hour by car from the Eastern Region capital of Koforidua. Dzamam consists of sub-districts and communities which are largely farmers of cassava, maize, and cocoa yam. There are also fishing villages since the Volta River and its tributaries are in the area. Market day is Friday in Asesewa (mini-market on Monday) so that is the busiest transport day- with tro-tros and cars kicking up heaps of dust on the usually quiet roads. It has been a pleasure to get to know this area- with rich soil, lush green mountains during this rainy season, and welcoming people. The useful phrase, “Mo choom ka” or “Thank you very much” in the local Krobo language, has served us well.