By Grey Frandsen

Grey is a member of Pilgrim Africa’s Board of Directors and recently returned from a visit to help launch Pilgrim’s malaria reduction program in Katakwi. 

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As we prepare for a warm holiday next week in our homes, families in Pilgrim’s project area are receiving life-saving indoor residual spraying in their homes. Here is a quick overview of what the holidays will look like this year for families impacted by malaria.

For those of us in the U.S., the next week is filled with joyous celebrations in our homes. Many of us will celebrate Christmas, Hanukkah or Kwanzaa with our families, friends and neighbors. We spend extra time making our homes “just so” in an effort to make our families (especially with young children) and visitors feel welcome. And what iconic image better captures the American Christmas spirit than young kids opening gifts under a tree? It definitely feels good to be “home”, and it’s a special season for those lucky enough to have one.

For those in certain parts of the Katakwi district of Uganda, where Pilgrim Africa is deploying a large-scale, multi-year malaria reduction intervention, this holiday season will also be filled with joy, but for very, very different reasons.

Before Pilgrim spray operators can spray, we help the families remove their belongings onto their front yards.

Before Pilgrim spray operators can spray, we help the families remove their belongings onto their front yards.

Instead of trimming a tree inside a living room, Ugandan families in Pilgrim’s program area are preparing to empty their homes of all of their belongings for a full day. Fortunately, you won’t see anyone complaining.

These families are eagerly awaiting their turn to receive something known in the malaria intervention arena as “Indoor Residual Spraying” (IRS) – the application of a special mosquito-killing insecticide on the inside walls and thatched ceilings of inhabited structures (with a focus on sleeping huts). IRS is a proven method for reducing malaria when used as part of an integrated malaria-fighting strategy.

For families receiving IRS, this is an exceptionally special holiday season. The malaria rate in this region is among the highest in the world, and most every family member in every family contracts malaria, on average, at least once per year, every year. It’s pervasive in all aspects of life and casts a veil of despair over these poverty-stricken communities, where basic malaria treatment is often out of reach financially, or simply unavailable, to the average family.

That’s why IRS is celebrated by communities so widely. Malaria specialists also celebrate its efficacy. From a technical malaria-fighting perspective, there are few interventions that have such immediate and effective impact in the fight to reduce malaria transmission. For families who cannot afford preventative methods or malaria medicine for their loved ones, an application of IRS in their homes means a period within which the risk of contracting malaria is lower. For a community, wide-scale IRS coverage is a critical component to suppressing the vector population, which in turn helps to reduce further malaria transmission.

These written numbers on doors allow us to give each structure a unique ID and then track what we do via GPS and handheld tablets.

These written numbers on doors allow us to give each structure a unique ID and then track what we do via GPS and handheld tablets.

In this IRS operation, 9,000+ structures will be treated. The chemical our spray teams spray on the inside walls of each inhabited structure is designed to provide mosquito-killing action for up to six months. The chemical kills on contact when initially sprayed, but most importantly, it retains its potent killing power (and repellency) for months after application. While IRS is only one part of an effective malaria intervention strategy, it’s an effective and proven system that delivers real results in a short period of time.

Pilgrim’s approach to forming genuine partnerships with the communities it serves adds additional value to this IRS operation. I am particularly proud of the fact that Pilgrim hires staff locally, creating new jobs and new training that will have a lasting impact. This important work is being done by 150 new Pilgrim Africa team members recruited directly from the communities within which IRS will be conducted. They’ve been well-trained in all aspects of IRS spray operations but they also bring with them a deep appreciation for the local landscape and the families they serve, helping to improve efficiencies and trust.

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Here are two of our spray operators decked out in full gear. You can see the size of the spray canisters and our bikes.

For sure, their work is exceptionally difficult. These IRS operators are braving long days in hot weather in dark overalls, wearing helmets and full face-masks, and carrying 50lb spray tanks (called “applicators”) and extra bottles of insecticide.

The spray operators move from homesite to homesite covering, on average, up to 7 to 10 structures in a day. To keep costs low and to improve mobility between job sites on bumpy dirt roads and trails between homes, we’ve equipped our operators with bicycles specially outfitted with racks to help them carry their IRS spray tank and extra chemicals with them.

Our spray operator here is spraying insecticide into the rafters of a sleeping hut.

Our spray operator here is spraying insecticide into the rafters of a sleeping hut.

As these spray operators go from home to home with their life-saving holiday gift, families greet these men and women as true heroes. While their story is rarely told, I’m proud of the men and women who have chosen to play a part in the fight against malaria in their own communities, and by carrying out the hard work to do so.

The Big Goal: stopping the malaria transmission cycle

This IRS program is part of Pilgrim’s efforts to build a new, scalable malaria reduction model for high-transmission areas that can serve as a template for national efforts. IRS is one important component of this model.

Our combination strategy attempts to dramatically reduce both the mosquito population AND the number of human carriers of the malaria parasite throughout our project area. Our intended result is a rapid collapse of the parasite prevalence that we then can sustain through routine interventions and ongoing partnerships with these communities.

Our chemical for spraying requires mixing with water with just the right ratio. Because we can't transport water in large quantities on bikes, we ask that each resident be ready for their spray session with water to mix. Most villagers have to travel a significant distance to secure water, so this isn't a small thing.

Our chemical for spraying requires mixing with water with just the right ratio. Because we can’t transport water in large quantities on bikes, we ask that each resident be ready for their spray session with water to mix. Most villagers have to travel a significant distance to secure water, so this isn’t a small thing.

So as we prepare to enjoy family time in our warm homes in the next few weeks, let us transport ourselves, even for just a moment, to the experience that our brothers and sisters are having in Katakwi. Families there are eagerly awaiting the arrival of one of the greatest gifts of all – freedom from malaria.

Making a contribution this holiday season would go a long, long way.

Our spray operators, who work 10-12 hours a day in the heat, make less than $10 a day.

That means that a $100 contribution today, which is about the price of one nice meal for a family of four, or the cost of a nice Christmas tree, would provide up to 10 days of spray operations, which would cover anywhere between 80 and 100 structures, or approximately 40 family homes.

These 40 families would be given the gift of a malaria-free home for up to six months.

If you’re interested in having an even larger impact, you could pay to spray an entire village. How many families could you protect? Imagine freeing 100 homes from malaria so that their inhabitants can have a safe, restful, and healthy holiday.

One of our team members takes a breather, but we don't have time to rest. Until we finish all of the homes receiving IRS in this phase, our team members work long days with true joy and pleasure. They know that their work is literally saving lives.

One of our team members takes a breather, but we don’t have time to rest. Until we finish all of the homes receiving IRS in this phase, our team members work long days with true joy and pleasure. They know that their work is literally saving lives.

A generous contribution of any level in Pilgrim’s indoor residual spraying program would be the biggest gift you could give this holiday season.

This would be a gift from your home here in the US to the homes of families in Uganda. We are so blessed to be able to support them. By helping families defend their homes from this deadly disease, we can give the gifts of safety and hope this Christmas season.
I am exceptionally proud of the hard work our teams are doing in the field, and I’m honored to be a member of the board. I hope you’ll consider joining our Pilgrim Africa family by making a gift at this critical time.