Nowhere is the importance of Long Lasting Insecticide Nets (LLINs) and...

the efficacy of artemisinin-based combination therapies (ACTs) clearer than in the Riga (camps) of the Fulanis of Kpada in Pategi Local Government Area of Kwara State, and in the thatch houses of the fishermen of Idale Keta, a fishing settlement of about 200 inhabitants in Ogun Waterside Local Government Area of Ogun State. With funds from The Global Fund to Fight AIDS, Tuberculosis and Malaria, via the National Malaria Control Program (NMCP), Institute of Human Virology Nigeria (IHVN) malaria intervention activities have reached these villages and more.

Kpada, Pategi LGA of Kwara State

Kpada, which is about 46 kilometers from Pategi, can only be reached with jeeps and trucks. Interestingly, all the huts in the Riga have treated nets.Garba Abu, a young Fulani man of 22 and student in a Missionary School in Kpada says "we are very happy about the treated nets because they kill mosquitoes. In fact, very few of our people here complain of malaria frequently because of the availability of the nets." He says they were able to get the nets from the Primary Health Center (PHC), Kpada, through the help of Mrs. Mary Joshua who taught them how to use the nets and keep their environment clean. "As you can see, our Riga is very clean. Madam Mary comes here often to talk to us and find out if anyone has malaria. She comes to give us the malaria drug and teach us how to take them. She comes to find out how we are doing too and we go to her home for the same reason." He was speaking on behalf of his 80-year old father who needed some rest.

Mrs. Mary Joshua is one of 59 Role Model Care Givers (RMCGs) that IHVN is supporting through Living Care Foundation (LCF), a Community Based Organization (CBO) in Oke-Ose community of Kwara State. "These RMCGs were trained by IHVN to ensure that people in their communities sleep under treated mosquito nets and access and use malaria drugs (ACT) properly. They were also trained to encourage their communities to keep their surroundings clean in order to reduce mosquito populations," says Mr. Sesan Adewoye, Director of LCF.

For Madam Mary, it is a rewarding but challenging experience. "The fact that people can come to my home, a mere volunteer, to receive treatment for malaria and listen to my advice on how to stay well and safe from mosquito bites, is a great thing and I am very happy. Another source of joy for me is that people in my community believe that the nets work and the drugs that I give them are fantastic." According to her, a family of a three-year old girl who fainted because of malaria but recovered after a three-day treatment with coartem dispersible tablets, gave her firewood and water to appreciate the assistance she extended to them when the girl was ill. "I told them that the coartem I gave their daughter was free but they insisted that I accept their gesture of appreciation for the help I extended to them." In Kpada, Madam Mary was warmly welcomed wherever she visited with this writer. "When my son Stephen was sick with malaria, I took him to the house of Madam Mary for treatment. She gave him coartem and it really worked. I have used several malaria drugs before but none worked so well like the one she gave my boy. I am now telling people who are sick with malaria to go for the drug that Madam Mary gives," says Mrs. Juliana Mordecai, 38 and teacher in Kpada community. Mrs. Dorcas Adams, 51 and mother of 7 children also attests to the usefulness of the treated nets she got from the PHC and the effectiveness of the malaria drugs she also receives from Madam Mary. "The first time I used the nets, I noticed mosquitoes don't make noise anymore in my house and looking at the nets every morning I noticed that mosquitoes and insects that perched on it died," Mrs. Adams adds.

Banni Ogidi, Ilorin West LGA of Kwara State

In Banni Ogidi suburb of Ilorin, many of the villagers say they do not have the treated nets and that the Basic Health Center in the area has no coartem in stock for some time now. Mr. Oluwafemi Oyedeji heads the Save the Future Initiative of Nigeria (SAFIN), a CBO that IHVN engages to cover four local government areas of Ilorin West and East, Isin and Ekiti in Kwara State. He acknowledges that some households do not have nets because they were not available when the nets were distributed to individuals by the health center. Mr. Oyedeji oversees the work of 32 RMCGs. He was also trained by IHVN to stem the increase of malaria in this community. He says the greatest challenge in the area is the need for behavior change to improve usage of the nets and malaria drugs given to some of them. "The RMCGs are tired of lack of drugs but I have kept encouraging them to continue with their sensitization work of making those who have nets to use them. Malaria activities must not come to an end because of the complaint of no nets and drugs, I keep telling them and they are doing well in their efforts to save lives in the communities.

Physically challenged Ramatu Muniru, 30 and mother of two children (Jamiu 12, and six months old Isyaku), is one of the people benefiting from the outreach activities of Alhaji Nurudeen Shehu, 60, to curb the menace of mosquitoes in Banni Ogidi. Alhaji Shehu, who is the Chairman of the Banni Ogidi Ward Association comprising 500,000 community members, is a RMCG trained by IHVN and coordinated by Mr. Oyedeji. Ramatu says that though she does not have treated nets, the ACT given to her at the health center worked very well when she and her two children were down with malaria. Another person who got the nets is Moromoke Isah, 40 who says "I use the nets very well and can teach others how to use it. I have come to know so many things about malaria and how to prevent it through Alhaji's concern for the well-being of this community."

Idale Keta, Ogun Waterside LGA of Ogun State

In Idale Keta, a fishing settlement of about 200 inhabitants on a creek in Ogun Waterside local government area of Ogun state, the use of mosquito nets is compulsory. According to the community leader known as the Baale, Chief Isaac Ajimuda, "you cannot live here without a mosquito net. In the night the number of mosquitoes is unbearable. All the thatched huts here have treated nets that we sleep under at night." He also says that "before we started having these treated nets, we had untreated ones. But these treated nets kill mosquitoes." Chief Ajimudu says that the incidence of malaria sickness has reduced but "not completely because three months ago, my son Benson, 4, was very sick and that meant going to Ode Omi, which is about one and half hour journey on a canoe, daily for three days to receive malaria treatment from the PHC there. The health workers insisted that we have to come daily because his case was a bit serious and needed to be constantly followed up. My timber and fishing business was disrupted during those three days." He got his nets from the PHC in Ode Omi but says that he appreciates the effort of Mrs. T. A. Adebanjo, Director of Rays of Hope, which is a CBO supported by IHVN and her staff Francisca Jemiseye, who visit them regularly to teach them how to stay away from mosquito bites and use the correct malaria drugs when they are sick. Babare Julius, a community volunteer coordinates the work of the RMCGs like Mrs. Adesola Balogun who covers the fishing settlement of Ode Omi. Others that Julius covers include Idale Keta, Makun Omi, Ibiade and Abigi villages in the local government area. Mrs. Adebanjo's Rays of Hope is being supported to monitor RMCGs providing malaria treatment in 5 local government areas of the state: Ijebu Ode, Ijebu North, Ijebu North-East, Ijebu East and Ogun Waterside. The CBO draws tremendous support from Ode Omi community leaders especially His Royal Highness, Oba Beyioku Adenuga Ojafoyewe, the Lenuwa of Ode Omi.

Ikenne, Sagamu LGAs of Ogun State

Another CBO that IHVN is supporting to educate the people of Ikenne, Sagamu, Remo North, Odogbolu, Ifo and Ipokia local government areas of Ogun State on availability of malaria intervention activities is Peasant Dragnet, which is coordinated by Mr. Lekan Sodipo. Over 46 role model care givers that he coordinates have been trained by IHVN to reach out to the people in their homes. Mrs. Bola Odunsi, 42, a traditional birth attendant (TBA) who manages Ibukun Oluwa Maternity Home in Sagamu Remo is one of them. Another is Mrs. Morenike Odunayo, 40, also a TBA who runs Omolewa Traditional Home in Ikenne. One of Mrs. Odunayo's clients is Mrs. Fawusa Bakare whose grandchild had malaria two months ago. "I ran to her as usual for malaria treatment and after 3 days of taking the coartem my grandson recovered completely. The drug is good and I always tell people who have malaria to go to her for treatment. What I need now is a treated mosquito net to add to the one I have," says Mrs. Bakare.

In Ileshan Remo, Mrs. Gladys Adeola Adenuga, one of the RMCGs trained by IHVN is receiving commendation for her interest in the well-being of the rural dwellers in her community – "it does not matter if they are poor or rich," says Mr. Sodipo. She is a trained nurse with over 25 years' experience in maternal health care and runs Olurun Iyananu (IyaIbeji) maternity Home in Ileshan. "Mama took delivery of my three babies in her maternity and the youngest had malaria one month ago and I ran to Mama who gave us drugs free. And my baby, Sarah became well again after just three days," says Mrs. Aminat Dennis, 28 and a trader in Ileshan. Also encouraged by Mrs. Adenuga, fondly called Mama, is a University teacher, Mrs. Lucy Salami, 40 and mother of two children. "When my son was sick, I went to Mama to ask for what she has because I was tired of the malaria drugs that come with restlessness, reactions and sleeplessness. Mama gave me coartem for Richard who is only 4 years. After just 2 days he was up and playing without experiencing any reaction. My 2-year old Annabel was down with malaria two months ago and Mama was there to help freely. I was surprised that Mama did not receive any money for the coartem she gave me the first time. In fact, I was like asking to know the source of the drug that she will not receive a form of payment for. Mama however reassured me that the drugs are free." Another RMCG that Peasant Dragnet is supervising include Mrs. Idiatu Omotoke Ahmed, 37, also a TBA in Isara Remo village of Ogun State.