Inspired by a cause in which one can directly impact the lives of millions of people, Cover Africa was founded by eight undergraduates, including myself, in January, 2007. Cover Africa is a registered Cornell student organization affiliated with The Cornell Public Service Center, and dedicated to fighting malaria in Sub-Saharan Africa. It is estimated that one child dies every thirty seconds from malaria in Africa. Seventy-five percent of the victims of malaria are children under five and pregnant women. Ninety percent of the incidences of malaria worldwide occur in Africa. Meanwhile, malaria is a preventable and treatable disease. Cover Africa is grounded on three initiatives: [b]awareness, prevention, distribution[/b].
The death toll of malaria in Africa is estimated to be one million per year. Over three hundred million are affected. In addition, the effects of malaria on endemic areas are not limited to suffering from the disease itself. The malaria epidemic is so extreme in Africa for multiple reasons including the wet environment, resistance to medications of many forms of the Plasmodium Falciparum parasite, and poverty. As a result, among other things, there is a clear lack of health care workers, money to buy bed nets, roads on which to more easily distribute bed nets, sanitation facilities, health care facilities, and food. In different ways, all of these problems play a role in the malaria epidemic. [b]Malaria is a disease of poverty and a cause of poverty.[/b] Africa as a continent, but particularly South of the Sahara, (Ghana, Burkino Faso, Ivory Coast, Kenya, Guinea…), includes some of the most impoverished areas in the world. Simultaneously, malaria is costing Africa about twelve billion dollars per year. Together with AIDS and tuberculosis, malaria is one of the leading causes of poverty in underdeveloped countries today. Malaria is one of the root causes of increased school absenteeism, decreased tourism, discouragement of foreign investment, and strain on the healthcare system. Malaria accounts for up to fifty percent of hospitalizations and outpatient visits in Africa. Children who suffer long-term physiological effects of malaria, are deprived of their ability to learn, and may suffer from chronic anemia, brain damage, poor attention span, even cortical blindness.
The type of mosquito that carries malaria in Africa, is the female anopheles mosquito. Anopheles mosquitoes feed mostly when you are most vulnerable, at night while you are asleep. Studies have shown that the use of insecticide treated mosquito nets lowers the risk of contracting malaria by at least sixty percent. The reason that bed nets are not one hundred percent effective is that the nets are not always used correctly, people are not necessarily under the nets all night long, and it is possible to be bitten during the day. However, if people at risk in Africa had access to insecticide treated bed nets, assuming only sixty percent effectiveness, at least 600,000 lives could be saved this year. That does not account for the children who could be spared from neurological damage and the potential increase in productivity in malaria endemic areas.
In 1901, Italian physician, Giovanni Battista Grassi, implemented an experiment in which he proved that covering oneself in material that mosquitoes cannot penetrate does prevent malaria. In one of the most densely malaria infested regions of Italy at the time, one hundred twelve people were paid to live inside a house with screening on both windows and doors. They stayed there during twilight hours, when female anopheles mosquitoes are most active. The control group was made up of four hundred fifteen people who went outside as usual. Of the one hundred twelve subjects, only five became infected with malaria by the end of the study while almost all subjects in the control fell victim to the disease. Thus, the developing world has been aware of how malaria is spread and what we need to do to eradicate malaria in Africa since 1901.
No one has invested the time, energy, or resources to end what has now become a devastating crisis. My involvement in the fight against malaria was greatly inspired by a quotation that I heard at a conference led by Americans for Informed Democracy, The People Speak, and United Nations Foundation. It is included below because it applies directly to the motivation behind this service-learning trip and expresses the passion that we hope involvement in this program will instill in other students.
[b]"Our response to this problem will define this generation. What will you say when your children ask you, 'How did you let so many women and children die when you had the ability to save them and you knew?' Will we say that you didn't care, that you didn't care [u]enough[/u]? This situation is solvable."[/b]
(Cynthia Scharf, Public Information Officer, UN Office for the Coordination of Humanitarian Affairs, Jan. 3rd, 2007.)
Currently, with no available vaccine, preventing the proliferation of malaria via the use of insecticide treated bed nets is one of the most cost efficient and effective ways to fight malaria. However, prevention and distribution come hand in hand. Cover Africa's third initiative, distribution, focuses on insuring that the insecticide treated bed nets are delivered effectively to those most in need.
In May, 2007, Cover Africa partnered with [u]The Ghana Health and Education Initiative[/u] to create a service learning trip for Cornell students to travel to Northern Ghana in December, 2007. Local staff members of The Ghana Health and Education Initiative have been serving Humjibre for four years and hosting volunteers each summer. As locals themselves, their relationship with the villagers, as well as their understanding of local healthcare concerns and culture, are superb. GHEI was founded by medical students at the University of Maryland, in 2001. It focuses on creating sustainable programs around English literacy and health-education. Long-term interns manage GHEI projects in Ghana under the direction of the organization’s Ghanaian Program Director, Clement Donkor. They have worked on malaria in Humjibre through distribution of bed nets, malaria education, and holding annual malaria days. However, GHEI needs financial support and manpower to increase programming and net distribution. We will provide this support through our partnership. During this service-learning trip, students will travel to a malaria endemic area to distribute bed nets and use training, as well as to empirically measure the influence of this project on the community. This program is an opportunity for students to explore relief work and global health, experience a new culture, and witness how they can be the force of change in the future, as well as now.
This past summer, one Cover Africa executive board member (Aleinikoff, S.) worked with GHEI, piloting the malaria prevention program with three other GHEI volunteers. They conducted a survey, based on a survey by the WHO, of one hundred and thirty-four homes in Humjibre, Ghana. Of those one hundred and thirty-four homes, fifty-four had already acquired a bed net and of those, seven bed nets had ever been retreated. Due to financial constraints, GHEI was able to distribute only fifty bed nets over the course of summer 2007. To learn more details of this past summer with GHEI, please open the links below.
GHEI Summer Report 2007
Survey Implemented Summer 2007
Students will be living in the village, alongside the people of Humjibre, eating traditional Ghanaian food and getting to know the local Sefwi culture. They will also have opportunities such as drumming lessons, hair braiding, fabric making and Twi lessons. Along with bed net distribution and implementing the malaria assessment survey that they helped to devise, participating students will also be planning malaria education programs for the community, and a bed net re-treatment day (to soak the nets in Permethrin, the insecticide which kills mosquitoes, greatly increasing the efficiency of the prevention).
Students participating in the service-learning trip are taking the initiative in addressing fundraising concerns. They are fundraising for their expenses as a group as well as for insecticide treated bed nets and re-treatment tablets (insecticide). Meanwhile, Cover Africa is participating in fundraising for insecticide treated bed nets and re-treatment tablets as well as student travel scholarships by applying for grants, contacting Cornell departments, and holding events such as a bake sale, tabling on Ho Plaza, and a concert at The Nines. We recently received a pledge of $500 from The Cornell Store, and $150 per student traveling from Vice Provost Susan Murphy, thanks to a generous donation from The Bartels Family.
Professor of Entomology, Dr. Laura C. Harrington, is the class advisor. Participants will take part in a two-credit class both this semester and next semester (Entomology 410 Syllabus). Thus, participating students will be studying and working together for a full year, providing time to discover the most efficient group dynamics. The class will be conducted as a seminar class, with guest lecturers each week. During the fall semester, the course will provide the background on malaria and an introduction to Ghanaian culture. It will also serve as planning time for the trip and intervention. Example topics that will be studied include traditional African medicine, the current international aid strategies in Ghana, data collection to minimize bias, and the most common language spoken in Ghana: Twi. The second part of the course will be a two and a half week service trip to Humjibre, Ghana in December and January. The third part of the class will take place in the spring. The spring 2008 course will serve as an evaluation period. Students will analyze the results of the survey to assess their work, analyze their methodology, evaluate their experience, and work to improve the service learning program for the following year. Using the same survey each year will allow us to measure the progress of our intervention over time. We hope that data analysis shows effective intervention, and that this program could be used as a model for other villages in the Western Region.
When students return to Humjibre, they will be involved in assessing the effectiveness of those fifty bed nets that were distributed. Also, students will expand upon the survey formatted this past summer and apply it to a larger percentage of the total population to develop data that more fully encompasses the local population. A random sample of six areas in the village will be taken and students will visit a total of 360 households to gain information about living conditions, prevention mechanisms currently in use, incidence of malaria, and other poverty measures. Next December, a new set of Cornell students will return to Humjibre, Ghana. If empirically proven to have a significant effect on the incidence of malaria in Humjibre, this project could be implemented in other areas of the Western Region of Ghana in the future. If we find for some reason that the project is not as effective as we had expected it to be, it will be equally important to analyze why this is so and how future projects of this kind can be more successful.
Through this program, students will have the chance to investigate the implications and influence of long-term development work versus emergency relief work—a crucial differentiation for future leaders in international service. Currently, malaria in Sub-Saharan Africa has reached the level of an emergency crisis. The distribution of insecticide treated bed nets is mostly an emergency relief effort. It only takes twenty-four hours for a three-year old child to die of malaria post the onset of symptoms. The ongoing project assessment, bed net use training, malaria information sessions, and Cover Africa’s investment in raising awareness of malaria, are long-term development goals. In addition to contributing to the fight against malaria, we hope to create a more globally conscious and informed group of students, including ourselves.
Cover Africa article in The Cornell Daily Sun
Ghana Health and Education Initiative
The Cornell Public Service Center