Piles of furniture, clothes, pots, pans, toothbrushes, and blankets sit piled high on the dusty ground outside several houses in Odumasi, a small town in the Ashanti region of Ghana. Dozens of men dressed in dark-green overalls and carrying metal cylinders make their way through the village, entering home after home.
Donning bright orange polo shirts, two female volunteers look on with a watchful eye, answering their neighbours’ questions and pointing the men in one direction or the other.
“When they come to spray, we are the ones who tell the community when it’s going to happen, and explain to them what to do and how to prepare,” says Ruth Oppong, one of the community volunteer advocates.
“We are committed to ending malaria in our community. That’s why we are doing this,” adds her colleague, Adwoa Asantewa.
Today’s operation is part of Ghana’s ongoing fight against malaria, a disease which kills nearly half a million people worldwide every year, 90% of who are in Sub-Saharan Africa, according to WHO. Despite recording a significant decrease in the number of malaria deaths – 599 in 2017 compared to 2985 in 2013 – Ghana is still at work eradicating the disease.
So far, indoor residual spraying (IRS), where long-lasting insecticides are sprayed on the inside of homes to deter mosquitos, has been one of the most effective malaria control interventions in Ghana. “When we started in 2006, our goal was to reduce malaria cases by 50%, but two years later the reported cases had gone down by 75%,” says Samuel Asiedu, director of AGAMal, a non-profit organization working to reduce malaria morbidity and mortality in Ghana.
“Before, we used to have a lot of children getting sick. They would have a high fever and convulse, but since they started spraying the malaria cases have gone down,” says Veronica Kumah, a women’s representative in New Dokyiwa.
“When children get malaria, it brings a lot of complications to women because they are the ones who look after them. They cannot work, and it drains their purse,” says Veronica. “Since women are taking care of the children, they have passion for the programme. And if women support, we will be successful.”
Every week, the women of New Dokyiwa meet with Veronica to discuss issues related to health and clean up surrounding areas of their town to prevent mosquitos from breeding.
Their efforts, coupled with the indoor spraying, have drastically decreased malaria cases. But despite the programme’s initial success, numbers have plateaued due to mosquitos developing resistance to the chemical being used in IRS, says Asiedu.
“With malaria control, if you don’t maintain it, you can go back to a situation that was even worse than before. We cannot lose what we have gained,” explains Keziah Malm, program manager for the national malaria control programme at the Ghana Health Service.
In an effort to ensure progress, Ghana is one of the first countries in Africa to introduce two new ‘third generation’ insecticides. If used in rotation with each other, they will significantly decrease the likelihood of resistance.
But the introduction of new insecticides – which is being done through The Innovative Vector Control Consortium (IVCC) NgenIRS project, with funding from Unitaid and Global Fund – is only part of the battle against malaria.
“The community needs to be involved for it to work,” says Alberta Bosomtwe, social behaviour change communications manager with AGAMal. “That’s why we need our community volunteer advocates, who help us mobilize and educate the community.”
And while the spray operators are men, many of the volunteers are women, and they play a vital role in the programme.
“It is very easy for us women to make an impact. We are able to convince people that getting their house sprayed is a good thing.” says Ruth.
Adwoa agrees. “We women are the first to identify whether a child is sick with malaria, and we are the ones to take care of them. We know the effects it has on the community.”
“If women are leading in the fight against malaria, we are bound to succeed.”