Fighting malaria in Malawi

A Malawian community member washes her bednet at a demonstration by her Volunteer.
By Kristina Ciarlo
Sept. 18, 2017
Learning should be fun. Regardless of age, if we are not engaged with the material being taught, we quickly lose interest.

I think we have all experienced this at some point. Just picture a crowded lecture hall; the professor in the front talking at the students, going on and on, no pause for discussion or questions. Every single face staring back with the same blank expression and eyes glazed over, clearly thinking about their to-do lists, plans for the weekend, or (my personal favorite), what’s for lunch.  Here’s a different scenario: you attend a seminar with a passionate presenter. You spend more time up and out of your chair than you do sedentary. You leave feeling excited, challenged, and looking forward to using what you learned. I like this scenario better. You like this scenario better. Everyone likes this scenario better.

A big part of what I do in Malawi is health education. I teach about malaria, HIV/AIDS, nutrition, etc. Sometimes it is easy to make the material fun and exciting. For example, in my GRS (Grassroots Soccer) program, I teach kids about HIV and gender issues through games. We don’t just tell the students that having sex with someone older increases their risk of contracting HIV, we show them through limbo, and it is absolutely a crowd favorite. Pad projects are another big hit among the women. It’s easy to sneak in important health discussions while sewing, chatting, and laughing as a group. Sometimes there is a really important topic that you want to cover, but are struggling to think of a creative way to present it. It can’t always be fun and games… or can it?

I started facilitating a pregnancy and malaria sessions for local women last April. After reading about a Malaria in Pregnancy activity, I wasn’t sure how it would go over in my community. I needed to explain a complicated, yet extremely important topic, without putting the audience to sleep. I decided to try the activity I read about at least once and it was a huge hit! Since April, I have done this activity countless times, and will continue to do so until I run out of people to share it with.

Two jars are covered with plastic poked with holes. Colored liquid is being poured in the jar with the mosquito on it.
The two jars represent two mothers.

The aim of this activity is to show how malaria affects a fetus when a person is pregnant. Malaria can cause a lot of issues, including anemia, miscarriages, stillbirths, low birth weight, birth defects, and maternal death. A big problem is that pregnant women often test negative for malaria even when they do have it. This is because the malaria parasites “hide” in the placenta. The parasites in the placenta do not mingle with the mother’s blood, so a malaria blood test will show negative, when it should be positive. The malaria parasites also cause the placenta to thicken, which blocks oxygen and nutrients to the baby. This is what we show in the activity I was explaining above.

To start the demo, I ask for volunteers to hold two clear jars filled half way with water, both covered in plastic wrap poked full of holes. Each container represents a pregnant mother, and the water is their unborn baby. The plastic wrap over the top of the jars is supposed to be a placenta. A placenta allows the transfer of nutrients and oxygen from mother to the baby, hence the holes in the plastic.

We then pretend that one “mother” has malaria. She has not been sleeping under her bed net. We put a picture of a mosquito on this container to remind everyone that this mother and fetus have malaria. Since placental malaria causes the placenta to thicken and harden, we place tape over some of the “placenta” holes for this mother and baby.

I then use colored water to represent the nutrients and oxygen the baby needs to grow big and strong. As we pour the water over the placenta of the healthy mother, the baby receives lots of colored water through the holes in the plastic, aka nutrients and oxygen.

There are two jars. The one with the mosquito on it has colored liquid being poured into it.
The colored liquid represents nutrients.

But what about the mother with malaria? Only a small amount of colored water is able to seep into the container, which means the baby is being deprived of essential nutrients and oxygen!

This demonstration helps expecting mothers comprehend the health information they are being taught, because they can physically see what is happening to each “fetus.” This project has been such a success with so many different groups and people run to get their friends so we can show them too. At the end, it is exciting to witness the crowd teaching back, clearly understanding and fully able to explain how malaria affects pregnant women and their babies.

Health Volunteer Kristina