Health Volunteers Educating Villagers on Malaria Prevention

April 24, 2003
By Kate Woodsome
The Cambodia Daily

Sure, the food handout filled their stomachs, but the information that came along with it changed their lives. For the past five years, farmers, mothers, fathers and children have been emerging from remote villages in Ratanakkiri a free meal and a little advice on malaria.

Village health volunteers, trained by Health Unlimited, are conquering language and land barriers to teach the residents of 40 villages how to prevent malaria, a disease that has affected approximately 40 percent of the province's population, said Nut Vutha, Health Unlimited's senior medical adviser.

In an area populated by hill tribes that have little formal education and often don't speak Khmer, people boasting primary and secondary school degrees are highly coveted. Four such people have been recruited as trainers by Health Unlimited, and are invaluable for their aptitude in the Tampuon, Jarai and Kreunt languages, Nuth Vutha said.

A recent study of the health beliefs and malaria practices about malaria in Ratanakkiri showed that villagers' understanding of the disease has a long way to go. The research, conducted by the National Malaria Center, noted that 45 percent of participants did not know what caused malaria and only 10 percent reported that only mosquitoes lead to the disease. Many perceived convulsions, caused by high fever, as spiritual interference. And 67 percent said malaria could not be prevented.

To overcome these misconceptions, health volunteers take a participatory learning approach to train the villagers, often using drama to demonstrate how the sting of a mosquito can cause more than an itchy bump.

"We ask people to role play. Someone acts like a mosquito and someone else is the patient," Nuth Vutha said. 'Then [they pretend] they have a fever and chills."

The workshops have been highly effective, with villagers opting to sleep under protective mosquito bed nets instead of in the open air, he said. Farmers working outside the villages also are more inclined to carry nets with them when sleeping away from home.

Determining the content of the workshops often is more laborious than the actual exercises, Nuth Vutha said. Villagers' traditions and learning styles, typically more reserved and rudimentary than those practiced by general Khmer society, must be considered.

To assure that the lessons are effective, information, education and communication material is being developed to take into account the villagers' culture and traditions, as well as the strong gender disparity that has left 60 percent of women compared to about 30 percent of men ignorant of what causes malaria.

Questionnaires have been distributed and preliminary lessons have been tested and revised, Nuth Vutha said. Now it is up to the Health Ministry to approve the IEC, which will be used in an expanded program covering 240 villages. The program will begin once money from the Global Fund is released to Cambodia.