I'm at a conference this week and today heard a particularly interesting talk about the efforts to reduce malaria in Africa, especially among those in extreme poverty.
The promotion and use of bednets has had a significant and truly impressive impact on malaria reduction. But, the speaker mentioned that in the early days of these bednet campaigns, it was found that only approximately 60% of those who received bednets used them. The various international partners in these efforts spent much time thinking about the reasons that nearly 40% of those receiving bednets did not sleep under them, and various proposals were put forward to study the causes and possible solutions. After much time spent thinking about how to develop an effective study that would help quantify the problems and solutions to the use of bednets, one local person said, "why don't you just help the people hang up their bednets." After all the complex discussions that had taken place, that one simple solution, to hang bednets for those who received them, was ultimately what raised bednet use rates from 60% to over 90%. Helping families hang their bednets is now standard protocol in malaria bednet campaigns throughout Africa.
This story, when we heard it, raised chuckles through the audience, because it was such a perfect example of over analysis by the "experts" and simple, real, effective solution-finding by the local people. The story reminded me of an article I read several years ago, and have always appreciated, that was published in the British Medical Journal (link below). The article effectively raises an important and serious point through humorous means by pointing out that experimental trials are not always possible, nor are they always necessary, before promoting certain health strategies.
Granted, too often, our strategies are not well evaluated. But, we need not go to the other extreme and think that all our solutions need to be tested through rigorous experimentation before we can implement them. Indeed, in the real world of health and rights, sometimes, as the bednet story well illustrates, what is most needed is careful, culturally-informed thinking.
I don't want to loose the inspiring story here about how a simple solution (bednets) and a simple strategy (hanging them up for people), is truly having a life-saving affect on millions of people in Africa, but I think you'll find the linked article similarly thought-provoking.
http://www.bmj.com/cgi/content/full/327/7429/1459?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=)
The map above, obtained from Worldmapper.org (a site I recommend), shows the proportion of carbon dioxide, methane, and nitrous oxide (commonly referred to as "greenhouse gases") emitted from each country in 2000. The map below shows the proportion of childhood deaths from diarrhea in 2002.
What's the connection between climate and health? More on that in an upcoming post, but it is widely acknowledged that the increasing release of carbon dioxide, methane, and nitrous oxide into the atmosphere is having a noticeable and negative affect on health, especially malnutrition and diarrhea. 