Twinomugisa is a primary school teacher in Hoima district. She and her family struggled for many years with an ongoing cycle of malaria infection that would prevent her from going to work and impact on the family’s finances. She saw too the impact malaria had on the children she taught, especially in their attendance rates and their grades.
This is the story of how Twinomugisa overcame her family’s own struggle with malaria and multiplied the positive impact by taking her knowledge into her classroom to benefit her students and their families.
Malaria is one of the most common infectious diseases in Uganda and is an enormous public health problem. It accounts for 25-40 percent of outpatient visits at health facilities, 15-20 percent of all hospital admissions, and 9-14 percent of all hospital deaths (UDHS 2016). Malaria is not just a disease commonly associated with poverty, it can also be a cause of poverty and a major hindrance to economic development – economic impacts of the disease include; the cost of healthcare, working days lost due to sickness and days lost of education.
Twinomugisa, a teacher at a primary school in Hoima district, struggled to prevent herself and her family from frequently contracting malaria. Being an educated teacher, she could not understand how she could fail to defeat malaria in her home. She would have to miss teaching her classes when she got sick.
Mary, a key influencer in her local area, trained by Malaria Consortium as part of USAID’s Malaria Action Program for Districts (MAPD) program, would visit Twinomugisa during her routine household visits to educate her on the ways to prevent malaria. She would speak to Twinomugisa about the importance of using a Long Lasting Insecticidal Net (LLIN) and ensuring that her surroundings were clear of tall grasses and empty bottles – where water could collect and encourage mosquitoes to breed. Twinomugisa disliked using the net, “it’s hot, I’ll suffocate, it itches,” she’d say, but Mary the key influencer did not give up visiting her. With this continuous support, in time, Twinomugisa decided to see for herself if what Mary said was true and if sleeping under an LLIN could stop her from getting malaria.
Twinomugisa started using the LLINs that she had in her home, she also received more new nets during a recent mass distribution of LLINs and disposed of the old nets. She ensured that everyone in the family slept under them and would check on the children each night. After a while, Twinomugisa noticed that the malaria episodes in her home had reduced, until there was no one falling sick with malaria.
Twinomugisa began to save the money she used to have to spend travelling to the health facility and for the malaria treatment for her children when they got sick each month and instead used the money to purchase chickens. On average she would spend 20,000/= (twenty thousand shillings) on treatment for each person in her home of four people.
“I would fall sick and then as I got better, the children would get sick, so it was a cycle of malaria infection in my family. But now we are healthy and the chickens have been laying eggs which we can sell or eat at home, something that we could not do then.”
After defeating malaria at home and realising the enormous benefits, Twinomugisa decided to start sensitising children in her class on malaria prevention. But it did not seem to work, absenteeism continued and the children continued to perform poorly because of this. She decided instead to summon the parents of children who always missed classes due to malaria to talk to them about making sure their children were properly protected and continued to summon them until those children got better and had improved their attendance at school. In a short time, students might be absent for other reasons, but not malaria; “the parents were very grateful to me,” a smiling Twinomugisa said.
Twinomugisa is committed to keep talking to her neighbours and those around her about the benefits of malaria prevention so that they can also change their behaviours and reap the benefits. She has also shared her experience on the radio to help spread the message beyond her village and continues to share malaria prevention messages with the pupils in her class.
The Malaria Action Program for Districts is a five-year, USAID-funded programme implemented by Malaria Consortium in partnership with Jhpiego, Banyan Global, Communication for Development Foundation Uganda (CDFU), Deloitte Uganda and Infectious Diseases Institute (IDI).
The project covers 49 districts in Central, Mid-Western and West Nile regions of Uganda, with an estimated population of 13 million people. The goal of the project is to improve the health status of the Ugandan population by reducing childhood and maternal morbidity and mortality due to malaria.