No electricity. No running water. Pit latrines for toilets. This is rough country by Western standards. It seems more like camping to me except nature makes a far more pleasant place to do one's business than fly-ridden holes in the ground.
A hand pump attendant at a local gas station in Oyam.
Every morning while I sit around sipping instant coffee people here are hard at work carrying home enormous bundles of firewood on their heads and trekking to the nearest borehole, sometimes a few kilometers away, to fill up 20-liter jerricans of water. Though this is “winter,” which means the dormant season for crops, there still seems to be plenty to do, at least if you are a woman. People here live such basic lives that just $150 can feed a household of 17 for a year, explained one farmer who showed me around his tidy homestead of mud huts. I'd been wondering why people don't just buy mosquito nets to protect themselves at night since they cost at tops $5. Visiting a hospital with a child ailing with malaria costs far more in time and money, not to mention the priceless danger to human life.
But I can now see how difficult it is to manage malaria here. How do you cover people who sleep on mats on the floor? How do you set up window screens in mud huts? How do you protect children who toss and turn in the night, flopping arms and legs against the net where mosquitoes can bite? If you do manage to protect a child, they won't build up partial immunity to the disease so that it can strike harder as an adult. Mosquitoes in these parts are a constant torment and one slip up can have you down and out with malaria.
A mother comforts her child, who suffers with malaria, outside a hospital. She complained the child had not breastfed in days.
Still, I have been truly dumbfounded by the ignorance of some people who resort to witch doctors and traditional practices before finally giving up when it's nearly too late to bring a child back to health. I've heard from several doctors who told of seeing patients whose parents cut out the roots of their baby teeth because they thought doing so would reduce fever. Another common practice is to make small cuts on their chests to let out the supposed worms which were causing the malady. All this before finally heading to the clinic. These children arrive suffering from severe malaria as well as mouth and skin infections.
I can see the government's point in wanting to simply prevent malaria by spraying insecticide in people's homes. It's clear, however, that too little has been done to assist those seeking help in other ways. Villagers complain about being given only one bed net to cover dozens of children. Health centers are chronically short of anti-malaria medicines. I visited one clinic this week that didn't even have bed nets in the pediatric ward where most of the children were suffering from malaria! I asked the doctor what was going on, and he said the patients steal the bed nets. Who can really blame them?