Reducing the incidence of malaria. through local actions

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Reducing the incidence of malaria through local actions Activities for young people to earn a badge and save a life Living within the temperate zone of the world is much less challenging than living within the tropics. The climate is more equitable and people can be protected by vaccination against infectious diseases. By contrast within the tropics the weather is much more extreme being much hotter with some parts receiving higher rainfall (giving rise to tropical rain forests) and other areas being very dry resulting in deserts. In addition its inhabitants are exposed to tropical diseases for which few vaccines have yet been developed. This set of activities (together with a related module for leaders and teachers) have been devised to make young people more aware of one such disease namely malaria which affects more than 200 million people annually. These activities illustrate the role of the mosquito in spreading the disease and describes what can be done to limit its incidence working with local Scout Groups in various African countries. We hope that these activities are enjoyable as well as being informative and educational. Linked to these activities is a resource box with all the necessary resources. This box can be purchased at a nominal cost by completing the order form on our website www.scoutsagainstmalaria.org.uk

Malaria activity pack and resource box Activity type Age range resources 1 Incidence of malaria Group All Images, video clip discussion 2 Where malaria occurs Team game 8 + Map of Africa, coloured pencils 3 How malaria occurs Team game 11+ Card set true or false 4 Mosquito dice game Team game All Parts of mosquito, dice 5 Balancing a mosquito Individual activity 8+ Cardboard, tooth picks, blue tac, scissors, coloured pencils 6 Why malaria is so effective Group discussion 11+ Images of fair traded products 7 Safe travel Team game 8 14 Board game, counters, dice 8 Transmission of malaria Team game 11+ Card set 9 Making a mosquito Individual activity 11+ Pipe cleaners, eyes, scissors, glue 10 Erecting a bed net and preventing mosquito biting 11 Helping African scouts to distribute bed nets to vulnerable families Team activity 8+ Bed net, twine, bamboo poles, scissors Group activity 8+ Images what African Scouts are doing Not supplied Scissors; coloured pencils; bamboo poles (for raising bed net) suggest 4 x 1.0 m (uprights) ; 8 x 1.8 m (top and side bracing); twine (string); glue This activity pack can be downloaded from the SAM website or purchased together with the resource box by completing the order form on the SAM website.

1 The incidence of malaria Aim: How malaria is spread and what can be done to avoid being bitten Background Malaria is contracted through the bite of a particular type of mosquito called the anopheles mosquito which may be infected with a parasite which can cause malaria. Through the female species need for blood, if the mosquito carries the parasite then in the process of drawing blood a parasite is injected into the blood stream. It is this parasite which infects the liver cells and thus results in malaria. Unlike infectious diseases which are encountered in temperate climates and for which vaccines are available, no vaccine is currently available to protect against the introduction of the malaria parasite into the blood stream. As symptoms of malaria include very high temperature, vomiting and diahorrea, young people under age of 5 are particularly vulnerable and can die as a result of contracting this disease unless treatment can be initiated within 12 hours. As the anopheles mosquitos are active at night, the simplest and most effective long term solution is to sleep under a bed net which is impregnated with an insecticide which can kill the mosquito. Over half the population at greatest risk from malaria in Africa still sleep unprotected by mosquito nets which cost about 2-3 each. However such nets must be correctly used and cared for. The activity Siting in a circle and introduce the topic of tropical diseases like malaria. Through discussion find out what they know; then consider the following questions What is malaria How is someone infected Where does it occur Who is most at risk Show video appropriate for age range. After the video, discuss how can such a disease be prevented and why our help is needed Outcome Each person to have some knowledge about the disease and how it can be prevented Resources Video clip, projector, lap top or images Video links Leo and Kya, Friends against malaria [6+] https://www.youtube.com/watch?v=16pljgnvjx8 This video is suitable for younger persons and is told through the eyes of two friends, one from Africa and one from the UK. It explains what malaria is, how it is contracted, who is affected, the symptoms and how it can be prevented. A gentle introduction to the possible outcomes of being bitten. Peter Capaldi (Dr Who) visits the main hospital in Lilongwe, Malawi [11+] https://www.youtube.com/watch?v=ogsbbvbpi4g This video is suitable for older persons and is narrated by Peter Capaldi. It talks about malaria, how it can be prevented and what can happen if someone is bitten and is admitted to hospital and has a sad ending. A more mature approach to the impact of malaria and provides the basis for a discussion about what can be done to save a life Leader s notes Incidence of malaria and a race against time

Typical areas where malaria carrying mosquitos can be found can be found

2 Where malaria occurs Aim: Identifying in which African countries does malaria occur on a large scale and why? Background Malaria is caused by the bite of one type of mosquito the anopheles which may be infected with a parasite which can enter the blood stream if the mosquito is infected. These types of mosquito are primarily found in the sub tropical areas of the world. They thrive in regions where the air temperature is consistently high during the day and night and there is access to stagnant pools of water where their larvae can breed. Such areas are generally found within the tropical areas of the world, which stretch 2500 km either side of the Equator. They cannot breed in desert areas as these are generally too dry or in mountainous areas which are generally too cold at night. Sub Saharan Africa carries a disproportionately high share of the global malaria burden as in 2015, the region was home to 90% of the world s malaria cases and 92% of malaria deaths. The activity Sitting in a circle, discuss the incidence of malaria and how it is transmitted by the anopheles mosquito. Give each team a map of Africa and set of red and green pencils Each member in turn selects a country and discusses with his team whether conditions are suitable for mosquitos to breed. If so he/she colours that country red; if not green After a set time period say 5 7 minutes, each map is examined by another team and it is decided whether the countries have been correctly identified or not. The team which has correctly identified the largest number of countries is the winner Outcome Discuss why so many families in countries where the mosquito are present, are at risk Resource Per team copy of map of Africa, and green/red coloured pencils Leaders notes Where malaria is endemic and why

3 How malaria occurs Aim: to establish what is known about malaria Background Mosquitos have been in existence for a very long time and have been able to adapt to their surroundings and ecosystem over many millions of years. As far as the mosquitos are concerned, humans are just another source of blood! It is important to prevent being bitten especially at night when the anopheles mosquito, the parasite carrier, is active. The use of insecticide treated bed nets is the most common form of long term prevention provided these are correctly erected and used. If bitten, it is important to monitor the effects of the bite and to seek treatment as soon as any of the malaria symptoms are detected. Activity This activity to be undertaken after the general discussion about malaria, how it can be prevented and if bitten what treatment is available. Each team is given a set of cards each of which contains a fact about malaria. Each member of a team takes in turn a card and discusses with his team whether the fact is true or false. The card is then placed under the true or false column and continue until all the cards have been classified. Each team to look at another team s facts and discuss whether the facts are correctly labelled. The team with the highest number of correct facts wins. Outcome To reinforce knowledge about the disease and what can be done to prevent it Resource A set of cards with facts about malaria and a true and false card Follow on activities transmission of malaria Leaders notes How malaria occurs and infects the body; preventing the spread of malaria For further resources consult our website www.scoutsagainstmalaria.org.uk Statements All mosquito bites result in malaria (false) Both male and female mosquitos can induce malaria (false) Anopheles mosquitos are only active at night (true) Female anopheles mosquitos bite to obtain blood to feed their young (true) All anopheles mosquitos inject parasites when they suck blood (false) A vaccine is available to prevent malaria (false) Malaria is not dangerous because its symptoms are not severe (false) Bed nets are a way of preventing mosquito bites (true) Bed nets are easy to erect (only if they can be hung) Mosquitos cannot find holes in nets (false) Only young children are vulnerable to malaria (false) There is no urgency to start treatment if someone is bitten (false) Mosquitos transmitting other diseases are only active during the day false)

All mosquito bites result in malaria Both male and female mosquitos can introduce malaria parasite Only anopheles mosquitos carry the malaria parasite Anopheles mosquitos are only active at night Bed nets are an important way of protecting you while you sleep Female mosquitos bite to obtain blood to feed their young Malaria is not dangerous as its symptoms are not severe Only young children are vulnerable to malaria When mosquitos bite they inject a parasite which causes malaria Mosquitos can find holes in bed nets Treatment should be started as soon as possible Mosquitos can also transmit other diseases and are active during day True False

4 Mosquito dice game Aim: A fun game to learn the parts of a mosquito Each team is provided with a set of body parts and a dice Players take it in turn to roll a dice and add the body part corresponding to their number to their mosquito. However it is necessary to throw a 6 first to obtain the body before any other part can be added. Each throw can only result in one body part Players may only add the correct number of body parts to their mosquito. First team to complete the mosquito wins. dice Part Number of parts comment 6 Body 1 Must start with body 5 - - 4 Wings 2 3 Front legs 2 yellow 2 Rear legs 4 white 1 - -

Aim: To balance a mosquito and colour it in 5 Balancing a mosquito Print the images of a mosquito on cartridge paper or a similar type of light card Each individual cuts out the shape of the mosquito using scissors Attach a toothpick to underneath the mosquito to act as its proboscis (mouth) using sellotape or a gummed label Then stick a blob of blue tac under each wing and move until you can balance it on your finger tip Finally colour in your mosquito to decorate it and take it home

6 Why malaria is so effective Aim: To understand why malaria is still infecting so many people each year Background First and foremost it is a tropical disease for which no vaccine currently exists. Mosquitos, the disease carrier have been around for millions of years and are likely to continue their existence for many years to come. Even though there is a global partnership to fight the disease led by the World Health Organisation, no effective vaccine has yet been forth coming. Mosquitos will always breed in countries where it is hot and wet which conditions are found in many African countries. Reducing places where mosquitos can breed is very effective as their larvae require stagnant pools of water in order to become adults. As it is difficult to eliminate all pools of water in a wet climate, the only other option is to spray the surface of a pool with insecticide wherever possible. There are two other factors which can reduce the resistance of people to such diseases climate change which is causing changes in rainfall resulting in crop failure in a number of African countries. People have therefore had to migrate to neighbouring countries which might have a more equitable climate. This enforced migration has created stress in the surrounding countries whose land may only just be sufficient to support the present local population. poverty which may mean going without one or more meals a day. One way of reducing poverty is to buy fair traded products. The activity Sitting in a circle and discuss why malaria is so difficult to prevent. Questions to be considered Who is most at risk? How does this affect their ability to survive being bitten? Why are so many people vulnerable? How can a changing climate affect the ability of populations to feed themselves? Is poverty is a factor? If so can buying fair traded products help them? Outcome How malaria occurs and infects the body; reducing poverty by buying fair traded products. Reducing poverty by buying fair traded products Producers of products like food, do not always receive a good price for their products. The fair trade mark, which is internationally recognised, indicates that the producer is paid a premium over and above what he would normally receive. Such funds can be used to buy food for the family, seed for growing crops and to pay fees to enable their children to go to school. These producers are generally located in developing countries, many of which lie within the tropics. There is an ever increasing range of products which carry the fair trade mark. Possible Activities Undertake survey of fair trade products in one or more local shops Sample blind tasting of fair traded and non fair traded products can you detect a difference? Develop recipes and cook meals using fair trade ingredients When going shopping with parents, encourage them to select products which carry the fair trade mark

7 Safe travel through a country where mosquitos are active.game played in teams with each person having a counter placed at square #1. Players take it in turn to shake the dice and move counter according to the number on the dice. If the square on which your counter lands has an action carry this out. First person to travel through the country safely and reach home wins. Home safe 100 stopped taking tablets 99 98 97 Did not use net 96 95 94 Sick! incorrect clothes 93 92 91 81 82 83 84 85 86 87 88 89 90 80 79 78 77 76 75 74 72 forgot lost to spray Took tablets tablet 61 62 63 64 65 66 67 68 69 70 Took tablet 71 60 58 57 56 54 53 52 Took tablet 51 41 43 44 45 46 47 48 49 50 31 Use net 40 39 38 37 36 35 34 33 32 21 22 23 24 25 26 27 travel to malaria safe area 29 30 Took tablet 20 19 18 Start trip 1 2 missed a day 16 13 12 11 Took tablets pre trip 3 4 5 6 7 8 Resources Laminated board, counters for each team member, dice Correct cover up 10

8 Transmission of malaria - teams arrange a set of cards to identify various pathways A healthy person lives in sub tropical Africa Person does not catch disease Person dies Person recovers

A healthy person lives in sub tropical Africa Hot and wet climate so mosquitos present Anopheles mosquitos can carry a germ that causes malaria Anopheles mosquitos only active at night Wears protective clothing after dark Sleeps under insecticide treated bed net Person does not catch disease Did not wear protective clothing after dark did not sleep under bed net Person bitten and malaria germ enters blood stream Person dies Treatment started too late No clinic nearby where treatment can be started Infected person develops high fever, shivers & sweats Reaches clinic and malaria germ detected Treatment started Person recovers

9 Making a mosquito Aim: To make a mosquito from pipe cleaners Resources Pipe cleaners of 3 different colours, googly eyes, scissors and glue; cut 1 pipe cleaner into thirds and cut the other two colours into 1/3 and 2/3; Activity is for each person to assemble a mosquito from a set of pipe cleaners. The mosquitoes should be taken home and the Scout should be able to explain to his parents why malaria is such a scourge and what Scouts can do save lives in Africa by raising funds to purchase nets. The instructions are set out below but a simpler way of assembling the mosquito is to follow in turn each step of the leader in making your own mosquito 1) Roll both ends of 1/3 pipe cleaner in towards centre to form eyes; glue eyes in each centre 2) Form wings by bending ends of a 2/3 pipe cleaner in towards the centre 3) Create legs by twisting together three 1/3 pipe cleaners and bending downwards 4) Join eyes and wings by threading a full length pipe cleaner through eyes and twisting around wings; join eyes/wings to legs by twisting pipe cleaner around complete assembly 5) Form body by twisting long pipe cleaner to form base and proboscis

10 Erecting an insecticide impregnated bed net Background The anopheles mosquitos that are responsible for spreading the malaria parasite are active at night. So the most suitable form of long term protection is to sleep under an insecticide impregnated mosquito net which has two benefits it will prevent families being bitten by such mosquitoes when they are asleep and the insecticide will kill the mosquitos. Aim The activity is to erect a mosquito net using bamboo poles as a framework and then your group has to enter ando sit inside the net with no gaps which could allow a mosquito to enter. Resources Bamboo poles, twine, scissors, bed nets Activity The long life impregnated bed nets are designed to be hung from the walls of a room. In a hall, the only way to erect the net is to construct a framework of bamboo poles from which the net can be hung. This generally requires 4 uprights, 4 cross pieces and 4 cross braces which are joined together using twine. The net can then be hung on or draped over the framework. As the net is quite fragile, it must be handled with great care to prevent holes through which mosquitoes can enter. If you are doing this outside you can secure the upright poles in the ground and drape the net over these poles.. Outcome To realise how difficult it is to erect a net without any gaps and why African Scouts often help families to erect the nets. Also why the nets are the only long term method of preventing being bitten by a mosquito which might carry the malaria parasite Leaders notes Use of bed nets

12 Joining the global partnership to fight malaria - What African Scouts are doing to limit the incidence of malaria and how we can help - Background Malaria remains one of the leading causes of illness and death in sub tropical Africa and is responsible for 30 to 50% of all outpatient visits to hospitals. About half the population living in this region still do not have access to these long life insecticide impregnated bed nets so it is a race against time to purchase and distribute the nets as resistance to existing insecticides is growing. So Scouts in the UK and in 4 African countries (Uganda, Ghana, Malawi and Gambia) have joined the global partnership to fight malaria. What African Scouts are doing Once we are able to send funds to them, the Scouts identify a village which is in need of these bed nets and organise a campaign working with the District Health officer and local charities, This involves identifying vulnerable families which are those with young children under the age of 5 or expectant mothers. As can be seen from the photos, the following activities are involved Explaining the incidence of malaria and how bed nets can be erected Distributeing the bed nets to these families Helping with erecting the nets Ensuring that parents are aware of the symptoms, where treament is available and why immediate help must be sought if bitten. Earning the SAM badge To earn the SAM badge, UK Scouts have to undertake two activities Learn about the disease and why it affects so many people in Africa and why long life insecticide impregnated bed nets are such an important part of limiting the spread of the disease Individually or collectively raise funds; suggest an average of 5 per head which can be used by to buy and distrubute one bed net which could save a life Activity This should take the form of a group discussion about how we in the UK could make a difference to help those people who do not have any form of protection.. Resource Photos showing distribution campaigns in Uganda and Ghana. Follow on activities Fund raising to help African Scouts purchase and distribute insecticide treated bed nets. Leaders notes Joining the global partnership to fight malaria More information about these campaigns is described in the SAM newsletters which can be down loaded from the SAM website For further resources consult our website www.scoutsagainstmalaria.org.uk

Discussing how malaria occurs and can be prevented, Jinja District, Uganda Distributing the nets, Jinja Distrct, Uganda

Helping to erect a long life insecticide impregnated bed net for a family with young children, Nyame Bekyere village, Ashanti district, Ghana Insecticide impregnated bed net erected in a family home, Jinja District, Uganda