Interviews "Malaria"

This page contains three interviews on the subject of malaria. They were part of some educational research work concerning Malaria in Ghana conducted in July and August 1999.

Orientation "Interviews"

Aim of the Interviews
Structure of the Interviews
Choice of Interview Partners
Problems concerning the Interviews

Interview One
- What can you tell me about malaria?
- When did you last suffer from malaria?
- How do you treat malaria?
- How do you prevent malaria?
- What causes malaria?
- How does malaria affect Ghana?
- What did they teach you about malaria in school?

Interview Two
- What can you tell me about malaria?
- When did you last suffer from malaria?
- How do you treat malaria?
- How do you prevent malaria?
- What causes malaria?
- How does malaria affect Ghana?

Interview Three
- What can you tell me about malaria?
- When did you last suffer from malaria?
- How do you treat malaria?
- How do you prevent malaria?
- What causes malaria?
- How does malaria affect Ghana?

Summary of additional interviews and informal talks
- School girl
- Student
- Other information derived from informal talks

Conclusion and Interpretation

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The interviews on this page were conducted  in Tamale, the capital of Ghana's Northern Region, in July 1999, and were part of an educational paper on the subject of malaria with the aim to prepare a number of lessons for Ghanaian teachers who are interested in the subject.

Aim of the Interviews

The aim of the interviews was to find out about urban people's knowledge on the topic of malaria and what of this knowledge they may had derived from school.

Due to my experiences while teaching at Tamale International School in 1995/96 and from a personal insight in living as well as teaching conditions in northern Ghana, I wanted to investigate the topic of malaria and how it is covered in schools in Tamale (Ghana).

1996, I got the impression that malaria was not one of the priority topics in school, even though many Ghanaians suffer from this disease every year. Through private, informal conversation, I got the impression that common people in the country don't really know enough about the disease to prevent it efficiently and that medical drug abuse due to inferior knowledge was a major problem.

Thus, I decided to verify these impressions by conduct of formal interviews in which the major points of interest were followed up by a set of questions.

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Structure of the Interviews

All the conducted interviews followed the same structure: After the person had been shortly briefed on the aim of the interview, their personal data, including age, sex, level of education, occupation and position as well as their place of living, were taken. (Due to personal data protection the names of the interviewed people are not stated on this page.)

Then, the interview was conducted along the following set of key questions:

What can you tell me about malaria?
This question serves as a general invitation to the interviewed person to tell freely about what he or she knows, and also provided a general idea of how to conduct the interview in detail.

When did you last suffer from malaria?
This question not only provides information about the commonness of the sickness but also gives an insight in how efficient the interviewed person's prevention measures were and what grade of exposition he or she has to face.

How do you treat malaria?
This question aims to find out about the means people use to cure malaria and why they prefer a certain treatment to other available options.

How do you prevent malaria?
This question helps to investigate the preventive measures the interviewed people took to protect themselves, and in some cases their families from malaria.

What causes malaria?
This question aims at the epidemiological knowledge of the interviewed person. Of special interest are concepts which are not scientifically sound as well as local believes.

How does malaria affect Ghana?
This question tries to investigate into the interview person's knowledge about the scale of malaria in Ghana and the consequences of the sickness for the national economy.

What did they teach you about malaria in school?
Finally, the last question tries to find out, if the knowledge stated during the interview was derived from school and whether the subject was taught in school or not.

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Choice of Interview Partners

The people I interviewed during may stay in Ghana where chosen for the following reasons. First, they were all known to me before the interview was taken. This allowed for some interpreting of the their comments as their living conditions were known. Second criteria was availability, nobody plainly refused an interview but with some people I could feel too much reluctancy. Thus, they were not interviewed. Third, female persons of an age span between 15 - 40 where preferred as they are more likely than other parts of the population to apply their knowledge about malaria not only to themselves but also to their children.

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Problems Concerning the Interviews

In order to conduct the interviews a number of problems had to be overcome, concerning technical problems, language and the candour of the interviewed people.

Technical problems were caused by the recording equipment which could not cope well with the fact that during the interviews technical appliances like two ceiling fans were operating. Thus, some of the recorded interviews couldn't be recovered from the tape later on, and I had to rely on my own notes taken during the interview. Because of this, the affected interviews have been summarized together with some other more informal communication after the three interviews on this page.

Another problem was language. The official language in Ghana is English, but most people speak their own tongue, of which there are more than 200. Thus, talking to people who don't have much of an English speaking practice was difficult and possible misunderstandings cannot be excluded. An interpreter could not be used under this conditions as it would have hurt the interviewed person's feelings.

The last problem is a general problem for the conduct of interviews: the candour of the interviewed person. It is a known fact, that research work done in Ghana by foreigners sometimes bases conclusions on incomplete, or even wrong information extracted from the questioning of Ghanaians, unwilling to give away their personal doings to intruding strangers. I tried to overcome this problem by interviewing people who were known to me and explaining in advance the aims of the interviews. Through this, I was able to get some additional information on the topic through casual talking from people who had been interviewed and others.

Considering all this, the statements made in the three transcripted and only slightly revised interviews should be taken with a "grain of salt".

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Interview One

The interviewed person, 32 years of age, is a mother of two children, who is working as a secretary for an insurance company in Kumasi, second biggest town of the country and one of the major trading centers. The woman, who has completed college in Tamale some years ago, and her family are living in the outskirts of the town in a setting which is typical for the Ghanaian middle-class. The interview took place in a private house in Tamale on the 18th July 1999.

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What can you tell me about malaria?

A: Malaria is a sickness caused by mosquitos or bad surroundings. When the female mosquito bites you, then you get malaria. By getting malaria you are first experiencing weakness, headache, then nausea. Then you realise you have malaria.

Q: So, if you have this symptoms, you know you are suffering from malaria?

A: If you are not sure, you go to hospital for a malaria test. So when they test it and they realize you have malaria plus [probably malaria positive], then they have to give you some treatment: Chloroquine.

Q: Do you normally take chloroquine?

A: Chloroquine tablets or injection. When they realize, the malaria parasite it too much, then they give you a higher drug, more than chloroquine. Like halfan or chamoquine.

Q: You said, if you go to hospital, they would test you. How do they do this testing?

A: They pull your blood and test it on a machine. The machine will determine whether you have the parasite or not. So, if they test it, the machine will let you know whether you have it.

Q: Have you seen this machine? Do you know how the machine works?

A: For the machine, if they pull your blood, they just let you out and they test it. It is like a microscope. So, they put the blood under, looking through it.

Q: Is there something else you can tell me about malaria?

A: It is just a deadly disease. So, by avoiding to get malaria, one has to get a better ventilation and try to be closing your doors. Then your area should be neat. Where you live should be neat. No standing waters. And at least, get a mosquito spray to spray your room.

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When did you last suffer from malaria?

A: About two month ago.

Q: Did you go to the hospital? Or how did you realize it was malaria?

A: I realized that I was very weak, I had some headache, then I felt like vomiting. So, I realized I was sick. I was not able to eat. So, I went to the hospital. When I went and complained to the doctor, he gave me a lab form for malaria investigation. So, when I went, they said it was malaria. I had malaria plus. So, I took the form back to the doctor and he gave me some chloroquine.

Q: When they told you that you had malaria, did they just tell you that you had malaria or did they tell you, that you had a certain type of malaria?

A: They said I had malaria. You know they have malaria plus and malaria plus plus or what. So, they said I had plus. [Either she means "malaria positive", or less likely a parasitaemia of 11 - 100 parasites per 100 thick film fields.]

Q: You had probably chloroquine tablets, how did you take them?

A: I took four, four and two. [A normal course in Ghana.]

Q: Afterwards, were you alright?

A: I had itching body, so I went back and they prescribed hydrocortison for me, injection. [Itching is a common side effect of chloroquine in dark skinned people.]

Q: But the treatment was successful?

A: Yes.

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How do you treat malaria?

Q: You said, you normally go to the hospital. Do you always go to the hospital or do you sometimes treat yourself?

A: Sometimes I do self-medication, when I realize the suffering is not too much for me. When the sickness is not too much.

Q: Do you use chloroquine in all cases? Not anything else like Halfan?

A: Halfan when the malaria is so serious. Then, they prescribe me that one once. So I normally use chloroquine. And for the headache, they give paracetamol. [Paracetamol also lowers the fever, but possibly prolonges some aspects of the disease.]

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How do you prevent malaria?

A: As I told you, by spraying the rooms. Every week I give Maralex [probably a chloroquine-based drug] to my children for prophylaxis. So my children don't usually get malaria.

Q: Are you also taking some prophylaxis or is it only for the children?

A: It is only for the children. (laughs)

Q: So do you think the prophylaxis works?

A: Yes.

Q: Do you remember the last time your children had malaria?

A: About six month ago.

Q: If you spray the rooms, how do you do it?

A: I spray the corners.

Q: Do you spray the walls, too, or just the corners?

A: Oh, just the corners.

Q: Can you tell me, why you spray the corners?

A: They say, if you spray the corners it's better. Like it circulates.

Q: Who told you, that it is the best to spray the corners.

A: (laughs) I don't know. I think I learned it from my mother.

Q: Is there anything else apart from spraying and the chemoprophylaxis you do to prevent malaria in you and your children?

A: Apart from that, they have some pomade when they are sleeping on their body. So the mosquitos would not come close to them.

Q: If you put this repellent on your children, do you put it every day?

A: It should be put every day.

Q: So, are you actually putting it every day, or are you saying it should be put every day?

A: OK, I am putting it small, small. I put it on their bodies small, small.

Q: But how often, every day?

A: Not every day, at least two days interval.

Q: If you put the repellent on your children, to which parts of the body do you apply it?

A: Their face, their hands and their legs.

Q: The children, if they are sleeping, are they wearing long-sleave or short-sleave dresses?

A: Long-sleave dresses. If the weather is warm, they wear short-sleave dresses.

Q: Do you apply the repellent to the feet?

A: Yes, I put the pomade on the feet.

Q: Is there any other thing you do to prevent malaria?

A: That is all. Some people also use mosquito coils.

Q: Now, let me ask you some other questions concerning malaria prevention. Maybe in your house you've got a water tank. If yes, is it covered?

A: Yes, it is covered.

Q: Are there any bodies of water around the house?

A: At least, outside the house. The water is far from the house.

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What causes malaria?

Q: You said, if a mosquito bites you...

A: It has to be a female mosquito.

Q: Do you have any idea, why it is actually a female mosquito and not a male mosquito that gives you the malaria?

A: Is it because of the eggs, or what? I've forgotten.

Q: Because of the eggs?

A: Yes, because of the eggs.

Q: Let's say a female mosquito bites you. Do you always get malaria, if one bites you? Is every mosquito dangerous? Or are they maybe some female mosquitos which are not dangerous?

A: Like, the male mosquito, if they bite you, you won't get malaria. But the female one, you get malaria.

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How does malaria affect Ghana?

A: The effect of malaria in Ghana is too much, because there are a lot of mosquitoes around and the government has to spend a lot of money on it, by buying drugs. A lot of drugs, from outside. Then, eventually due to lack of production, because a lot of people fail to go to work. So, eventually production falls. And a lot of deaths in the country. Even when you suffer from a different sickness, finally it is malaria which kills in the country. That's all.

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What did they teach you in school about malaria?

A: That malaria is a very dangerous disease and you have to be very careful. How to prevent it. To avoid standing-by waters and always close your doors and spray in the rooms. By taking Maralex every week. That's all I can remember.

Q: Are there other sources of information about malaria you had?

A: From the hospital, my mother friends.

Q: Do you have a TV set at your place.

A: Yes.

Q: Do you remember having watched a program about malaria in TV?

A: I don't remember any.

[On August, the 22nd 1999, a Sunday morning, Ghana television showed a programme on malaria in Kenya.]

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Interview Two

The interviewed 29 year old women is working part-time as typist for one of several lottery companies in Ghana. She lives in a compound-house near the center of Tamale town and represents the common urban worker, who has completed college but has to live on a very modest income. The interview was conducted on 24th July 1999.

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What can you tell me about malaria?

A: You get malaria through mosquitoes. The mosquitoes like places like the gutters. That is where the mosquitoes come in. And if they come in and you don't sweep away the water or whatever is around you, then you are likely to get malaria. Because, when they bite you, they pour that bacteria in you. And your body would start to pain you. Some people get stomach ache if they have malaria. Then, some people do vomit. For me the vomiting is too much. When you vomit, you would see that it is very yellow. The treatment of malaria is chloroquine. One thing about chloroquine, when I take chloroquine, I get reaction. I scratch my body for five days. I can' t bath. So you have to avoid malaria. To avoid malaria you have to make sure, there is no bushy thing. Make everything clean, even in the house. Mosquitoes like places that are crowded. Maybe somebody would just come out an put the shirt down. There are so many things in the bedroom or in the house you see them piling up. Immediately the mosquito gets a chance to come into the house, then they are likely to be in your room. Anytime, they hide in the dark places. In the evening, then they come out and you see them. So, that is what I know about malaria.

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When did you last suffer from malaria?

A: I had malaria last year I can't remember the month (hesitates) June or July.

Q: Did you suffer much from that malaria attack?

A: I laid down for one week. So, it was quite severe. And it comes and goes. Maybe in the mornings you feel better, but than around two o'clock in the afternoon you see that you feel cold all the time. And you would be shivering and you have to lay down. And you start vomiting and you vomit and vomit and vomit. Even if you get treatment, sometimes it doesn't go just like that. It takes two, three or four days before you get better. But even if you get better, you can be laying down for two weeks sometimes. But when you go to the hospital, maybe than they give you injection and maybe some tablets of paracetamol. But the main treatment of malaria is chloroquine.

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How do you treat malaria?

Q: You said you are treating malaria with chloroquine, but how do you realize you are having malaria?

A: As for me, my body is itching me, inside my leg. And I am feeling dizzy. Then, I feel cold. My joints pain. And then very suddenly, headache. I get headache, severe headache. I can't bend down. When I bend down, I have to hold the head. That is when I know, I am having malaria.

Q: What is your next step. What do you do about it?

A: If I just know I am getting malaria I initially take paracetamol. Then, you see, I'll be fine. Within one hour I'll be OK. Then you think the malaria is gone. But the next hour or the next two hours it will come back. So, to enable to keep you going, before you could go to see a doctor, you either take paracetamol or aspirin. Then you may go and see a doctor. If you chew that and the pain doesn't go, for two days or three days, then you have to go and see a doctor.

Q: So you normally wait two to three days, before you go to hospital?

A: Yes.

Q: Do you always go to the hospital or do you sometimes buy the medication directly from the chemist's?

A: Sometimes, I don't go to the doctor. If I know that it is malaria, I just go to the chemist's. Sometimes I get the injection, sometimes the tablets. And I'll be fine.

Q: Did I get you right, you go to hospital if you are not quite sure that it is malaria?

A: Yes, if I am sure about it, I treat myself.

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How do you prevent malaria?

Q: You've already told me that you have to be careful about mosquitoes and your surroundings, but are there some additional things you do to prevent malaria?

A: (thinks) I think it depends on neatness, too. Everything around you should be neat. Make sure, you don't take too much oil in your food often. And you should drink a lot of water. (hesitates)

Q: Let me ask you some other things, do you have screen doors in the house?

A: Yes, oh yes, it keeps the mosquitoes out.

Q: And do you use something like mosquito coils?

A: I don't use them, because they don't work. I believe in the spraying of the rooms. If you spray, you draw the curtains and leave the room for one hour or two.

Q: How often do you spray?

A: If I feel there are too many mosquitoes. Maybe thrice a week. It depends whether you are a worker other whether you are always in the house. Because, if you spray like that, in the morning you leave, nobody is in the house. Then when you come back from the worksite in the evening, there is no need to spray again. But if you are always in the house, you can't spray in the daytime. You spray in the evening around six o'clock. That is the time the mosquitos are always ready in the room. Spray around six, and then, you look the door. After one hour you come in again, and you don't have any problem. What I mean is, it doesn't mean, you should spray every day. You can spray three times a week. It depends on the area and the environment you are living in. If there are too many mosquitoes, you have to spray four times a week. In an environment, where you think there are not many mosquitoes, you may spray once or twice a week.

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What causes malaria?

Q: You said malaria is caused by a bacteria inside the mosquito, can you tell me something more about it?

A: (hesitates) I don't know much about the bacteria. The mosquitoes like to go into the gutters, the dirty, dirty things. So they pick it from there. And when they come to bite you, than they leave that thing in you an take your blood away. So that is the bacteria I can't mention, that thing. They have it in them, because immediately they come from there and get you, that is when you get the malaria. They leave that thing in you and suck your blood away.

Q: So, do you get malaria from every mosquito?

A: If the mosquito does not have too much bacteria inside, like fresh mosquito, you would not get the malaria like that. Maybe it's too much, when they get you too much, you have to start treating malaria.

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How does malaria affect Ghana?

A: Malaria has affected Ghana so much, especially children. Small children, they die a lot from malaria. I don't know whether they are always exposed, you know. Because they are always running around, playing. Especially rural areas, that is where the mosquitoes are there plenty. Because in rural areas, somebody can just start planting corn, around their backyard garden. You know these backyard gardens, mosquitoes like them too much. As for children, they are not strong like us. So, immediately those mosquitoes get them, you see them peah, peah, peah, you see them suffering. And mosquitoes or malaria normally comes during raining season, like these time. You get malaria and everybody is complaining: "I'am sick".

The interview ended at this point as some people were coming for a visit.

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Interview Three

The interviewed 21 year old woman had only one and a half year of formal school education, as she was brought from her village to work as a housemaid in a family, who was feeding and looking for her. This kind of arrangement food against work for girls, is common in Northern Ghana and socially well accepted. Thus, the person referred to as "mother" in the interview is not the real mother, but rather the person taking care of the girl at that time. Despite a very poor formal education, the interviewed person is now working as a seamstress and lives with her "family" in a semi-attached estate house. The interview took place on the 25th July 1999.

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What can you tell me about malaria?

A: Malaria is caused by mosquito bites. If a mosquito bites you, you get malaria. Maybe, if there is a dirty water behind the house or... (thinks) you can get mosquitoes at any time.

Q: Let me ask you, are the mosquitoes living in the dirty water?

A: No! But the water grows them.

Q: So if there is dirty water, the mosquitoes would come?

A: Yes.

Q: Do you know why the mosquitoes are coming to the dirty water?

A: Because the water is dirty. And, if you are not clean, maybe if you are having a pot, and you don't clean inside, the mosquito can come any time.

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When did you last suffer from malaria?

A: (thinks) Half a year ago.

Q: How did you know, you had malaria?

A: You are feeling cold, and you have headache and pain.

Q: Did you have to vomit?

A: Yes.

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How do you treat malaria?

A: Your parents would send you to the hospital or they buy you medicine to treat it.

Q: Last time you had malaria, did you go to the hospital?

A: A nurse, who I know, gave me chloroquine injection.

Q: So, you went to the hospital.

A: Yes.

Q: So you don't normally take the tablets?

A: No, I just make the injection. I take it in the evening and in the morning and that's all.

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How do you prevent malaria?

Q: Is there anything you do to avoid mosquito bites?

A: Maybe, you spray the house. Or you take medicine. First of all, my mother used to give us chloroquine, every weekend, two tablets a week.

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What causes malaria?

Q: You have told me about the mosquito bites. Can you tell me anything about the mosquito, the way it looks?

A: They way they look like, they are small animals. How can you recognize them? Because they bite you. And you can see them.

Q: Can you hear them?

A: Yes, the noise.

Q: So, they disturb you in the night?

A: (laughs) Yes, sometimes.

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How does malaria affect Ghana?

Q: Do you think, malaria is an important sickness.

A: Yes, if the mosquito bites you maybe a lot of people complain about mosquito bites and malaria.

Q: If you get malaria, is it a problem?

A: Yes.

Q: Why?

A: (laughs) If you don't treat the malaria, it can kill you at any time.

Q: If you don't die from it, what does malaria do to you?

A: It makes you sick.

Q: For how long?

A: Maybe two weeks.

Q: Last time you had malaria, did you have to stay at home or could you go to work?

A: You can't go to work.

Due to the personal circumstances of the interviewed woman, no further questions were asked concerning malaria education in school.

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Summary of Additional Interviews and Talks

In addition to the above mentioned interviews two more interviews were conducted and the author had informal talks to several people during his stay in Ghana from July to August 1999.

School girl

An interviewed girl, who was not able to state her age, but is likely to be around 16 years old, attending the 6th grade of primary school, couldn't spontaneously tell anything about malaria on her own, probably due to language problems and shyness. She didn't remember the last time she suffered from malaria, but indicated the she normally tells her "parents" when she doesn't fell well. They would give her a medicine of unknown name for her to swallow. As she was able to describe the way she takes the medicine, 2 tablets at first, followed by 2 additional tablets after some hours and finally 2 tablets on the next day, the drug she takes has been identified as chloroquine. The girl also indicated, that the house was sprayed once a week by  an insecticide she sell at her "parents" store. She described mosquitos as small insects an indicated that their biting was responsible for the outbreak in malaria. The symptoms of malaria were described by her as weakness, developing yellow skin, feeling cold, pains in the joints and headache. Ask whether her teachers talked to her about malaria in school, she indicated that they did so several times, but was not able to tell what they exactly lectured on. She also admitted to having problems to follow the lessons which are taught in English but said, she prefers to be taught in English to lessons in the local language (Dagbani).

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Student

An 18 year old student attending the Polytechnic School in Tamale for mechanics, after he has completed Junior Secondary School, and who is living near the town center, called malaria a "killer-disease" which was caused by dirty surroundings and mosquitos. He said the last time he had malaria he was sick for three weeks. The symptoms he mentioned were feeling cold and hot, vomiting and weakness. He normally treats malaria with chloroquine, which he buys from the chemist's or he goes for injection to the hospital. Once he used Fansidar. To prevent malaria, he suggested to keep your surroundings clean, especially to clean the gutters. Additionally he recommended to always cover your food and not to take too much oil. He said in case of sickness one should go and check his or her blood in the hospital. He also mentioned that the disease was picked by mosquitos from dirty gutters and caused by dirty particles in feces. According to him, malaria is a common sickness in Ghana which can kill you and weaks your body. While you are suffering from it, you can't eat and are not able to attend work or school for several weeks. He said it didn't affect his schooling too much as he is normally able to make up for the lost time. According to him they talk about malaria in school and the teachers recommend good food, and the use of medicine if prescribed by the hospital.

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Other information derived from informal talks

A high percentage of people I talked to during my seven-week stay in Ghana suffered from malaria during that period. Most of them treated the malaria attack themselves, only a few went to the hospital. These was due to the cost involved in "seeing" a doctor, which means the bribe you have to pay to a nurse before you can talk to a doctor, and also probably a result of the strike of medical staff over allowances affecting the hospital at that time.

Many of the people also complained about an unpleasant side effects of the commonly used chloroquine: an itching body, or more precisely a chloroquine allergy. They said because of the allergic reaction they were not able to take chloroquine. One man complained he always had to vomit if he took chloroquine. All of these people indicated that it was difficult for them to get an alternative treatment as the other available drugs are normally far more expensive than chloroquine. One young man tried the local treatment which is widely used among the rural people: A tea made of neem tree (Azadirachta indica), pawpaw (Carica papaya) and guava (Psidium guajava) leaves. But he said it didn't work. Another person said he usually treated malaria only with paracetamol.

Everybody made mosquito bites responsible for the outbreak of malaria in a recent survey of the WHO only half the respondents in rural areas knew that mosquitoes transmit malaria [Fact Sheet 94] , but even the ones who knew that only the female mosquito actually bites and sucks blood apart from one biology teacher were not able to tell the difference between a female and a male mosquito. Only few knew about different kinds of mosquitoes and even less could tell them apart.

None of the people met used a bed net against mosquito bites according to one woman, bed nets were only used by village people, because the bed nets were too cheap , but many town people lived in houses with screened doors and mentioned to occasionally spray their rooms, while others used mosquito coils. But some also mentioned that they are sleeping outside during the hot season and they complained mosquitos were disturbing there sleep. On the other hand, people in the village didn't have this kind of protection. According to one woman they fan the room with a rug to chase the mosquitoes out of the room and they use some plant similar to Citronella which they think chases the mosquitoes away. Also, they are normally not able to buy the drugs sold in town and may consult a herbalist for treatment. During my stay, two children both around six months old from to different village families fell seriously sick with malaria.

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Conclusion and Interpretation

Although all people knew that malaria is spread by mosquitoes, most of them were not able to differentiate between mosquito geni or had an idea about the underlaying cause of the sickness. Most confused risk factors from other common infective diseases with malarial risk factors.

It seemed that teaching about malaria in school was either not effective or provided people with partially wrong ideas. However, once bits of information had entered into the knowledge of the population, they seemed to spread through family and other networks.

Another problem was caused by the lack of financial means, which resulted in the use of inferior treatment of malaria. Those who had the means were likely to show a medical drug using pattern which borders on what the local authorities call drug abuse. Others, especially if children were concerned, hesitated far too long, before they seeked medical assistance.

Thus, I conclude that even though some teaching about malaria is done in school, whatever information is provided, seem to be inadequate, especially under consideration of the sparse financial means most people have to cope with. It is also clear, that an improved schooling would not better the situation of those most in need, as these group of people do not have the means to attend school. But there is hope, that a better education of the public on the subject of malaria leads through individual conversation to a better understanding of the population as a whole.

At the end, it should also be mentioned that the information provided on this page is based on conditions in and around the Northern Region's capital Tamale. In a country as diverse as Ghana, conditions in other places and regions may differ by far and would need separate investigation. Thus, the provided information should not be taken as representative for a whole country but rather as an insight into a place within the country.

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Comments, suggestions or corrections, especially from Ghanaians, people from the teaching field or in malaria research to mattgig@freesurf.ch are most welcome.

Matthias Giger, August 1999 (Update: 30.01.2002)