All That Is Bitter and Sweet_ A Memoir - Ashley Judd [71]
It costs $6 to manufacture nets, which are sold for the heavily subsidized price of 150 shillings, or less than $2 in the villages. In 2008, this price was reduced to a mere 50 shillings. We deliver the nets to Kenyan health facilities at which we implement community behavior change communication, while selling the nets at these reduced prices, which can increase a sense of prideful ownership and use of nets. (By 2011, a happy confluence of political will and funding would allow PSI and other NGOs to undertake massive campaigns to distribute nets for free.)
Most rural Kenyans know about their clinics and women aim to go to them for ante- and postnatal care, even though it is sometimes a two-day walk to the clinic. Knowing the arduous journey will also yield malaria protection, they are more motivated to make the trip. A pregnant woman is highly susceptible to malaria; it makes her extremely sick and can cause a world of ills to her fetus, such as early termination or low birth weight if she is able to deliver. They constitute the highest risk and most vulnerable group and are a core focus of malaria campaigns.
From what I had observed, it made little sense to confront each condition—AIDS, malaria, unsafe drinking water, malnutrition—as a separate threat to the health and well-being of women and children. This old, siloed approach to health care and development aid was already on its way out. Now PSI Kenya integrates reproductive health, maternal and child health, and HIV prevention communication and services on every level.
One of the behavior change communication challenges in Kenya is teaching women and caregivers the value of mosquito nets and how to use them correctly. And this was what I was going to help demonstrate at a rural clinic.
A large crowd of nearly two hundred was gathered for our outreach event. Women sat on the grass, either pregnant or holding babies, and everyone was very curious and attentive in spite of the equatorial sun at midday. There was the usual pomp and circumstance in the form of repetitive welcomes and some fabulous singing to compensate for the stultifying protocol, then I demonstrated how to use and treat a net. I was given a typical plastic basin and showed how to use the gloves and dissolve the repellent tablet in water and saturate the entire net. Wonderfully, even though the event was fun, new technology means such steps are now obsolete, as pretreated nets are standard. And this was only five years ago!
Afterward, I interacted with my audience and felt confident of our day’s success: None, when they arrived, used nets. Now all would go home with both a net and information about malaria, how it was transmitted, how not to become sick, and treatment seeking behaviors if they were infected. They also said, when asked, that they would reach out to other families with their new empowerment, and last but not least, they said they would stand up to their husbands, who often insisted on sleeping under the family’s sole net alone, even with the knowledge that the mothers and children needed them the most.
To wrap up the demonstration, some wild, boisterous women sang for me again, becoming quite carried away when I joined them and basically creating a mosh pit where they knocked me from hip to hip like a little bouncy toy until I escaped, laughing, into the calm of the van.
I had one more appointment before I departed Nairobi. Before I left home, I had asked Gloria Steinem, a mentor and friend, “Who is the one person I simply must meet on this journey?”—something that has become a tradition on my trips. She has thrilled me every time with her introductions. Her referrals have connected me with heroes who have become friends and with organizations I now support that powerfully supplement my engagement with PSI.
Thus I arranged to meet the two women who ran Equality