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insights health #9

Hitting malaria where it hurts

Buying the best?

To buy or not to buy?

Forgotten people

Seeking treatment for childhood fevers in Tanzania

Mosquito nets challenge tradition in Tanzania

Malaria: the acceptable disease in Tanzania

Kenyan communities fight back against malaria

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Mosquito nets challenge tradition in Tanzania

New bylaws in 2002 legislating against 'misleading traditions' were passed in Kyela, southwest Tanzania. Although the bylaws were said to address malaria control, their formulation was influenced by local traditions.

One tradition concerned women who sleep outside at funerals. A new bylaw states that women are forbidden to sleep outside without a mosquito net. However, no bylaw addresses the common practice of men sleeping under the only net in a household, even though children and pregnant women are most at risk from malaria.

A second bylaw required young men to construct brick houses to stop mosquitoes, rather than building with bamboo or mud plaster. However, even brick houses can't prevent mosquitoes from entering through the roof or windows. It is much cheaper for households to buy mosquito nets for a whole family.

Failure to keep to the new bylaws risked a fine of 10,000 shillings (an average month's income in rural areas) or a sentence of six months in prison.

Clearly these bylaws are about more than just malaria control. Research revealed that:

  • Mosquito bites are traditionally symbolic of a woman's suffering when in mourning.
  • Sleeping under a net at a funeral or a son building a brick house for himself before he builds a home for his father results in punishment by witchcraft.
  • The sexuality of women is thought to be dangerous to others when mourning: discussions about mosquito nets and funerals quickly led to men's concerns that women meet their lovers at night.
  • Keeping a woman under a net at funerals is one of many ways in which men use symbols of 'modernity' to discipline women's behaviour.
  • Political conflict between young and older men leads to an increase in accusations of witchcraft.
  • By encouraging young men to build brick houses, older men are seen to be progressive and not practicing witchcraft.

Findings suggest that the bylaws probably originated from a study on belief and malaria in which local people took part. Policymakers need to be aware that the effects of such studies can extend far beyond their original remit. Research and policy recommendations include:

  • broadening the concept of 'belief' from the extraordinary (funerals and witchcraft) to the everyday (men sleeping under nets instead of women and children, and brick houses protecting against mosquitoes)
  • being aware that medical agendas can be hijacked by local issues
  • recognising that for local people, concerns about the risk of malaria must be understood in the context of competing risks, such as witchcraft and AIDS.

Rebecca Marsland
Department of Anthropology, School of Oriental and African Studies, University of London, Thornhaugh Street, London WC1H 0XG, UK
rm15@soas.ac.uk

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