Sustainable integrated malaria management by villagers in collaboration with a transformed classroom using the holistic process: Sanambele, Mali, and Montana State University, U.S.A

Abstract

Pesticides, bed nets, and malaria medications are not affordable to farmers in remote villages in Mali and other material-resource poor countries. When provided without cost, preventatives often do not reach remote villages. If they do, the rationale for their use is not fully understood by villagers. In a single village, authors explore success and failure of top-down or "outside" approaches. The hypothesis tested was: sustainable malaria management can be entirely village-based after interaction and dialogue with a collaborating, transformed, undergraduate or graduate classroom using the holistic process, village homestays, and life cycle storytelling. This integrated approach combined: economic stability for women from a handicraft enterprise; physical larval management; community awareness; outreach to village school and neighboring villages; and a sustainable, village-made larvicide from neem (Azadirachta indica A. Juss.) leaf slurry against malaria (anopheline mosquito) vectors. Storytelling was the medium used to transfer knowledge. Patience, active listening, rapid-response literature searches, cell phone-initiated sampling, and creative thinking were skills practiced by 137 Montana State University (MSU) students in transformed classrooms collaborating with villagers via a specially trained mentor system of 6 Malian scientists and an environmental engineer. The holistic process was initiated in 2005. Economic interventions and home stays in the village began in 2007. Community awareness, physical management of larvae, and storytelling began in 2008. Deaths in Sanambele during 2008 from cerebral malaria (all children 0-5 years) decreased compared to previous years, despite a national cerebral malaria outbreak in Mali. Dry season larval mosquito management began in March 2009. There were no deaths from malaria in 2009 and afterward. Neighbor village outreach began in 2010. Community awareness involved villages' formal and informal educational systems. Villagers used their available resources to manage mosquito larvae sustainably, significantly reduced the incidence of malaria, and began transferring this information to neighboring villages.