Stomp 2012 annual report

18 COUNTRIES 3,000 VolunteerS

ANNUAL REPORT | 2012

“THIS IS HOW AID SHOULD BE DONE”

-Michael Gerson, Washington Post STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

1

ABBREVIATIONS ACT BCC CBO CCM CDC CHW DHS FANC FY GHI Global Fund HHS HMIS IEC IPTp IRS ITN JHUCCP LLIN M&E MACEPA MCH MiP MIS MNM MoH MOP NGO NIH NMCP OR PATH PEPFAR PMI PSI RA RBM RDT SP USAID USG WHO

Artemisinin-based combination therapy Behavior Change Communication Community Based Organization Community Case Management Centers for Disease Control Community health worker Demographic health survey Focused antenatal care Fiscal year Global Health Initiative The Global Fund to Fight AIDS, Tuberculosis and Malaria Department of Health and Human Services Health management information systems Information, education and communication Intermittent preventive treatment for pregnant women Indoor residual spraying Insecticide-treated mosquito net Johns Hopkins University Center for Communications Programs Long-lasting insecticide-treated net Monitoring and Evaluation Malaria Control and Evaluation Partnership in Africa Maternal and child health Malaria in pregnancy Malaria indicator survey Malaria No More Ministry of Health Malaria Operation Plan Non-governmental organization National Institutes of Health National Malaria Control Program Operations research Program for Appropriate Technology in Health President’s Emergency Plan for AIDS Relief President’s Malaria Initiative Population Services International Resident Advisor Roll Back Malaria Rapid Diagnostic Test Sulfadoxine-pyrimethamine United States Agency for International Development United States Government World Health Organization

5

ACKNOWLEDGEMENTS

6

BACKGROUND

8

GOALS

9

INNOVATION

10 12 14

16

EFFICIENT USE OF RESOURCES

17

RESULTS

19

NEXT STEPS

20

COUNTRY PROFILES

21 23 24 25 27 28 30 31 32 33 35 36 37 38

PARTNERSHIPS TRAINING COMMUNICATION

BURKINA FASO CAMEROON ETHIOPIA GHANA GUINEA MADAGASCAR MALAWI MALI MOZAMBIQUE SENEGAL THE GAMBIA TOGO UGANDA ZAMBIA

FIGHTING MALARIA IN EVERY VOLUNTEER COMMUNITY REDUCING MALARIA DEATHS IN TARGET COUNTRIES BUILDING AN ONLINE COMMUNITY OF PROFESSIONALS To: Peace Corps Senior Leadership From: Chris Hedrick, Peace Corps Senegal Country Director and

Coordinator, Stomping Out Malaria in Africa initiative

Thank you for the opportunity to provide you with the first annual report on progress made by Peace Corps’ Stomping Out Malaria in Africa initiative (Stomp).

Over the past year, this effort has grown from a concept paper, to a public launch, to field training and programs making a difference in malaria prevention in 18 countries across Africa. Nearly 1400 Peace Corps Volunteers have been engaged with partners in malaria prevention activities as a result of Stomp. Peace Corps is growing into an important part of the vast international effort to continue to reduce the number of people, especially children, who die from this disease.

Much progress has been made, but much work remains.

This report details our approach to bring innovative partnership, training, and communication tools to the field, quickly building a large cadre of Volunteers and staff committed and equipped to making an important difference at a very low financial cost to Peace Corps. We are managing and growing Stomp with the initiative’s core values always in mind: knowledge, collaboration, experimentation, documentation, sharing and scrappiness. Looking forward, we aim to accomplish even more with an abiding sense of urgency.

We deeply appreciate the support of Peace Corps leadership in enabling this initiative to begin and to grow. We hope that this summary of our past year’s achievements will provide you with the information you need to continue to help Stomp grow its impact across Africa.

STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

5

BACKGROUND

Malaria, an infection caused by the plasmodium parasite, has been a critical public

health challenge for thousands of years. From the first recorded sighting in China in 2,700 BC, its signature high cyclical fever and anemia have gone on to kill hundreds of millions of people and the total number of infections is in the billions. In the year 2005 alone, World Health Organization estimates indicated that malaria infected between 350 and 500 million people and killed over 1 million, 90% of whom lived in sub-Saharan Africa. Most of those were children.

Malaria

Peace Corps

Since 2005, a massive international malaria control effort has begun to make significant progress. In 2010, WHO estimated that the number of malaria deaths annually had dropped to 655,000, with the majority of the decrease attributable to increased availability and usage of long lasting insecticide-treaded nets (LLINs).

With the LLIN coverage across the continent reaching high levels, however, the potential for additional gains through net distributions diminishes. The international malaria prevention community, while maintaining high levels of net coverage, has increasingly turned its focus to training community health workers to diagnose and treat malaria in the home. As an organization supporting grassroots development, Peace Corps Volunteers work closely with CHWs across Africa.

The Peace Corps traces its roots and mission to 1960, when then-Sen. John F. Kennedy challenged students at the University of Michigan to serve their country in the cause of peace by living and working in developing countries. From that inspiration grew a federal government agency devoted to world peace and friendship.

Throughout its history, the Peace Corps has adapted and responded to the issues of the times. In an ever-changing world, Peace Corps Volunteers have met new challenges with innovation, creativity, determination, and compassion. Malaria has been part of the Peace Corps experience from the beginning. In a 1961 memo to President Kennedy, Sargent Shriver, who spearheaded the creation of the Peace Corps and became its first director, outlined the three programmatic areas Peace Corps would address: education, food security, and malaria.

6

Since Sargent Shriver’s first malaria-focused Volunteers began their services in 1961, 200,000+ Americans have served in the Peace Corps, working in 139 countries in diverse sectors including agriculture, health education, small enterprise development, and conservation.

STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

On May 5th, 2009, President Barack Obama announce the creation of the Global Health Initiative (GHI), an effort to coordinate the activities of all US governmental organizations engaged in health related foreign assistance. Since that time, Peace Corps has been working to deepen its integration with partners at the President’s Malaria Initiative (PMI) and its constituent agencies: the National Institutes for Health (NIH), the Centers for Disease Control (CDC), and the United States Agency for International Development (USAID).

On April 25, 2011 Peace Corps launched its Stomping Out Malaria in Africa initiative at a World Malaria Day event at Peace Corps Headquarters in Washington DC. Peace Corps Director Aaron Williams along with USAID Administrator Rajiv Shah and PMI Coordinator Admiral Timothy Ziemer advanced a grand vision for a unique collaboration between Peace Corps Volunteers in the field, US Government malaria prevention professionals at partner agencies, partner NGOs and host country institutions across Africa.

Genesis of Stomping Out Malaria in Africa

World Malaria Day 2011

Peace Corps would train a cadre of highly specialized malaria prevention Volunteers - the Malaria Team - and embed those Volunteers in every malaria-focused organization in Africa with an urgent need for human resources. PMI would provide expert trainers, professional and technical mentoring of Malaria Team members and support in liaising with host country institutions and NGOs. Malaria Team Volunteers would make the organizations they worked in more effective and coordinate between those organizations and the field network of over 3,000 Volunteers in subSaharan Africa to bring the full focused effort of the Peace Corps Volunteer network to bear on the issue of malaria prevention.

Embedding Volunteers in partner organizations would create a significant increase in inter-organizational communication bandwidth. This increase in communication would lead to increased synergies among USG agencies and organizations funded

by USG funds in line with the vision of the GHI. A year later that vision is becoming a reality.

STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

7

VISION

GOALS

Stomping Out Malaria in Africa was built on the vision that through strategic partnerships, targeted training and mobilization of Volunteers, intelligent use of information technology, and radically efficient use of seed funding, Peace Corps will focus the efforts of over 3,000 Volunteers in sub-Saharan Africa to make an immediate and measurable impact in the fight against malaria.

FIGHTING MALARIA IN OUR COMMUNITIES

Peace Corps will work to ensure every malaria-impacted Peace Corps Volunteer community (village or urban neighborhood) has universal bed net coverage and comprehensive malaria prevention and treatment education programs.

PARTNERING TO DEFEAT MALARIA IN OUR COUNTRIES

Peace Corps will work with partners in all malaria impacted Peace Corps countries to achieve the internationally agreed upon milestone of near zero deaths caused by malaria by 2015.

BUILDING A MALARIA PREVENTION COMMUNITY INTERNATIONALLY Peace Corps will work with partners to catalyze a community of practice for front line malaria prevention professionals, using the Internet to facilitate documentation and sharing of malaria prevention best practices internationally.

CORE VALUES

KNOWLEDGE

Being a valued partner in malaria prevention requires a high standard of professional malaria knowledge and a commitment to staying current with new advances and best practices in the field. Volunteers will support monitoring and evaluation efforts.

COLLABORATION

Volunteers function within an ecosystem of partner malaria prevention professionals.

They work closely with those partners to avoid duplication of services and find synergies.

EXPERIMENTATION

Recognizing the crucial importance of innovation and demonstrated success, Volunteers will pilot interventions in their communities and work with partners to take successful experiments on the local level to scale nationally and internationally.

DOCUMENTATION

Long-term success in malaria prevention requires careful attention to lessons learned and best practices. To that end, Volunteers will extensively document their projects.

SHARING

Sharing documents, experiences, and lessons learned ensures that promising practices piloted by Volunteers and partner organizations can be widely replicated.

Special emphasis is placed on the concrete work of ensuring that documents are both discoverable and accessible to malaria prevention professionals around the world.

SCRAPPINESS 8

As stewards of taxpayer dollars, we will be ruthlessly efficient and do more with less.

STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

INNOVATIONS INNOVATION IS AT THE HEART OF STOMPING OUT MALARIA IN AFRICA

Malaria is a devious disease. It repeatedly frustrates the world’s best efforts to defeat it, developing resistance to every drug thrown against it and even crossing into humans from monkey hosts. Part of this resiliency is a result of its ability to evolve rapidly – it is a flexible, nimble disease.

To combat such a disease requires a team effort. It requires massive human resources trained to truly understand the context. It requires an intimate knowledge of the tools at hand. Most of all, it requires the outside the box thinking necessary to stay one step ahead of a wily foe.

Stomp leverages three key creative strategies:

INNOVATIVE PARTNERSHIPS

Instead of “partnership by occasional meeting,” STOMP assigns Volunteers directly to key

partners, exponentially increasing the quantity and quality of institutional partnerships.

INNOVATIVE TRAINING

Recognizing that no one organization is the sole repository of malaria knowledge, STOMP

works with a group of over 35 outside experts to design and deliver training for Volunteers. We

leverage Skype and other Internet tools to dramatically expand access to experts and reduce

training costs.

INNOVATIVE COMMUNICATION

Stomp leverages advances in real time communication, made possible by low and no-cost

Internet services to enable Volunteers across Africa to share best practices, develop strategic

plans, and build enthusiasm for the monumental group effort necessary to eliminate malaria.

STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

9

TRAINING

PARTNERSHIPS

COMMUNICATIONS

PARTNERSHIPS Building Institutional Relationships

Valuable

Volunteers in Senegal work with the MACEPA project, a PATH initiative to develop a malaria rapid response program to begin to eliminate the disease.

Based on an open source java platform, the program trains community health workers to identify malaria outbreaks and inform rapid response teams using SMS.

Working closely with the Centers for Disease Control, Volunteers working with their host country counterparts in Zambia are conducting a first of its kind 36 month study of the field longevity of long-lasting insecticide treated bed nets (LLINs) distributed in 2011.

Data is being collected on the number of holes, tears, and repairs of LLINs, and results of the survey will inform Zambia’s National Malaria Control Center’s LLIN replacement strategy.

Building institutional relationships with partners is key to the success of Stomping Out Malaria in Africa. Many organizations want to be better partners with their peers but struggle with the logistics of opening and maintaining clear lines of communication and processes of coordination. Based on an internal review of the efficacy of various Peace Corps partnerships, Stomp identified that those partnerships which involved the embedding or seconding of a Volunteer directly to a partner organization experienced an exceptional success rate. Embedded Volunteers dramatically increased the bandwidth between the organizations and simplified the process of coordination and joint strategic planning.

Based on this insight, Stomp has followed an innovative strategy of identifying key malaria prevention organizations at all posts and assigning Volunteers to those organizations with a dual mandate. Assigned Volunteers support the work of the organization directly and are also tasked with ensuring that all of the Volunteers in country are aware of the organization’s activities and synergize their malaria prevention activities with those of the partner. Over the past year, 30 malaria prevention organizations across Africa have benefited from the direct support of a Peace Corps Volunteer.

NATIONAL MALARIA CONTROL PROGRAMS The prime partners for all malaria work, including that of Stomping Out Malaria in Africa, are the National Malaria Control Programs in the countries where we work.

Over the course of the last year, Peace Corps programs in all Stomp countries have strengthened or begun relationships with their NMCPs. In The Gambia, this has resulted in a Volunteer being seconded directly to the NMCP to support their IT and program management needs. In Kenya, Volunteers have been assigned as counterparts to the NMCP’s District Malaria Control Officers in key high prevalence districts.

PRESIDENT’S MALARIA INITIATIVE The President’s Malaria Initiative is the largest institutional partner of Stomp, with 14 Stomp countries hosting PMI programming. Since the inception of Stomp, PMI has supported the program by offering their expert staff to Boot Camp trainings that have trained over 50 PCVs and 12 Peace Corps staff members. Those trainees in turn have trained hundreds of Volunteers throughout Africa in a cascade training model – (see Country by Country p. x – x).

10 STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

This map shows the 18 current Stomping Out Malaria in Africa programs. Programs in countries where Peace Corps is partnering with PMI are marked in red, and programs in countries without PMI colored orange.

Stomping Out Malaria In Africa partners with PMI in every country in Africa that Peace Corps and PMI overlap: Senegal, Mali, Guinea, Ghana, Benin, Ethiopia, Uganda, Kenya, Rwanda, Tanzania, Zambia, Malawi, Mozambique, Madagascar The majority of all Malaria Team Volunteers in Africa are assigned to PMI implementing partners including PSI, JHUCCP, CARE and others. PMI Resident Advisors in each country act as supervisors and mentors for incoming Volunteers, guiding their service and helping to ensure that Peace Corps efforts coordinate and synergize with the efforts of all other US Governmental organizations.

The 14 PMI overlap countries have cumulatively allocated $368,000 in their FY ’12 budgets for collaborations with the Peace Corps Stomping Out Malaria in Africa initiative.

MALARIA NO MORE Malaria No More is an organization dedicated to eliminating malaria in Africa by 2015. Their projects include the innovative Net Guarantee program for LLIN procurement, Nightwatch, a public awareness radio and television campaign, and Speak Up Africa, a project aimed at highlighting local African malaria prevention champions. Malaria No More staff have provided expert trainers for all Malaria Boot Camp trainings and Volunteers in Senegal and Cameroon are assigned directly to MNM. Additionally, curriculum for primary school malaria education developed by MNM is being rolled out for use by Volunteers across the continent.

JOHNS HOPKINS UNIVERSITY Center for Communications Programs (JHUCCP) JHUCCP’s NetWorks program in Senegal was one of the earliest institutional partners of Stomp. Volunteers in Senegal have worked with NetWorks on nationwide universal coverage campaigns and routine distribution logistics. Networks staff have been instrumental in training Volunteers at the Boot Camps.

UNIVERSITIES Using Skype as a delivery mechanism, Stomp has been able to engage partners at prestigious university research centers as trainers at the Boot Camps (see training p.x). Dr. Dennis Kyle at the University of South Florida and Dr. David Sullivan at Johns Hopkins University have been instrumental in ensuring the high standard of knowledge that all Stomp Volunteers bring to their assignments.

INSTITUTIONAL PARTNERSHIPS Major partners and organizations to whom Volunteers are assigned: NMCPs, PMI, USAID, CDC, PSI, Malaria No More, World Vision, JHUCCP, NetWorks (Senegal), ProMPT (Ghana), Ghana Behavior Change Support, COMMIT (Tanzania), RTI, ABT Associates, Care, MACEPA

Malaria No More is partnering with Peace Corps Cameroon to measure the effectiveness of its media outreach platforms. Using SMS, OpenStreetMaps and the Ushahidi platform, Volunteers will map malaria prevention messages across the country and study their relationship to disease incidence data.

JHUCCP’s ProMPT program partnered with Peace Corps Ghana on a unique bed net distribution targeting transient street dwelling populations, a difficult to reach and often overlooked group. (See Spotlight: Ghana on page 5).

STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

11

TRAINING PARTNERSHIPS

COMMUNICATIONS

TRAINING MALARIA BOOT CAMP

Valuable

Well-trained Volunteers are the key to Stomp, knowledgeable trainers are the prerequisite for great trainings, and having the best and brightest attend trainings together enhances learning. So Stomp created the Malaria Boot Camp program, a 10 day intensive training held in Thies, Senegal with over 30 expert trainers from partner organizations. Over the course of 3 Boot Camp trainings, Stomp has trained 51 Volunteers, 12 staff members and 1 member of the National Malaria Control Program staff member. Together they represent a Peace Corps Malaria Team currently covering 18 countries.

THE BEST TRAINERS

Expert trainers make the difference between trainees hearing the information and truly understanding the content – in a way that allows them to apply it to their work.

And no one person could ever be an expert in all aspects of malaria prevention.

Stomp works with partner organizations to engage expert trainers in all aspects of malaria prevention. University partners like the University of South Florida, Johns Hopkins University, and institutions such as the Centers for Disease Control and USAID lay the foundation of malaria science knowledge from which all malariaprevention activities build – covering topics including plasmodium and anopheles life cycles, diagnosis, treatment, etc.

Partner experts from organizations such as Malaria No More, JHUCCP, PMI, and others cover key operational aspects, such as the logistics of net distribution, Indoor Residual Spraying, developing public communications platforms, and advocacy, etc.

Local partners provide training in cultural implications of malaria prevention, working with illiterate populations, and working within governmental health systems.

And Peace Corps trainers explore what it means to be a member of the Peace Corps Malaria Team, the Peace Corps niche in development, how to add value to a partner organization, and how to leverage the network of over 3,000 Volunteers in the field in sub-Saharan Africa.

SKYPE 12

Bringing partner experts to Thies is prohibitively expensive, but Skype is a transformative technology. With an investment of less than $2000 in computer equipment, Stomp was able to create a distance-learning center in Thies, Senegal.

STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

Experts ranging from the Malaria Vaccine Initiative at PATH in Seattle to CDC experts in malaria and HIV co-infection based in Tanzania are all able to offer trainees their unique knowledge.

Additionally, multi-party Skype allows for generational knowledge sharing within the Malaria Team. Volunteers from past Boot Camps and partners at their assigned organizations join in panel discussions with new Malaria Team members, discussing the challenges and strategies for new Volunteers entering the organizational culture of a partner organization.

Distance learning sessions over Skype are balanced with hands on and field sessions.

Malaria No More facilitates trainee visits to the community-led malaria prevention program at Thienaba Seck, an international model for grassroots malaria prevention and the catalyst for the Speak Up Africa program.

Through partnerships with the Senegalese National Malaria Control Program, trainees visit all levels of the health infrastructure from regional level hospitals, to clinics, to health huts and explore how the different levels function together to provide malaria prevention and treatment services.

HANDS ON FIELD VISITS

Since stock-outs are an important issue in malaria prevention, trainees visit regional and local pharmacies and learn skills in analyzing supply chain systems.

When Volunteers complete their Boot Camp training and return to their posts, PMI Resident Advisors provide an in-depth orientation to malaria prevention in their country, allowing Malaria Team members to contextualize the information they received at Boot Camp and strategize how to apply it to their country.

Malaria Team members return to their posts to partner with local staff to train the rest of their community. To support them in these trainings, Stomp has developed an Introduction to Malaria Prevention curriculum in collaboration with Peace Corps’ new Focus In Train Up program. These standardized lesson plans help Malaria Team Volunteers provide the best possible training for all Volunteers.

KNOW YOUR COUNTRY

STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

13

COMMUNICATION

NO.01 BUSINESS S TORY

SPECIAL PAGE

KNOWLEDGE SHARING

On-going sharing of knowledge and best practices across 18 African countries

FACEBOOK GROUPS

Learning doesn’t end when you walk out the schoolroom door and it doesn’t end when Malaria Team Volunteers return to their countries. Ongoing knowledge sharing ensures that Malaria Team members have the most up to date information about key issues and knits these Volunteers into one team, with a shared purpose and vision.

Innovative ideas no longer need to spend the months or years that they used to take traveling from the field to HQ and out to other Volunteers in the field. As Thomas Freidman says, “The world is flat.”

Volunteers want to share their operational knowledge with their peers. Almost 100% of Volunteers and a growing number of staff already use Facebook. These two insights led Stomp to leverage Facebook Groups as a tool for communication and best practice sharing, both within the Malaria Team and with key partners.

Volunteers, staff, and key partners have access to the Malaria Team Facebook Group, a bulletin board for asking questions, sharing the latest events, and receiving encouragement and insight from their peers.

GOOGLE DOCS

While Facebook is a fantastic platform for instant feedback from a large peer group, many resources are too large to fit in an FB post, and finding information and documents can be difficult. However, 95% of all Volunteers use Google’s Gmail as their email provider and thus have access to Google Docs, an online file repository.

Stomp has developed an online resource library in Google Docs available to all Malaria Team Volunteers. There, Volunteers can access lesson plans, case studies, and other media resources for malaria prevention. It is entirely searchable using standard Google Search and Malaria Team Volunteers can access it through their existing Gmail logins.

Country-specific portions of the Google Docs library are made available to all Volunteers from that country.

14 STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

Stomp maintains a public facing website at www.stompoutmalaria.org that highlights Volunteers, their counterparts, and their unique malaria interventions. Built on a Free Open Source Software (FOSS) content management system, the site offers Volunteers with virtually no experience in website building simple tools to create, edit, and publish their projects in real time.

STOMP.ORG

Volunteers without regular Internet access publish updates from their cell phones in a system that integrates live Twitter feeds on to each country profile page.

Volunteers with Facebook accounts are able to log in with their existing credentials and post content to the website and their Facebook profiles simultaneously.

A live chat bar makes it possible for Volunteers and site visitors alike to communicate directly with the Stomp partnership coordinator, a 3rd year Volunteer located in Dakar.

Designed to function seamlessly whether viewed on a computer, tablet, or smart phone, the site brings the professional lives of Volunteers and their counterparts to their families as well as malaria prevention specialists around the world.

STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

15

EFFICIENT USE OF RESOURCES The successes of the initiative have been achieved with extremely efficient use of funds by focusing on three key strategies: partner resources, leveraging crowdsourcing and using existing low cost and free platforms.

PARTNER RESOURCES Partners contribute more than 70% of all training for Stomp free of charge. At standard consultant rates, this represents more than $75,000 annually. Partners also contribute substantial material to Volunteers in the form of lesson plans, visual aids, and media that can be used in Volunteer projects.

Partner organizations that are assigned Volunteers support the housing and work related expenses of those Volunteers – notably PMI has allocated $368,000 to these expenses as well as small grants programs and support for in-country trainings.

CROWDSOURCE RESOURCES Training materials development and visual aid development are time consuming and expensive. By distributing the work between many Volunteers across Africa, Stomp develops materials faster and strengthens the Malaria Team at the same time, increasing the effectiveness and motivation of the Volunteers and staff involved.

The stompoutmalaria.org website is a prime example of this, with content provided and actively updated by over 20 Volunteers and staff members.

The February 2012 Boot Camp was the most cost effective Boot Camp to date, with an operating cost of $30.61 per attendee/day, down from $43 per attendee/day in the June 2011 Boot Camp and significantly less than the $127 per attendee/day of comparable multipost trainings.

16

FREE AND LOW-COST PLATFORMS Tools like Facebook and Google Docs are radically changing the economics of knowledge sharing and group work. Relying on these tools obviates the need for expensive IT management resources and makes resources more accessible to Volunteers who are habituated to their use.

Skype allows free video conferencing calling between multiple posts at a level of sophistication that was impossible at any price merely 5 years ago. The ubiquity of Skype is what allows the distributed trainer model that the Boot Camp is built on: since everyone has and uses Skype, it is not necessary to provide potential trainers with specialized equipment.

FISCAL YEAR 2012 BUDGET

Travel

Staff

Boot Camp Operations

Technology

Other

Subtotal by Funding Source

Region Funds PEPFAR funds $59,194

$77,557 $55,750

$- $12,960

$15,840 $2,000

$- $1,000

$- $130,904

$93,397

TOTAL $224,301*

* Budget differs from initial proposal. Additional planned and budget activities have been moved to FY 13 for logistical reasons STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

RESULTS

Over its first year, Stomping Out Malaria in Africa has laid the foundation for significant Peace Corps malaria prevention efforts over the next 5 years. A training model has been developed and refined, key partnerships have been formed or strengthened, initial activities have begun in the field, and a communications network has been put in place to share lessons learned from those activities.

TRAIN UP AND TEAM BUILD-OUT In its first year of operations, Stomping Out Malaria in Africa built out a Malaria Team across 18 of Peace Corps’ 25 African posts. A total of 51 Volunteers and 12 staff members each received over 85 training hours in malaria prevention during 3 Boot Camps.

Returning to their posts, Malaria Team members worked with colleagues to provide over 30 trainings, reaching 1,398 Volunteers.

INITIAL PARTNERSHIPS In Stomping Out Malaria in Africa’s first year of operations, Peace Corps developed or strengthened institutional relationships with 33 malaria prevention partner organizations and 18 National Malaria Control Programs.

A formal Memorandum of Understanding was developed with Malaria No More that provided Volunteers in Cameroon and Senegal the opportunity to work directly with the ground-breaking organization and provided Volunteers across Africa with access to their high quality lesson plans and media resources.

STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

17

Working with PMI, Stomp was able to place 16 Volunteers with PMI implementing partners. Additionally, through the MoP process, PMI allocated $368,000 to support Volunteer training, small projects, and living expenses of Volunteers assigned to implementing partners.

INITIAL FIELD ACTIVITIES Over 555 Volunteers have engaged in malaria prevention activities, ranging from mosquito repellent neem cream demonstrations and trainings of community health workers, and media outreach campaigns.

Volunteers have gained valuable skills supporting nationwide LLIN distributions in 7 countries. Additionally, Peace Corps Volunteers have been the driving force behind 4 regional distributions totaling 7,960 nets, including a first of its kind distribution targeting socioeconomically disenfranchised migrant workers in Ghana (see page x).

COMMUNICATIONS NETWORK BUILD-OUT Since the launch of Stomp’s web site there have been over 1,000 unique visitors and the pace of use is accelerating with over 35 new users per day and peak use of more than 100 users per day.

The Google Docs resource library has grown to over 2,700 documents including lesson plans, visual aids, and case studies.

18 STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

NEXT STEPS Moving into its second year Stomp has laid out these mid-term, strategic goals: Training is the key to the success of Stomping Out Malaria in Africa, both for Malaria Team members and generalist Volunteers. The Boot Camp program will be expanded and the number of in-country trainings increased with an emphasis on cross sector training for Volunteers outside of the health sector. As the number of trained Volunteers increases and new partnerships come online, Volunteers will be expected to increase the number and scope of field activities. LLIN distribution will be a key focus area, ensuring that every Volunteer community has universal coverage and accompanying education campaigns.

FIGHTING MALARIA IN OUR COMMUNITIES

Objectives: • By the end of Fiscal 2013, every Peace Corps post in Africa will have Malaria Volunteers and all volunteers will be active in malaria prevention – an increase from 555 field activities this year to over 3000 activities per year in FY ‘13 • 75 Malaria Volunteers will be trained annually at Malaria Boot Camps and 100% of all Volunteers in Africa will receive malaria prevention training • Volunteers will partner with local health officials and other partners to ensure universal LLIN coverage in 80% of Volunteer communities.

• 80% of Volunteer communities will receive malaria prevention education.

Stomp will strengthen existing partnerships and look to expand its partner network. PARTNERING TO The strategic focus will be on institutionalizing and formalizing existing informal DEFEAT MALARIA partnerships.

IN OUR COUNTRIES

Objectives: • By the end of Fiscal 2013, Peace Corps will develop and sign MOUs with 3 additional partner organizations. Likely target organizations include: JHUCCP to continue to enhance our Volunteer and staff training and Against Malaria to enable Volunteers to expand participation in bed net distributions, particularly where PMI does not have a presence.

• Add 4 additional University partners will be engaged through the Masters International. The University of Pittsburg and USF have both expressed an interest in increasing the number of MI students they send to Peace Corps to do malaria prevention work.

Stomp will increase the amount of content available on stompoutmalaria.org and increase integration with outside partners. The Google Docs repository will be made available to all Volunteers in Africa, and the amount of volunteer generated content will increase. Stomp will increase its engagement with Malaria No More’s Speak Up Africa platform to increase malaria advocacy.

BUILDING A MALARIA PREVENTION COMMUNITY INTERNATIONALLY

Objectives • By the end of Fiscal 2013 the number of volunteer generated documents in the resource library will grow from 2,500 to over 7,500 • All volunteers will use the resource library and every Peace Corps post will provide localized content.

• Volunteers will provide over 100 testimonials to Speak Up Africa STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

19

COUNTRY PROFILES

20 STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

BURKINA FASO Burkina Faso, through their innovative High Five program, has been able to integrate malaria prevention into the work of all of their 173 Volunteers this year. The High Five is a set of activity areas including Malaria, HIV/AIDS, Hygiene, Tree Planting, and Gender/youth development that every Volunteer in country, regardless of sector, must complete as part of their project plan. High-five activities are part of the Volunteer Reporting Tool and all Volunteers reported some level of malaria prevention work in their VRFs. There are a wide range of malaria activities carried out by Volunteers, but the most common are mosquito repellant neem cream demonstrations and bed-net usage campaigns. Health Volunteers are particularly active and focused on reinforcing and building the capacity of local health workers to promote malaria prevention and treatment.

Facilitating the High Five activities was Burkina Faso’s Malaria Team: 1 Peace Corps Response Volunteer, a third year PCVL, and APCD Dr. Claude Millogo all of whom attended the Malaria Boot Camp. Together they have provided malaria training to all 173 Volunteers in country, as well as 25 counterparts in partnership with Jhpeigo. The Malaria Team is currently collaborating with Jhpeigo on a series of three-day cascade training of trainers for local community health workers that will train 60 CHWs who will each be expected to train over 20 individuals, resulting in a Dr. Claude Millogo discusses malaria client reach of over 1200 people. prevention with Soxna Niang at the Malaria Boot Camp

In addition to their partnership with Jhpeigo, Peace Corps Burkina Faso has partnered with Red Cross Burkina Faso on 2 bed net distributions in conjunction with Camp Glow, in Boromo and Kaya. Over 160 nets were distributed for 320 students along with comprehensive malaria prevention education. As there have been no national bed net campaigns in Burkina since 2010, Volunteers have focused the majority of their efforts on net maintenance and repair, educating members of all 173 Peace Corps communities on the importance of keeping LLINs in good condition.

LOOKING TO THE FUTURE During the next year, PC Burkina will be working along with partners Jhpiego, Deliver, and the NMCP to promote bed-net usage and maintenance and correct use of rapid diagnostic tests for better disease detection and data collection. Activities will include community awareness campaigns on net usage, how to hang nets, how and when to wash nets, and how to repair torn nets. Additionally, after nearly a year long stock-out, RDTs have finally arrived in country and were distributed to all districts in late March 2012. PCVs will work with health center staff to make sure RDTs are appropriately used and good data is kept reporting on confirmed malaria cases. Care-seeking behavior will be another important message in making sure people go to the health centers where RDTs and treatments are available.

The Malaria Team will also work to develop a manual of sector specific “activities-in-a-box” to help all Volunteers easily undertake malaria activities as part of the High Five program. They will also increase the number of resources available online through the pcburkina.org website and an internal Sharepoint™ database.

21 STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

BURKINA FASO

Wall of Photos “Last August my counterparts at the CSPS and I set out on a plan of action to address the problem of the dramatically heightened incidence of malaria in the months of September through December. In order to better educate the community on malaria and increase prevention activities, we created a collective “Mosquito Net Wall of Photos” at the CSPS. Any community members who consistently slept under their mosquito nets were eligible for their photo to be taken with their bed net and to be added to the wall of photos. Participants were then invited to come take home their photo in January, after they were displayed for three months.

The ultimate goal of reducing the number of cases in the community by 25 percent this rainy season was a tougher goal to reach, but we believe that by the end of the year we began to see some of the impact of our work reflected in the numbers. In September, when the project was just getting started, the number of cases of malaria was slightly higher than the previous year, but by October (and through December) the number of cases started to drop. The actual cause of this drop is difficult to prove, but the timing of the decrease in malaria cases with women's groups trainings, community mobilization, and overall awareness of malaria through the "wall of photos" suggests a hopeful correlation. The community experienced 817 cases of malaria cases from September to December 2010, and experienced 664 cases of malaria during the same period of time in 2011.This is approximately a 19 percent decrease.

-Bridget Roby PCV Burkina Faso

22 STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

CAMEROON Peace Corps Cameroon has 3 Malaria Team members, including 1 staff member and 2 Volunteers, and institutional relationships with PSI, Malaria No More, and the National Malaria Control Program. The Malaria Team has trained 47 Volunteers and counterparts at an In-Service-Training in March of 2012.

Health Volunteers in Cameroon are attached to the health system at the clinic level and Volunteers’ work in malaria prevention has focused on student health clubs and training community health workers, so far reaching a total of 622 individuals. Volunteers created a program for teaching primary and secondary school teachers how to incorporate malaria prevention themes into their lesson planning reaching 335 students.

A total of 9 Volunteers worked on malaria prevention activities through community mobilizations and health talks mostly with women at the health centers, during vaccination campaigns, prenatal consultations, and antenatal clinics. During national LLIN distribution campaigns, Volunteers trained community health workers on correct net usage and maintenance.

LOOKING TO THE FUTURE In the upcoming year Peace Corps Cameroon Volunteers will support a secondary mosquito net distribution of 215,000 LLINs with partners MILDA and UNICEF. Peace Corps Cameroon will be pursuing a strong focus on the use of IT in malaria prevention with multiple partners. With Malaria No More the Malaria Team is launching a pilot project using Ushadi for mapping malaria posters and billboards to measure the effectiveness of media outreach. They will also be working to crowdsource maps of malaria incidence.

The Malaria Team will be working with PSI/ACMS to implement a Medic Mobile based cell phone data collection system to collect indicators on a community case management (CCM) of malaria project. The SMS project is named "voglo" after the Beti word for listen as the project is designed to better listen to what is happening in the field. The goal of the voglo project is to improve the CCM monitoring system and field management through the use of mobile phones. Over 250 people in four regions of Cameroon have already been trained in the use of this mobile technology and the system will be scaled up over the coming year.

Ushadi With dozens of development organizations putting out a bewildering array of messages, it’s difficult to know which messages are where, and which messages are making an impact. Peace Corps Response Volunteer Jesse Cassanova is working with Malaria No More to find out using Ushahidi, a crowd-sourcing platform developed in Tanzania. Ushahidi allows every day people to text in (crowd-source) their knowledge of existing malaria prevention messages whether they’re billboards, posters or radio PSAs.

23 STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

ETHIOPIA Ethiopia began work on the Stomping Out Malaria in Africa initiative in February of 2012 after sending PCV Dan Allen and PTA Abdi Ahmed to the Boot Camp in Senegal to become members of the Malaria Team. On returning to post the Malaria Team worked with PMI partners to provide training to Volunteers at regional in-service trainings. To date 23 Volunteers and 44 counterparts have been trained on use and maintenance of LLINs, IRS, and field case management.

Working with C-Change, a malaria awareness/education NGO partially funded by PMI, Volunteers in Ethiopia have become active in an LLIN hang-up and keep-up campaign, educating community health workers and their communities. Proper net usage, rather than ownership, is a major problem in Ethiopia that PCVs and CChange can help address.

LOOKING TO THE FUTURE Peace Corps Ethiopia recently sponsoring a World Malaria Day to kick off their first full year of Stomping Out Malaria in Africa. Volunteers across the country marched with their counterparts to raise awareness about the importance of malaria prevention and raise the visibility of Peace Corps malaria efforts. In the coming year Peace Corps will work closely with C-Change to refine the training model for community health workers Peace Corps Ethiopia is also developing institutional relationships with additional partners and planning Volunteer training events for June and October.

A Peace Corps Ethiopia Volunteer teaches her family the importance of LLINS

24 STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

GHANA Peace Corps Ghana sent 3 Volunteers to the first Boot Camp in June of 2011, assigning them to key partners at ProMPT Ghana, ITFC/OMOA, and JHUCCP’s BCS Project. Through these connections, Peace Corps Ghana Health Volunteers have been active in 5 LLIN distributions including a Ghanian first attempt to reach the Kayayei people, a disadvantaged community of migrant workers. ProMPT Ghana provided 4,300 LLINs which were distributed by Volunteers to Kayayei in Kumasi following a Peace Corps-led census and registration campaign.

The Malaria Team along with representatives from PMI has conducted 4 trainings for Peace Corps Ghana Water and Sanitation and Health Volunteers. The PMI Resident Advisor also facilitated an in depth malaria training for Volunteers working on the Anemia and Parasitemia Study (see highlight page 26). In addition to LLIN distributions and research activities, Volunteers have been active in neem cream extension and education activities focused on correct LLIN hanging and usage.

LOOKING TO THE FUTURE Moving into the second year of Stomping Out Malaria in Africa, Peace Corps Ghana will increase the support for field Volunteers through their SWAT Team (a committee of regional Volunteers charged with supporting malaria prevention work of their peer Volunteers). Strategic emphasis will be placed on involving nonhealth sector Volunteers in malaria prevention.

Work will continue with the CDC/PMI/University of Ghana on the Anemia & Parasitemia Study, Phases 5 & 6 (in Oct-Nov 2012 and Apri-May 2013).

Though national LLIN distributions were largely completed in 2011, there remains a “catch-up” universal coverage campaign in Northern, Upper West and Upper East Regions and Volunteers in those regions have already been selected for participation.

Going Where the Need is Great . a stifling hot March evening in Kumasi, Ghana’s second “On largest city, I joined Peace Corps Volunteers David Kalpakchian and Hannah Braun to hand out and hang up insecticidetreated nets (ITN). We know that insecticide-treated nets are a highly effective way to protect people from malaria infection. Because of this, Ghana is working to achieve “universal” coverage, meaning one ITN is available for every two people. This effort is important to the kayayei and other groups whose socioeconomic and transient status make them much less likely to have access to ITNs. Distributing nets with David and Hannah, who live and serve with local populations, reminded me that America is a force for good in the world. From the Peace Corps and faith and community-based groups, to the men and women in our military and USAID and CDC staff, Americans are finding local solutions to complex problems, and improving millions of lives in the process. “

- Rear Adm. (RET) Tim Ziemer, U.S. Global Malaria Coordinator

25 STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

GHANA A Peace Corps Research Agenda “Working with the CDC Resident Malaria Advisor, Peace Corps Ghana Volunteers supervised the data collection process in the field for research into the efficacy of Indoor Residual Spraying in the Burkpurugu-Yunyoo District.

Approximately 2,000 children in 72 communities were tested during each phase of the study and properly treated if found to be positive for malaria with a history of fever.

“With a program of that magnitude, there was obviously a lot of paperwork and PCVs really filled a role in that, giving the project heads up-to-date analysis of field reports and preliminary data (whereas it would have taken a few weeks after the completion of the study to slog through all the reports and come up with some meaningful numbers). PCVs have proven themselves an invaluable asset to this program, according to the project lead – utilizing their local language and cultural knowledge to build rapport with the community members we are working with and the Ghanaian staff implementing the study.

Health Water and Sanitation Volunteer, Jean Leav,

“They’ve also been able to provide other information, like the working with members of the technician’s team creation of a GPS mapping system for use in further studies and University of Ghana participants to review field data (most of the villages we are working in are not on a map and very difficult to locate without a navigation system) and studying the outdoor activity pattern of children under ten as it relates to anopheles mosquitoes’ biting habits. In addition, they have worked with the project coordinator on gathering malaria slide data at nearby hospital labs and performing data quality checks through past records.

AP3 took place in November of 2011 and AP4 just completed this April. PCVs will definitely be invited back for the 5th and 6th phases of study, continuing the collaboration between Peace Corps Ghana, CDC and the President’s Malaria Initiatives.

-David Kalpakchian PCV Ghana PCV David Kalpakchian working on mapping GPS data points collected during the survey

Project Coordinator, Dr. Paul Psychas with PCV Liz Magnusson, reviewing data in the field

26 STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

GUINEA Peace Corps returned to Guinea in 2010 as the country moved to democratic elections following a 2009 military coup. The first Health Volunteers arrived in late 2011 and the post has been building out institutional partnerships throughout the year. Key partner meetings have included CRS, Childfund, PlanGuineé, PSI, HKI and UNICEF.

The President’s Malaria Initiative expanded their work portfolio to include Guinea for the first time this year, with their first Resident Advisor arriving in country in fall of 2011. One of the initial PMI malaria prevention programs will be run by RTI (the Faisons-Ensemble project) and Peace Corps Guinea is in ongoing negotiations to place Volunteers with that program.

Supporting the startup of the PC Guinea Health program, a Malaria Team Volunteer was recruited through Peace Corps response. Attending the September 2001 Boot Camp, this Volunteer worked with PC Guinea staff to draft the Health framework, with emphasis on malaria goals, objectives, and indicators, develop training curriculum for the Health program, train 55 Volunteers and initiate a community survey program of students net use behavior.

Results of the surveys indicate that net ownership and usage by students is extremely low in Peace Corps communities. Less than 35% of respondents indicated that they slept under a mosquito net, even though a majority of households had at least one LLIN. LOOKING TO THE FUTURE Peace Corps Guinea will continue building out their fledgling Health program and deepening the institutional ties with key partners. As PMI ramps up activities, Peace Corps Guinea will assign a Volunteer as a dedicated liaison to PMI, supporting PMI programming. The post will also be assigning multiple Volunteers to the RTI Faisons Ensembles project.

Peace Corps Response Volunteer Peter Thomas with the team from PSI Guinea

27 STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

MADAGASCAR Madagascar has been one of the most active Peace Corps posts in malaria prevention activities. With a Malaria Team of 3 Volunteers and 1 staff member, Peace Corps Madagascar has built an incredibly strong working relationship with PMI, placing Volunteers at their SanteNet2 project and with Deliver. As part of that partnership Peace Corps Madagascar is gearing up to support the national LLIN distribution in October of 2012.

Malaria prevention is built into the curriculum for all Volunteers, and a focused 2 day malaria/MCH training built on that curriculum to train 21 Volunteers and 21 counterparts in Care Groups, neem cream, monitoring & evaluation, and project design and management. Additional similar trainings are in preparation.

Based on the project design and management component of the training, 7 Volunteers were able to develop successful SPA applications for malaria prevention activities to coincide with World Malaria Day. And 10 Volunteers have created neem cream projects, including one Volunteer who is working with his district hospital to train all the nurses in the district.

8 Volunteers did a combination malaria prevention mural, Neem cream demonstration and ‘wall of fame’ net use photo wall projects (see Burkina Faso) for World Malaria Day. One health Volunteer did the project multiple times throughout the month of April at various Volunteer sites in her region. Additionally, the same project will be run with the 29 current trainees at their host family site.

Also for World Malaria Day, 2 Volunteers on the south east coast sponsored a malaria awareness campaign, traveling by boat and stopping in villages along a canal where the malaria rates are very high. They promoted net use and did neem cream demonstrations.

Malaria Prevention Mural Painting

LOOKING TO THE FUTURE Further into the year, Peace Corps Madagascar will hold regional trainings in the southeast part of the country in June with Volunteers and their counterparts on data gathering and community analysis. This training will be financed by USAID. In August, the post also plans to hold a BCC training in the north of Madagascar focusing on Radio, theater and community mobilization with a local performance group brought in as the trainers. Stomping Out Malaria in Africa will be integrated into every PC official training.

28 STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

MADAGASCAR Building Bridges .

“Peace Corps Madagascar is developing partnerships between Volunteers and key partners with plans to integrate Volunteers into PMI projects, PSI LLIN distributions and other community centered projects.

During the Q2 FY’12 malaria partners meeting Peace Corps Madagascar was connected with the Mahefa Project (USAID funded community health program in association with JSI) that allowed 2 Volunteers living in the project area to participate in the start up meetings for the community health project. They will attend the upcoming BCC training provided by Mahefa and be a part of the project over the course of their service.

“Peace Corps Madagascar has also connected with the NMCP and is in discussions regarding how Peace Corps can be a resource for the distributions coming up in the next 2 years. This will mark the first time that Peace Corps has been included in the NMCP’s strategic planning.

“It’s vitally important for Peace Corps to have a seat at the table at these important meetings. That’s how we find out where it is most strategic for us to be.”

-Nicki Keusch PCVL Madagascar

29 STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

MALAWI Peace Corps Malawi has been working with the National Malaria Control Program and PSI to support net distributions since 2010. In June of 2011, Volunteers working with their community health workers and others distributed over 21,000 LLINs in the region of Salima and 44,000 LLINs in Nkhotakota during a mass distribution campaign. Additionally PSI allocated 10,000 LLINs for smaller community led distributions in 20 Peace Corps communities with support in site selection provided by the Ministry of Health.

PCVs have also been placed strategically with other USG agencies like USAID-PMI as well as CDC in order to complement each other in the fight against Malaria in Malawi. PCRV Antonia Mariani, working with PMI is supporting the National Malaria Control Program in planning the universal net distribution campaign for the whole country to take place later in 2012. PCV Katie Dieringer works with CDC at the Malaria Research Centre where they are carrying out research on drug efficacy and resistance trends.

Training has been an important element of Peace Corps Malawi’s growing engagement with malaria prevention. Malaria Boot Camp-trained Volunteers have led training sessions with health Volunteers and malaria-prevention has been fully integrated into the PST curriculum. Peace Corps medical staff discuss malaria biology, epidemiology and transmission. And Peace Corps Malawi staff lead sessions on malaria prevention in the field. Through PC Malawi’s partnership with USAID, CDC and PMI, PMI Resident Advisors trained Volunteers on bed net distribution, ongoing national programs, and malaria as a cross cutting issue and how this affects all other parameters of life and the development of the nation.

LOOKING TO THE FUTURE In the coming year, Peace Corps Malawi will join other national partners to plan for and support the execution of a universal LLIN distribution campaign. Peace Corps Malawi will work the PMI to identify further opportunities to assign Volunteers to key institutions like the Malaria Research Center and PSI.

Answer the Call When Peace Corps announced that Volunteers were urgently needed to assist with a malaria prevention initiative, I felt compelled to answer the call. Malaria remains a leading cause of mortality in Malawi and is the primary cause of outpatient visits in the country. It is responsible for 30 percent of all hospital deaths among children under five.

So far we have distributed over 600,000 nets in the last month, and it has been a great learning exercise.

Though my colleagues and I are making significant progress in this endeavor, much more work remains to be done. More Volunteers are needed to answer the call and join us in our efforts to Stomp Out Malaria. The experience you gain through this groundbreaking project is priceless.

-Greg Clements PCV Malawi

30 STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

MALI One of the first countries to join Stomping Out Malaria in Africa, sending 2 Volunteers and 2 staff members to Boot Camps in 2011, Mali has long been involved in malaria prevention with their counterparts and partners at organizations like CARE Mali.

Through a series of 6 trainings, Peace Corps Mali and their Malaria Team were able to train 128 Volunteers in malaria science, community outreach and bed net distribution. Based on these trainings, Volunteers supported net distributions by PSI, local health ministries and World Vision. Over 134,000 nets were distributed with Peace Corps Volunteers support in logistics and community outreach.

In addition to large-scale action during LLIN campaigns, over 50 Volunteers engaged in local malaria prevention activities in their communities ranging from neem cream trainings to public education murals to work with Care Groups. Additionally, one Volunteer per region took on the work of being a malariaprevention advocate in the Volunteer community, promoting and coordinating activities in preparation for World Malaria Day. LOOKING TO THE FUTURE In March 2012 Mali experienced a military coup d’etat and a rebellion in the three Northern districts leading to the evacuation of all Peace Corps Volunteers. This has affected Peace Corps Mali’s ability to plan for the future of the Stomping Out Malaria in Africa initiative in the country.

Should the situation stabilize and Peace Corps return to the country, further malaria related plans would include building out institutional relationships with key partners and increasing the engagement with net distribution campaigns run by partner organizations.

Seeing Malaria From March 3-8, a group of Mali PCVs biked a total of 40 miles and visited 6 villages to spread theStomping Out Malaria in Africa message. The first stop on the tour was Djoliba the home town of acclaimed musician Salif Keita. PCVs rolled into town early in the morning and set up a table in the market.

With their Stomp Out Malaria shirts and event banner, they quickly attracted a crowd. The Volunteers led a malaria discussion with the group and taught them how to make neem lotion. While the Volunteers also taught the Mosquito Bonk and used a microscope to show what malaria looks like, the best was saved for last.

Right before packing up, Aramatou Djale approached the Volunteers. Inspired by the neem demonstration given by the Volunteers, she ran home and prepared the lotion herself. She proudly returned to the market with her finished product. Women immediately surrounded her and asked her a series of questions of which she was more than happy to answer. The Volunteers left Djoliba to move on to the next village confident that Aramatou would continue to carry on the Stomp mission.

31 STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

MOZAMBIQUE Like Ethiopia, Mozambique sent their first Volunteer to the Malaria Boot Camp in February of 2012. Though the post has a longstanding institutional relationship with the Ministry of Health from their work on PEPFAR, malaria prevention is a new undertaking for PC Mozambique. The post is working to expand their institutional relationships with PMI, the National Malaria Control Program and PIRCOM (Programa InterReligioso Contra a MalĂĄria).

As part of their newly formed relationship with PMI, PMI Resident Advisors ran a first ever PMI/PC training for 42 Volunteers in January, focusing on malaria prevention basics, and the Mozambican context.

Prior to formalizing their relationship, individual Volunteers in the field had done significant malaria prevention work including assisting with an LLIN distribution in the district of Homoine (population 100,000) in August of 2011. Other secondary activities for PEPFAR Volunteers have included: malaria prevention murals, theater groups, and health lectures.

For World Malaria Day, Volunteers hosted a radio panel discussion for community leaders and health professionals, and a World Malaria Day festival for youth. The festival will include a net distribution, health talks and a soccer tournament and will be sponsored by PMI, USAID and the Ministry of Health.

LOOKING TO THE FUTURE Moving into the next year Peace Corps Mozambique will build out its institutional relationships with PMI, PSI, Worldvision and other partner organizations. They will also create a Malaria Action Committee to increase the Volunteer engagement and create a platform for knowledge sharing.

Peace Corps Mozambique also plans to build out their training commitment, increasing the malaria prevention training for all Volunteers, and identify training partners.

PC Mozambique Volunteers train with the Program Inter-Religioso Contra MalÄ ria

32 STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

SENEGAL Capitalizing on the use of Senegal as the training site for the Malaria Boot Camps, Peace Corps Senegal has sent a total of 8 Volunteers and 1 staff member to the Boot Camp training. Those Volunteers have led regional and national trainings for their peers, training 250 Volunteers (100% of the PCVs in country).

Of those 250, over 150 Volunteers have participated in recent malaria prevention activities, from neem lotion demonstrations to malaria awareness tourneys. Many have done home visits to raise their communities’ understanding of the symptoms and treatments of malaria, the important of seeking treatment, and how to use and maintain mosquito nets. Others have brought those same lessons into classrooms. Many have been involved in the country’s campaign to deliver enough bed nets to cover every bed in every village across Senegal.

During Stomping Out Malaria in Africa’s first year, the Government of Senegal continued their national universal coverage LLIN campaign, covering the Regions of St. Louis and Matam. In both regions, Volunteers played a key role in their communities, and with their local health structures, supporting transportation logistics, training, and EIC outreach in conjunction with the distribution.

Additionally, in the Kédougou region, Volunteers and counterparts distributed 2880 nets to fill in the gaps from nets damaged or lost since their universal coverage campaign in 2009.

Volunteers worked closely with Malaria No More to extend a 7 day malaria prevention curriculum for middle and elementary school children. Malaria No More also runs the innovative Nightwatch radio program – a series of radio PSAs by trusted celebrities reminding families to use their LLINs every night. Volunteers have been working to place Nightwatch PSAs on their local community radio stations and increase the brand awareness around the campaign.

In the north of Senegal, the malaria prevalence is low and the Government of Senegal is working with the MACEPA project to develop an SMS-based rapid response program for malaria outbreak control and eventual elimination. Peace Corps Senegal has assigned a Volunteer to MACEPA who is working to train local community health workers in how to use the java-based SMS platform.

Women dancing at an LLIN Distribution

Dr. Pape Moussa Thior training Volunteers

A regional planning meeting in Kolda

33 STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

SENEGAL LOOKING TO THE FUTURE Moving into Stomping Out Malaria in Africa’s second year, Peace Corps Senegal will look to expand collaboration with NetWorks, MACEPA, and Malaria No More. Malaria No More recently launched their Speak Up Africa campaign to increase the visibility of local malaria prevention efforts, and Peace Corps Senegal will assign a Peace Corps Response Volunteer to assist in web design, and media communications.

Volunteers will continue to contribute to the universal coverage campaign as it moves to the final regions of the country – Thies and Dakar – and support their local clinics system of routine distribution.

Peace Corps Senegal is also working to develop a new pilot model for the use of Masters International Volunteers in malaria prevention. 4 MI students have been recruited to serve in specially chosen regional centers where they will support the work of their regional or district hospital in malaria prevention and health systems strengthening as well as support the Volunteers assigned to clinics within the hospital’s catchment zone.

Plugging in to NetWorks “Thanks to Jessie Seiler’s work this past year; Peace Corps Senegal Volunteers have a new working relationship with NetWorks, a project funded by USAID in partnership with the Johns Hopkins Bloomberg School of Public Health. NetWorks has the mandate to coordinate and assist with the distribution of mosquito nets across Senegal in concert with the Senegalese Ministry of Health and other partners. NetWorks and their partners have committed to covering every sleeping space in Senegal with an impregnated mosquito net, a radical approach to the concept of universal coverage that was pioneered on a small scale

by PCVs here. It should come as no surprise that follow-up efforts rely on Volunteer fieldwork and innovation.

PCV Jessie Seiler, and Program Manager Matt McLaughlin co-facilitate a training session

“Joan Schubert, NetWorks’ director, recently asked that Peace Corps Volunteers conduct field tests on a curriculum developed to raise awareness about the proper use and maintenance of mosquito nets. Volunteers trained their counterparts and monitored the use of printed home visit flip charts before presenting results to NetWorks. As a result, NetWorks is now printing field-tested materials that will be used throughout Senegal. Peace Corps language instructors are reviewing the materials to ensure the Pular, Sereer, and Wolof translations are understandable. NetWorks also demonstrated a new way of modifying nets to Volunteers, who will bring samples of the circular, larger nets to tailors in their communities as a way of jump-starting their production in the field. Volunteers are also working with community radio stations to announce net distributions and educate rural populations in their own language, using communications strategies and key messages developed by NetWorks. ”These coordinated projects exemplify Peace Corps’ unique offering to organizations like NetWorks: our Volunteers live and work where their reach ends. Partners like NetWorks can scale up and replicate what they do in rural areas as a direct result of Volunteer involvement.”

-Mike Toso PCV Senegal

34 STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

THE GAMBIA The Gambia was one of the first posts to engage in the Stomping Out Malaria in Africa initiative and the first post to have a staff member attend a Boot Camp, in June of 2011. Building from that base, The Gambia began integrating malaria training into all sector trainings. 51 Volunteers have been trained in malaria prevention activities and the post has created a malaria prevention task force to advise the post on malaria prevention activities.

Peace Corps The Gambia has also built a strong working relationship with the Gambian National Malaria Control Program. Experts from the NMCP have participated in Peace Corps trainings including sending a representative to the Malaria Boot Camp in February of 2012. Their collaboration has already led to one high level Volunteer placement – an IT and project management focused Volunteer – working in the NMCP offices.

LOOKING TO THE FUTURE Over the course of April 2012, staff and Volunteers from The Gambia came together to finalize their malaria prevention framework and project plan for the next 5 years. Strategic focuses will include neem cream (see highlight), creation of murals and other pubic visual aids that reinforce national malaria prevention messaging, and formalizing best practice sharing between Volunteers and governmental partners.

Peace Corps The Gambia is also developing a baseline survey for all Volunteers to gather in depth information on the malaria situation in their communities and allow Peace Corps to prioritize resources in the zones with the greatest need.

Neem for Health and Profit Stephanie Starch lives in a small Fula village in Central River Region with about 20 households and works with her village and the other communities in Jamally district on community health programs. Noting the high prevalence of malaria in her district and the lack of income generating activities, she decided to kill 2 birds with one stone – Neem cream.

Neem cream is an organic mosquito repellent made from leaves of the neem tree (azadirachta indica) which grows throughout The Gambia and across Africa. Its insect repellent properties have been documented in its original homeland of India for thousands of years, and modern research is revealing the amazing efficacy of this miracle plant.

Stephanie developed a training program on entrepreneurship and money management with home fabrication of neem cream as the primary activity. Between that training and a community mural of how to make neem cream, her village is protecting itself and bringing in much needed income.

35 STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

TOGO Peace Corps Togo has had 1 staff member and 3 Volunteers attend the Boot Camp training, and has been building off that base to integrate malaria prevention programming into all its program areas. As Togo is not a PMI focus country the post has worked with other partners including local NGOs ASEDA, ATBEF, the National Malaria Control Program and the World Health Organization.

In early 2012, the WHO approached Peace Corps to propose a joint project for monitoring the success of the upcoming Global Fund financed universal LLIN distribution campaign. Peace Corps Volunteers would train host country national counterparts to act as independent evaluators, performing household surveys in and around Volunteer communities to determine whether the nets had reached their intended beneficiaries.

Malaria Team peers in Zambia and the US have been supporting Peace Corps Togo as they work with the WHO to refine the survey methodology and training curriculum.

During the startup phase, training has been a key focus of Togo. Malaria Team members returning from Boot Camp conducted trainings with post staff to ensure that all staff members understand the goals of Stomping Out Malaria in Africa. And Volunteers from across the country have been recruited into a system of regional points of contact (the “Malaria Army”) ensuring that no Volunteer is far from an extremely knowledgeable and engaged peer.

LOOKING TO THE FUTURE Moving into its second year of focus on malaria, Peace Corps Togo will work to ensure that 100% of Volunteers receive malaria training. And Peace Corps Togo’s Malaria Army will grow to include a Volunteer from every region.

As the WHO survey project ramps up, Volunteers across the country will be training community health workers in monitoring and evaluation and data collection ensuring that precious Global Fund resources arrive at their intended beneficiaries.

Finish What we Started “Today we are equipped with new tools to fight malaria including new anti-malarial treatments, new simple and rapid diagnosis methods, a vaccine to prevent malaria deaths scheduled to come out in 2015 (and others on the way to prevent transmission), and most of all a renewed vigor to finally finish what we started. There have been new efforts to implement universal coverage of insecticide treated bed nets and funding access to Rapid Diagnostic Tests (RDT) and malaria medication. Another key aspect of the renewed fight is a new goal of unified action both in scientific technology development and on the ground efforts.

“This training in Senegal and meeting the team of Peace Corps Volunteers has inspired me to worked more in the fight against malaria and sparked optimism that we can accomplish our goals with wise investments and a unified effort from all those in the fight against malaria.”

- Elizabeth Stevens PCV Togo

36 STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

UGANDA Peace Corps Uganda has made extensive use of the Peace Corps Response program to provide experienced knowledgeable Volunteers to important partner organizations. These Volunteers and staff members have built out institutional relationships with a strong network of malaria prevention partners including: Abt Associates, Bushenyi Village Health Teams, Communications for Development Uganda, Uganda Health Marketing Group, Soft Power, Uganda National Deaf Association, Northern Uganda Media Exchange Committee and the Ugandan Ministry of Health.

Working with these strategic partners, Peace Corps Uganda has been able to begin integrating malaria trainings in their pre-service training of Volunteers and all-Volunteer training events. Additionally, Volunteers have been extremely active in partner trainings, working with Soft Power to train over 1500 people in basic malaria knowledge, use of bed nets, and treatment seeking and with local Village Health Team members to increase community engagement with malaria prevention.

Volunteers have also participated in LLIN distributions. Working with Soft Power Health, Volunteers have contributed to the distribution of over 1,100 nets and the manufacture of 450 unique hammock nets (see below).

LOOKING TO THE FUTURE Over the coming year Peace Corps Uganda will complete the integration of malaria prevention into its training curriculum, training all incoming Volunteers. They will also create a malaria Volunteer think-tank, a PC sponsored Volunteer committee designed to increase and maintain institutional focus on malaria Volunteers in Bushenyi district, in partnership with the Uganda National Association for the Deaf, will be developing a pilot program aimed at providing malaria awareness education to the over 70,000 deaf individuals in Uganda.

Peace Corps Uganda will also expand on its relationship with UHMG to provide support local community health workers selling subsidized LLINs.

Nets Made at Ho me Finding employment is difficult for youth in Ngora parish. Many haven’t completed their schooling and do not have the financial means to do. The Ngora Parish Harmack Company (NPHC) aims to do something about it, teaching business skills and the fundamentals of microfinance to training group for youth.

PCV Mathew Boddie is currently working with NPHC on a project teaches these youth to produce mosquito net hammocks to sell to local Ugandans and tourists. In the process of learning those skills, youth within the company receive equal portions of the profit made. Selling the hammocks to local clinics that face bed shortages, the project both address healthcare needs and creates a sustainable income-generating project.

The group decided on this initiative after realizing the number of children who sleep on the floor, without a mosquito net to prevent malaria. It is their mission in Ngora to provide every youth, especially those under the ages of 5, with a bed and a net to sleep under.

37 STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

ZAMBIA Peace Corps Zambia was one of the first posts to send a Volunteer to the Boot Camp in June of 2011, but has a history of malaria prevention work that significantly predates the creation of Stomping Out Malaria in Africa and a unique focus on research. From early 2010, Volunteers worked closely with PMI on a study of Fansidar use with malaria positive pregnant women in Luapula Province.

With the arrival of the first Stomp Volunteer, Peace Corps Zambia began reaching out to other malaria prevention partners, and strengthening the links with PMI. In September of 2011, a Volunteer was assigned to Society for Family Health (a PSI affiliate) to create and implement a Net Longevity Study with Dr. Allen Craig of the CDC.

Dr. Allen Craig with Volunteers and counterparts at a training for the Net Durability Field Study

Zambian Volunteers have also been active in supporting national net distribution campaigns.

Working with clinics in the Northern district, Volunteers supported logistics and provided complementary education programs for a World Bank sponsored net distribution. In Luapula province, Volunteers played a similar role, supporting their local clinics during a 6 million net distribution managed by World Vision.

Peace Corps Zambia’s relationship with PMI has allowed for a strong training collaboration. Dr. Allen Craig has worked with Peace Corps trainers to present malaria prevention education to 138 Volunteers. Those Volunteers will be reporting on malaria prevention activities in a new 2012 framework with indicators derived from PMI standards.

World Malaria Day celebrations in Kamasu

Peace Corps Response Volunteer Jane Coleman (right) with the USAID/CDC Malaria Operation Planning Team

38 STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT

ZAMBIA LOOKING TO THE FUTURE In the second year of Stomping Out Malaria in Africa, Peace Corps Zambia plans to increase the level of malaria prevention training offered to all Volunteers, rolling out the FITU packages provided by OPATS. Peace Corps Zambia will also take steps to increase the number of malaria related SPA grants written by PCVs – providing project design and management trainings, and direct support from Malaria Team Volunteers for those needing help with the process.

Expanding partnerships is also a key strategic direction of Peace Corps Zambia. The post will deepen ties with PMI, increase cross collaboration with Africare and Care working in southern province, and build a relationship with Vestergaard Fraanzen in Lusaka to source discounted nets for PCV SPA grants.

In monitoring and evaluation, the post will seek to increase the quality of reporting on malaria education and prevention activities during GLOW camps throughout the country. Collecting and analyzing data from 38 PCVs participating in the Net Study will be a key activity, along with managing the logistics of sending net samples to the CDC for advanced testing.

Lastly, for the continuity of the net durability study program, new PCVs will need to be trained in study design.

Research at the Last Mile In August of 2011, Peace Corps Volunteer Casey Kean began collaborating with CDC Resident Malaria Advisor Dr. Allen Craig to design research protocols for a long-term net durability study. In September of that year, Volunteer Ashley Kowal extended for a third year to focus on the net study, finalizing the protocol and beginning the process of rolling it out to the field.

The study utilizes Peace Corps Volunteers and their local Zambian counterparts living in villages in Luapula and Northern Provinces where LLINs were distributed and hung up February – June, 2011. A sample of randomly selected homes in villages with a PCV were enrolled in the study which involved visits to the home every 6 months to count and measure the numbers of holes/tears and repairs in the net.

Each PCV with their host country counterpart will follow 25 LLINs for the length of the study. At each home visit a brief questionnaire is administered and kept by the PCV. A sample of approximately 500 PermaNets and 500 Olyset nets will be examined for up to 36 months in this study.The results of this study will be used by the National Malaria Control Centre (NMCC) to plan for replacement of LLINs.

39 STOMPING OUT MALARIA IN AFRICA | 2012 ANNUAL REPORT