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Tuesday 28 April 2009
The great malarial bed-net swindle
Ceri Dingle explains why her charity has made a film exposing the piety of the ‘Save Africa’ bed-net campaign.
Ceri Dingle

In 2007, then US president George W Bush declared an annual World Malaria Day on 25 April. This year, to mark the event, Western campaigners who want to reduce the incidence of malaria have been working overtime to convince us that we can ‘save Africans’ by spending £5 on a bed-net.

Top in the bed-net-promoting PR stakes is ex-British prime minister Tony Blair’s Faith Foundation, which is distributing a patronising little film called The Story of a Bed Net (1). It is a sermon on how bed-nets will rid the poorest parts of the world of malaria, just so long as poor Africans are provided with clear and simple lessons on how to use them.

Increasingly outraged by these pious and misleading bed-net campaigns, young volunteers at the charity that I run, WORLDwrite, have produced a hard-hitting filmed riposte, Early to Bed-Net, which is currently showing on the charity’s news channel, WORLDbytes.

The film’s title is inspired by the way that anti-malaria campaigns have made the ‘mosinet’ their No.1 priority for keeping more (but not all) African children alive. Mosinets are fine, see-through meshes that hang over and around the bed to stop insects from biting the person inside while allowing air to flow through. They are usually treated with an insecticide to kill or repel mosquitoes. However, the insecticide doesn’t last long, and the nets need to be replaced after just a few washes. Nets are used as an alternative to the industrial spraying of anti-malarial insecticides, which is how malaria was wiped out in many parts of the developed world.

The low horizons of the bed-net initiatives are summed up by Joe van der Voort in the WORLDwrite film as ‘the most patronising and pompous campaigns we have seen in a long time’; African volunteer Helder Da Costa says ‘there is almost a sub-text saying Africa’s development will remain retarded, while allowing the West to feel good that they are doing something’. So what is wrong with bed-nets? Here are a few of the dangerous assumptions lurking behind the bed-net campaigns:

• Like naughty children, Africans must go to bed early in order to protect themselves, because in malarial areas mosquitoes bite when night falls and humidity rises.
• Western, developed countries don’t have to do very much thanks to the bed-net campaigns: just spend a fiver on a net and you can possibly ‘save a poor person’.
• Under the bed-net initiatives, ‘preventing malaria’ means taking small, very low-tech steps which involve no development whatsoever, thus helping to maintain the status quo.
• Bed-nets are preferred over industrial spraying because they are very hands-on, do-it-yourself and environmentally friendly aids, thus pressing developmental buttons such as ‘local sourcing’ and ‘appropriate technology’.
• Much of the bed-net campaign is more about making Westerners feel better than really transforming African people’s lives. Campaigners can send bed-nets to Africa for very little money, and they receive a badge to show that they have done so.
• One attraction of the bed-net campaign is that it circumvents national governments in Africa, which are presumed to be corrupt or insufficiently concerned about their people’s health and wellbeing. Western aid agencies can apparently be trusted with selling and shipping the nets and doing lots of monitoring because they are not up to their necks in corruption.
• Written into the bed-net campaign is a deep hostility towards modern, chemicalised methods of destroying malaria. The story is that, yes, we in the West are malaria-free, but we ruined everything by using nasty chemical pesticides and industrialising agriculture; at least bed-nets won’t ‘spoil’ Africa and there is no chance they will propel developing countries towards modernity or anything ghastly like that.

It all smacks of the modern missionary position, with the emphasis on local, individual behaviour change (‘sleep under a bed-net’) rather than the macro-level eradication of the disease. As British academic Vanessa Pupavac has explained:
‘The changing international development strategies revised international health policy goals from the ambitious disease eradication and cure model to a more modest disease management and prevention model, and from hi-tech medical care to basic health needs…. Public health in development thinking has become attached to environmental concerns, where populations in developing countries are constructed as part of nature and protecting their wellbeing is equated with protecting nature… International development strategies are seeking to promote wellbeing in the presence of disease, not its absence.’ (2)

If any of these campaigns were serious about malaria eradication, pesticides would be top of their agenda. You would think that dichlorodiphenyltrichloroethane (DDT), which remains the most effective pesticide for dealing with malaria-carrying insects, would at least get a mention somewhere in the campaign literature. But it doesn’t. While some of the campaigns admit that indoor residual spraying (IRS) ‘may be useful if appropriately handled in some areas’, they cannot bring themselves to utter the name of the substance that would be used in these circumstances: DDT.

This is no doubt due to Western environmental sensibilities. The demon DDT, a non-herbal, non-traditional, Western invention, was used to great effect to wipe out malaria in the West, until it was banned on environmental grounds in 1972, despite court hearings which found it to be harmless. The ban was inspired by Rachel Carson’s book Silent Spring, yet Carson’s science has been found wanting many times in recent decades. It took until 2005 for the World Health Organisation to admit to DDT’s harmlessness. Meanwhile, most countries adhered to the Western-generated ban for fear of donors withdrawing funding, and fear of trade sanctions (threatened by the EU) against agricultural exports. Countries which ignored the ban and continued to produce and use DDT, such as India and China, largely contained their malaria problem. Today, however, DDT is used in fewer than 20 of the 109 malarial countries, and the parasite is flourishing, particularly in Sub-Saharan Africa.

As Hamsa Galoa says in the WORLDwrite film, in those countries where DDT has been widely used, both now and in the past, ‘no one has ever died from [contact with DDT]’; however ‘millions continue to die from malaria’ in countries where no DDT is sprayed. There has never been a shred of evidence that DDT is harmful in any way, except, of course, to pests.

The WORLDwrite film has clearly already touched a nerve: we have started receiving emails from ‘outraged’ and ‘appalled’ campaigners, concerned about the ‘dangerous message’ we are peddling. What is most striking is the level of fear people have about using chemicals to tackle the problem of disease. ‘Are you suggesting the West should dump dangerous chemicals on people in Africa?’, asks Lorna, who recommends that we ‘find out what herbs people use from their own local eco-pharmacopia’.

Wondering, as Jessica Mudditt puts it in the WORLDwrite film, ‘whether the next mosquito bite is going to kill you’ is a terrible state of affairs for people in malarial areas. Never mind staying up late or going out at night, simply a rip, a tear, a tangle in your bed-net, or a trip to a pit latrine in the middle of the night, might be a killer moment. And all of this because Western campaigners hate the amazing chemicals we have created that can wipe out the pests. As Agnes Marquis says in the film: ‘With malaria defeated, the world would benefit to the tune of about a million more people a year, with all of the great possibilities that could mean for humanity as a whole.’

Ceri Dingle is the director of the education charity WORLDwrite. The WORLDbytes report Early to Bed-Net is available to view here.

(1) See the Tony Blair Faith Foundation website.

(2) ‘Changing Concepts of International Health’, by Vanessa Pupavac, in A Sociology of Health, Sage, 2008, pp173-190

reprinted from: http://www.spiked-online.com/index.php/site/article/6612/