Thirteen hours by motorized boat across 90 miles of swamps to mainland Guinea. That is how far the 2,000 residents of the Katfoura fishing post in the Tristao Islands must travel for medical care.
This is significant as prompt access to malaria treatment can make the difference between life and death, and malaria is an ever-present challenge for people in Katfoura and the three isolated health districts of the Tristao Islands.
Located in the delta of the Kogon River along the border of neighboring Guinea-Bissau, this fragile, protected wetland is also home to mangrove forests and wildlife such as manatees, crocodiles, and endangered marine turtles. Unfortunately, it is also prime breeding ground for mosquitoes that carry malaria.
One of the most effective ways families can prevent malaria and thus reduce the need for medical care is to sleep under insecticide-treated bed nets. But the challenges of getting to a health facility makes it difficult for the households of Kafoura and the other six Tristao Islands to receive the free nets given to pregnant women during prenatal visits and young children during vaccine appointments. The communities were also missed in the mass distribution of free nets that the Government of Guinea organizes every three years.
For the 2022 mass campaign, the U.S. President’s Malaria Initiative (PMI), through the StopPalu+ project, assisted the Government of Guinea in ensuring that nets would finally reach every one of these families. The partners drew from lessons learned during the 2013, 2016, and 2019 mass distribution campaigns.
Unloading bundles of nets on the island Katfoura. Photo by StopPalu+
Essential to the process was involving the local community, an effort led by local NGO Initiative et Action pour l’Amélioration de la Santé des Populations (INAASPO; Initiative and Action for Improving the Health of Populations). Island leaders took part in stakeholder advocacy meetings. They helped to identify island representatives who participated in the micro-planning of the grand strategy, which created two new distribution sites in the archipelago.
In addition, they recruited residents to serve as enumerators, who helped determine how many nets were needed, and as mobilizers and educators, who explained to and encouraged families to use their nets all night, every night. The communities were also involved in the transport, storage and distribution of the nets, with PMI providing gas and per diem to support their labor.
Thanks to the special effort focused on the archipelago, almost 19,000 nets were distributed to 96 percent of the households in this remote area that makes up the Kanfarande sub-prefecture of the region Boke. This includes every single one of the 306 households of the Kafoura fishing post.
The secretary of the district office, Lamine Faro Keita, described the nets as a “great relief” and expressed gratitude for the “distribution agents and the donors who are fighting night and day despite the distance and all the risks so that our communities are satisfied during this campaign and despite our geographical position.”
“Because without nets, we are always attacked by malaria,” he said. “We thank StopPalu+ and USAID for their efforts.”
These nets are a fraction of the 3.7 million that PMI supported Guinea’s National Malaria Control Program in distributing across Boké and the neighboring region of Labé during the 2022 campaign. Guinea’s next mass net campaign is in 2025 and PMI is already poised to ensure the Trisato Island residents receive their nets again.
Bundles of mosquito nets preparing to leave Guinea’s Port of Kamsar for the Tristao Islands of Kanfarande including Katfoura. Photo by StopPalu+
Cover photo: Disembarkation of the nets in Dobaly. Photo by StopPalu+
The USAID StopPalu+ was a five-year project (2017-2022) led by RTI International that focused on supporting the Government of Guinea to reduce malaria-related morbidity and mortality. Working across 19 districts, StopPalu+ addressed gaps in malaria prevention and control by supporting essential health service delivery, behavior change communication, capacity strengthening and supervision, disease surveillance, and monitoring and evaluation.