Combating malaria is a tricky tradeoff in Mozambique.
The mosquito-born illness is the leading killer of children here, and the CDC-supported ministry of health is aiming to change that with a door-to-door campaign to spray the insides of homes with repellant. But DDT is toxic, and some scientists say spraying the insecticide should be used only as a last-ditch effort. It depends a bit on whom you ask.
We arranged to see a spraying campaign in Xai Xai, but it turned out the cadre of young men and women from the program were only making informational rounds that day. They still wore their full gear, perhaps to construe professionalism when meeting homeowners, perhaps to impress the visiting group of international journalists.
It’s tough work that takes place over 45 days. The workers each put in six days a week making informational rounds and spraying homes. Those interviewed said it was important to make contact with residents ahead of time; they experience little resistance when someone shows up in person to explain the benefits.
Malaria is treatable, yet poor access to health care makes prevention particularly important in Mozambique.
The government uses Indoor Residual Spraying largely because other mosquito-control methods, such as outdoor spraying campaigns, are prohibitively expensive. Mosquitos hang out on walls in homes, waiting to suck human blood and feed their eggs once people go to sleep. Applying DDT to the walls keeps them out. Residents must remove furniture and belongings from their houses before spraying and stay outside for three hours after.
The WHO’s position statement finds DDT to be the cheapest and most effective means of keeping malaria at bay:
DDT is still needed and used for disease vector control simply because there is
no alternative of both equivalent efficacy and operational feasibility, especially
for high-transmission areas.
Care to pump your house full of pesticide? For now it may be the lesser of two evils.