Fobang Foundation

Project Brief:

Cameroon is a country in Central Africa whose natural environment covers three ecological zones from south to north – the equatorial forest, the Guinea savannah and the Sahelian savannah. Malaria continues to be a public health problem: it accounts for 40% of the deaths and has a substantial impact on Cameroon's society and economy. The first national programme for the fight against malaria was initiated in 1992. It was changed into its present structure in 2002 to improve its effectiveness. Since then, more than 1 million insecticide-treated mosquito nets (ITNs) were distributed to pregnant women and children under the age of five. In 2006, it became clear that Plasmodium falciparum was resistant to amodiaquine and that the Anopheles mosquito was resistant to pyrethroids. In 2007, the National Malaria Control Programme (NMCP) decided to reorient towards a greater community participation in order to mitigate the difficulties it was having scaling up its interventions with insecticide-treated mosquito nets, the intermittent preventive treatment (IPT) of pregnant women with sulfadoxine pyrimethamine (SP), and the use of Artemisinin-based combination therapy (ACT). Counterfeit drugs and gaps in the supply and distribution channels make ACT one of the most challenging forms of malaria intervention. There is also a general lack of information or the information that is disseminated is not culturally relevant. This is why the more than 1,700 NGOs and partner organizations at the grassroots level must develop IEC (information, education, communication) packages themselves. In view of these difficulties, the Fobang Foundation proposes to promote effective disease prevention by explaining the biological basis of the disease and educating the population on better control methods. This prevention is one of the eight objectives of the framework the foundation has been continuously promoting since 1998.

At the national and policy level
To coordinate a biennial Malaria Report for Cameroon by helping the National Malaria Control Programme develop questionnaires, collect and analyse information from the provinces, and monitor sites and organizations involved in malaria prevention. We hope to help CAMAM (Cameroon Media Against Malaria, a branch of Cameroon Coalition Against Malaria (CCAM)) strengthen their focus by helping them produce the biennial ‘About Malaria’, a Cameroon-based information dissemination tool that addresses issues that are relevant for policy and prevention, and showcases effective interventions in Cameroon and Africa.

At the grassroots level
To promote effective malaria prevention by using adapted training kits to educate at-risk groups. ‘Wabu’, the Malian word for malaria, is a play about the dilemma of traditional African and Western approaches to the treatment of fever and malaria (staged at the 4th Pan-African Malaria Conference 2005 in Cameroon, the largest malaria conference ever (2,000 participants)). ‘Wabu’ was also made into a documentary and translated into French and Pidgin. This central theme will be used to carry out development-oriented popular theatre. In association with NADEC (National Association of Development Communicators) we will develop and promote the adaptation of malaria prevention information for rural areas. The Fobang Foundation is about to receive permission to run a community radio station (FM) in Yaoundé, the capital of Cameroon. Funds obtained from ongoing projects will be used to sponsor the malaria slots on Radio Health International, a communication-for-development branch of the Fobang Foundation. We intend to promote the prevention of malaria through the Falcon (Falciparum Control) Nets Programme, which will consist of insecticide-treated nets (ITNs) being made by people living with HIV/AIDS (PLWHA) and developing an education package for trainers distributing the nets to school health club members as a way of encouraging them to be role models and carry the same message to their families.

Drama performance by Fobang Foundation to pass  on difficult health messages                        

Annual Workshop on Health and Development: participants with mosquito nets sewn by Fobang Foundation

Project Report:

The report covers the period April 2009 - March 2010:

This project is running in parallel with an HIV/AIDS project funded by the Dutch Albert Schweitzer Foundation (NASF). This considerably increases the effectiveness of both programmes and prevents double spending.

The Fobang Foundation (FF) formulated eight objectives, five of which are key to the execution of the malaria project.

1. Research and capacity build-up

Objective: Work with the 'National Malaria Control Programme' (NMCP) and the 'Cameroon Coalition Against Malaria' (CCAM) to gather information in order to create a complete picture of the malaria situation in Cameroon. This includes malaria indicators in a number of important regions (in North-West, South-West and Central Cameroon as well as in the Adamawa regions). The focus is on children under five and pregnant women.

2. Cultural health education

We are working on the malaria manual, which we expect to complete in the autumn of 2010. FF is co-sponsoring the biweekly report 'About Malaria’, which also contains a comic strip on preventing malaria.

An important milestone was reached with the completion of the Radio Health International project, which will enable information about malaria to be broadcast over the radio. The broadcast tower has been completed, and radio equipment purchased and installed. Four journalists have spent the last three months fine-tuning and editing information and have even broadcast a test programme on 103.3 FM in Yaoundé.

3. School Health Clubs (SHC)

School health clubs (SHC) received sponsoring for project activities that are part of the 'Community Outreach Malaria and HIV Prevention' programme. On average, each club has 50 active members, and some 10 clubs are involved.

4. Theatre

The play ‘Wabu’ is being developed into a docudrama. Wabu tells the story of the difficulties an African family has choosing between a treatment based on traditional medicine and a treatment based on modern medicine.

5. Vocational and hope centre

The vocational and hope centre focuses on activities related to the production of insecticide-treated mosquito nets. 1,500 mosquito nets have been distributed through the school health clubs.

Deviations from the plan

• The effort that was put into completing the Radio Health International project affected the production of insecticide-treated mosquito nets: only 1,500 of the suggested 2,500 were made. There was also a shortage of material for the production of mosquito nets. The material comes from Nigeria and is not easy to obtain.
• A number of volunteers have left FF to pursue their professional and/or academic ambitions. This slowed down progress in certain areas. New volunteers need to be recruited.
• The reluctance of the ‘National Malaria Control Programme’ to collaborate on the publication of the malaria report means that we spent more time on it than planned. In the end, FF was given permission to publish the report.

Challenges

• One of the challenges we’re facing is funding for the office and other costs that are incurred. FF is asking its donors to provide funds.
• Another challenge is the development of the play Wabu, which is progressing with difficulty. Finishing the script, finding the right cast and making sure the production is good are all issues that need attention. We hope to receive additional funding from the London School of Hygiene and Tropical Medicine soon.
• It is also difficult to produce good-quality insecticide-treated mosquito nets because obtaining the material always depends on the procurement situation in Nigeria.
• FF expects that it can start supporting the radio programmes in 2010, but it is not clear whether there will be sufficient funding after that. The funds will sustain five journalists and two technicians, a strong transmitter (1000 W), the maintenance of the website, the telephone and electricity.
• This year, FF will evaluate the chosen strategy and ask for additional funding from its current donors NASF and MNM. FF will also use commercials and fund-raising campaigns to raise money for the radio programmes in the hope that they will be able to sustain themselves in two years time.

Lessons learned

FF has learned to make its projects less ambitious. It is better to achieve good results in small steps over several years, than to start a lot of activities that produce little to no result at all. FF is therefore asking that everyone be patient and continue funding the project just a little bit longer.