Mosquito Nets in Context

A while ago I heard an interesting story about Malaria prevention in East Africa.  I was reminded of it again while watching this TED video by Esther Duflo.

An aid organization working on the eradication of this preventable, treatable disease initiated a program of using mosquito nets to prevent insect bites and thus preventing the disease, but came across an unusual twist.

Any good project will rely on more than the technical solution for success, but will include good change management and communication, and this project was no exception. A team of educators worked with the local communities to explain the advantages of the nets, and how to use them. Large sheets of the clean white fabric were erected in the village centres and demonstrations were carried out. The local people acknowledged understanding and took the freely available items.

After some time the occurrence of Malaria has still not decreased, however. What was happening? The aid team suspected incorrect or inconsistent use of the mosquito nets and began to investigate. They discovered to their surprise that the nets were not being used at all.

Upon further conversations about the culture of the community, they found that in the local tradition, the use of white cloths to cover people, was restricted to the pre-burial rites of the dead. Not wishing to infer ill upon themselves, the nets were thus not used as coverings while sleeping.

The researchers suggested to the community leaders that another colour of net might be more appropriate. They agreed, the nets were dyed green and further supplies were ordered in green. The people readily adopted the use of the nets and the incidence of Malaria declined immediately.

This small contextual fact that was unknown to the Western aid workers, but proved to be the one fact that prevented the adoption of new practices, all other coherent questions being asked and answered. And this is the problem with using methods that either don't take context into account, or, as in this case, not asking quite the right questions. After all, in the change readiness assessment it is unlikely that one of the questions would have been, "What colour nets do you want?"