Sonia Shah: 3 reasons we still haven't gotten rid of malaria

Translator: Nelson Simfukwe Reviewer: Joachim Mangilima

So over the long course of human history,

Kwa muda mrefu katika historia ya mwanadamu,

the infectious disease that's killed more humans

ugonjwa wa kuambukiza ambao umeua wanadamu wengi

than any other is malaria.

kuliko mwingine ni malaria.

It's carried in the bites of infected mosquitos,

Unabebwa katika ving'atio vya mbu,

and it's probably our oldest scourge.

na inawezekana ni janga letu la muda mrefu.

We may have had malaria since we evolved from the apes.

Inawezekana tulikuwa na malaria tangu tulipotokea kwenye enzi za sokwe.

And to this day, malaria takes a huge toll on our species.

Na mpaka leo,malaria inachukua inasababisha madhara makubwa katika jamii yetu.

We've got 300 million cases a year

Malaria inagundulika mara milioni 300 kwa mwaka

and over half a million deaths.

na vifo vipatavyo nusu milioni

Now this really makes no sense.

Sasa,hii haiingii akilini kabisa.

We've known how to cure malaria

Tumejua jinsi ya kutibu malaria

since the 1600s.

tangu mwaka 1600.

That's when Jesuit missionaries in Peru

Wakati huo wamissionari wa Peru

discovered the bark of the cinchona tree,

waligundua gamba la mti wa cinchona,

and inside that bark was quinine,

na ndani ya gamba hilo kulikuwa na quinine,

still an effective cure for malaria to this day.

ambayo ndiyo tiba ya malaria mpaka leo.

So we've known how to cure malaria for centuries.

Kwa hiyo tumejua jinsi ya kutibu malaria kwa karne sasa.

We've known how to prevent malaria since 1897.

Tumejua jinsi ya kuzuia malaria tangu mwaka 1897.

That's when the British army surgeon Ronald Ross

Ambapo ndiyo kipindi ambacho daktari mwanajeshi wa Kiingereza Ronald Ross

discovered that it was mosquitos that carried malaria,

aligundua kwamba alikuwa ni mbu ambaye anaambukiza malaria,

not bad air or miasmas, as was previously thought.

sio hewa chafu au anga chafu ,kama ilivyokuwa ikifikiriwa mwanzoni.

So malaria should be a relatively simple disease to solve,

Kwa hiyo malaria inatakiwa iwe ni gonjwa rahisi kutibu,

and yet to this day, hundreds of thousands of people

lakini mpaka leo,mamia ya maelfu ya watu

are going to die from the bite of a mosquito.

wanakufa kutokana na kung'atwa na mbu.

Why is that?

Kwanini iwe hivyo?

This is a question that's

Hili ni swali ambalo

personally intrigued me for a long time.

binafsi limenifanya niwe mdadisi kwa muda mrefu.

I grew up as the daughter of Indian immigrants

Nimelelewa na wazazi wahamiaji wa kutoka India

visiting my cousins in India every summer,

nikiwatembelea mabinamu zangu nchini india kila kiangazi,

and because I had no immunity to the local malarias,

na kwa sasa sikuwa na kinga ya malaria,

I was made to sleep under this hot, sweaty mosquito net every night

Nilikuwa nalala kwenye chandarua chenye joto sana kila siku

while my cousins, they were allowed to sleep

wakati binamu zangu,waliruhusiwa kulala

out on the terrace and have

nje kwenye mitaro na

this nice, cool night breeze wafting over them.

kupata hewa nzuri ya usiku.

And I really hated the mosquitos for that.

Na nilichukia sana mbu kwa hilo.

But at the same time, I come from a Jain family,

Lakini wakati huohuo,nilitokea katika familia ya Jain,

and Jainism is a religion that espouses

na dini ya jaini inaunga mkono

a very extreme form of nonviolence.

sana aina ya kutofanya fujo.

So Jains are not supposed to eat meat.

Watu wa dini ya jain hawaruhusiwi kula nyama.

We're not supposed to walk on grass,

Hatutakiwi kutembea kwenye nyasi,

because you could, you know,

kwa sababu unaweza

inadvertently kill some insects when you walk on grass.

kuua wadudu unapotembea kwenye nyasi.

We're certainly not supposed to swat mosquitos.

Haturuhusiwi kuwaua mbu.

So the fearsome power of this little insect

Uoga wa kumuogopa mdudu huyu mdogo

was apparent to me from a very young age,

ulianza tangu nilipokuwa na umri mdogo,

and it's one reason why I spent five years as a journalist

na ndiyo sababu kwanini nimetumia miaka mitano kama mwandishi wa habari

trying to understand, why has malaria

nikijaribu kuelewa,kwanini malaria

been such a horrible scourge for all of us for so very long?

imekua adui mbaya sana kwetu sote kwa muda mrefu?

And I think there's three main reasons why.

Na nafikiri kuna sababu kuu tatu ni kwanini.

Those three reasons add up to the fourth reason,

Hizo sababu tatu zinaingizwa kwenye sababu ya nne,

which is probably the biggest reason of all.

ambayo inawezekana ndiyo sababu kubwa kuliko zote.

The first reason is certainly scientific.

Sababu ya kwanza ni ya kisayansi.

This little parasite that causes malaria,

Mdudu huyu mdogo anayesababisha malaria,

it's probably one of the most complex

ni mmoja wa vijidudu watata

and wily pathogens known to humankind.

wanaojulikana kwa mwanadamu.

It lives half its life inside the cold-blooded mosquito

Anaishi nusu ya maisha yake katika mbu mwenye damu baridi

and half its life inside the warm-blooded human.

na nusu nyingine ndani ya binadamu mwenye damu vuguvugu.

These two environments are totally different,

Haya mazingira mawili ni tofauti kabisa,

but not only that, they're both utterly hostile.

lakini si hivyo tu,yana uhamasa mkubwa sana.

So the insect is continually trying to fight off the parasite,

Kwa hiyo mdudu anaendelea kujaribu kupambana na vimelea,

and so is the human body continually trying to fight it off.

na binadamu nae anaendelea kupambana na vimelea.

This little creature survives under siege like that,

Mdudu anaendelea kuishi pamoja na mashambulizi haya,,

but not only does it survive, it has thrived.

sio tu anaishi,anastawi pia.

It has spread. It has more ways to evade attack than we know.

Amesambaa.Ana njia nyingi za kukimbia kushambuliwa zaidi ya tunavyojua.

It's a shape-shifter, for one thing.

Huwa vinabadili umbo,kwa kitu kimoja

Just as a caterpillar turns into a butterfly,

Kama vile funza anavyobadilika kuwa kipepeo,

the malaria parasite transforms itself like that

vimelea vya malaria vinajibadili kwa aina hiyo

seven times in its life cycle.

mara saba katika maisha yake.

And each of those life stages not only looks totally different from each other,

Na hatua hizo zote za maisha sio tu zipo tofauti,

they have totally different physiology.

zina mfumo wa tofauti kabisa.

So say you came up with some great drug

Kwa hiyo tuseme unagundua dawa nzuri sana ya kutibu

that worked against one stage of the parasite's life cycle.

inayopambana na hatua moja ya maisha ya vimelea hivi.

It might do nothing at all to any of the other stages.

Haitafanya kazi katika hatua nyingine yoyote.

It can hide in our bodies, undetected,

Vitajificha kwenye miili yetu,bila kugundulika,

unbeknownst to us, for days, for weeks,

bila kujulikana ,kwa siku,kwa wiki kadhaa,

for months, for years, in some cases even decades.

kwa miezi,kwa miaka,na wakati mwingine hadi kwa miongo.

So the parasite is a very big scientific challenge to tackle,

Kwa hiyo vimeleani changamoto kubwa sana kuishinda,

but so is the mosquito that carries the parasite.

mbu ambaye ndiye anaambukiza malaria.

Only about 12 species of mosquitos

aina 12 tu za mbu

carry most of the world's malaria,

zinabeba malaria yanayoambukizwa duniani

and we know quite a bit about the kinds of

na tunajua kidogo tabia ya

watery habitats that they specialize in.

umajimaji waliyozoea

So you might think, then, well, why don't we just

Kwa hiyo unaweza fikiria,kwanini

avoid the places where the killer mosquitos live? Right?

tusiepukane na sehemu ambazo mbu wanaishi?Sawa?

We could avoid the places where the killer grizzly bears live

Tunaweza epuka wanapoishi dubu

and we avoid the places where the killer crocodiles live.

na tunaweza epuka sehemu ambapo mamba anaishi.

But say you live in the tropics

Lakini tuseme unaishi kwenye maeneo ya tropiki

and you walk outside your hut one day

na unatoka nje ya tembe yako siku moja

and you leave some footprints in the soft dirt

na unaacha alama za miguu kwenye uchafu laini

around your home.

karibu na nyumbani kwako.

Or say your cow does, or say your pig does,

Au tuseme ng'ombe wako kafanya hivyo,au nguruwe kafanya hivyo,

and then, say, it rains,

na baadaye mvua ikanyesha,

and that footprint fills up with a little bit of water.

na hizo alama za miguu zikajaa maji.

That's it. You've created the perfect

Unakuwa umetengeneza

malarial mosquito habitat that's right outside your door.

makazi mazuri sana nje ya nyumba yako.

So it's not easy for us to extricate ourselves from these insects.

Inakuwa sio rahisi kuondokana na mbu.

We kind of create places that they love to live

Tunatengeneza sehemu wanazopendelea kuishi

just by living our own lives.

kwa kuishi maisha yetu.

So there's a huge scientific challenge,

Kwa hiyo kuna changamoto kubwa sana ya kisayansi

but there's a huge economic challenge too.

lakini kuna changamoto kubwa sana ya kiuchumi.

Malaria occurs in some of the poorest

Malaria inatokea katika sehemu masikini sana

and most remote places on Earth,

na sehemu za nje ya miji duniani,

and there's a reason for that.

na kuna kwa hilo.

If you're poor, you're more likely to get malaria.

Kama wewe ni masikini,una uwezekano mkubwa wa kupata malaria.

If you're poor, you're more likely to live

Kama wewe ni masikini,una uwezekano mkubwa wa kuishi

in rudimentary housing on marginal land that's poorly drained.

katika makazi duni katika ardhi ambayo ni yenye madimbwi mengi.

These are places where mosquitos breed.

Hizi ndizi sehemu ambapo mbu wanazaliana.

You're less likely to have door screens or window screens.

Uwezekano wa kuwa na nyavu za mbu milangoni na madirishani unakuwa mdogo.

You're less likely to have electricity

Uwezekano wa kuwa na umeme, unakuwa mdogo.

and all the indoor activities that electricity makes possible,

na shughuli zote ambazo zinawezeshwa na umeme ndani ya nyumba,

so you're outside more.

unakuwa upo nje zaidi.

You're getting bitten by mosquitos more.

Unang'atwa na mbu.

So poverty causes malaria,

Kwa hiyo tunaona umasikini unasababisha malaria,

but what we also know now is that malaria itself

lakini tunajua sasa kwamba malaria yenyewe

causes poverty.

inasababisha umasikini.

For one thing, it strikes hardest during harvest season,

Kwa kitu kimoja,huwa inakumba muda wa mavuno,

so exactly when farmers need to be out in the fields

muda uleule ambapo wakulima wanakuwa mashambani

collecting their crops, they're home sick with a fever.

kuvuna mazao yao,wanakuwa nyumbani wakiumwa homa.

But it also predisposes people to death

Lakini pia inawaweka watu katika hatari ya kifo

from all other causes.

kutokana sababu nyingine zote.

So this has happened historically.

Hili limetokea kihistoria.

We've been able to take malaria out of a society.

Tumeweza kuondoa malaria kwa jamii.

Everything else stays the same,

Kila kitu kinabaki vilevile,

so we still have bad food, bad water, bad sanitation,

tuna chakula kibaya,maji yasiyo salama,mazingira bora,

all the things that make people sick.

na haya yote yanasababisha watu kuumwa.

But just if you take malaria out,

Lakini kama utaondoa malaria,

deaths from everything else go down.

vifo kutokana na sababu nyingine vitapungua.

And the economist Jeff Sachs has actually quantified

Na mwanauchumi Jeff Sachs ameonesha

what this means for a society.

hii ina maana gani kwa jamii.

What it means is, if you have malaria in your society,

Inachomaanisha ni kwamba,kama una malaria katika jamii yako,

your economic growth is depressed

ukuaji wako wa uchumi unadidimia

by 1.3 percent every year,

kwa asilimia 1.3 kila mwaka,

year after year after year, just this one disease alone.

mwaka baada ya mwaka,kwa hili gonjwa moja tu.

So this poses a huge economic challenge,

Hii inaleta changamoto kubwa sana ya kiuchumi,

because say you do come up with your great drug

kwa sababu unasema umeleta dawa bora

or your great vaccine -- how do you deliver it

au chanjo bora-- unaitoa vipi

in a place where there's no roads,

kwenye sehemu ambazo hazina barabara,

there's no infrastructure,

hazina miundombinu,

there's no electricity for refrigeration to keep things cold,

hazina umeme kwa kugandisha vitu kwenye jokofu,

there's no clinics, there's no clinicians

hazina zahanati,hazina wataalamu wa afya.

to deliver these things where they're needed?

kutoa huduma hizi zinapohitajika

So there's a huge economic challenge in taming malaria.

Kwa hiyo kuna changamoto kubwa katila kupambana na malaria.

But along with the scientific challenge and the economic challenge,

Lakini pamoja na changamoto ya kisayansi na changamoto ya kiuchumi,

there's also a cultural challenge,

kuna changamoto ya kitamaduni pia,

and this is probably the part about malaria

na hii moja ya upande wa malaria

that people don't like to talk about.

ambayo watu hawapendelei kuiongelea.

And it's the paradox that the people

na ni mkanganyiko kwamba watu

who have the most malaria in the world

wenye malaria sana duniani

tend to care about it the least.

wanalichukulia hawajali kwa uzito.

This has been the finding of medical anthropologists again and again.

Haya yamekuwa matokeo ya tafiti za wataalamu wa afya tena na tena.

They ask people in malarious parts of the world,

Wanawauliza watu katika sehemu zenye malaria duniani,

"What do you think about malaria?"

"Unafikiri nini kuhusu malaria?"

And they don't say, "It's a killer disease. We're scared of it."

Na hawasemi"Ni ugonjwa unaoua.Tunauogopa"

They say, "Malaria is a normal problem of life."

Wanasema"Malaria ni tatizo la kawaida katika maisha"

And that was certainly my personal experience.

Haya ndiyo majibu niliyopata binafsi.

When I told my relatives in India

Nilipowaambia ndugu zangu nchini India

that I was writing a book about malaria,

kwamba nilikuwa nikiandika kitabu kuhusu malaria

they kind of looked at me like

waliniangalia kama

I told them I was writing a book about warts or something.

Niliwaambia nilikuwa naandika kitabu kuhusu majipu au kitu fulani.

Like, why would you write about something so boring,

kama,kwanini uandike kuhusu kitu kinachochosha.

so ordinary? You know?

cha kawaida sana?unajua?

And it's simple risk perception, really.

Na ni muonekano rahisi lakini ni hatari.

A child in Malawi, for example,

Mtoto nchini Malawi,kwa mfano,

she might have 12 episodes of malaria before the age of two,

Anaweza akaugua malaria mara 12 kabla hajafika umri wa miaka miwili,

but if she survives,

lakini anaishi,

she'll continue to get malaria throughout her life,

ataendelea kupata malaria maisha yake yote,

but she's much less likely to die of it.

lakini uwezekano wa kufa kwa ugonjwa huo ni mdogo sana kwake.

And so in her lived experience,

Kwa katika kuishi kwake,

malaria is something that comes and goes.

malaria ni kitu kinachokuja na kuondoka.

And that's actually true for most of the world's malaria.

Na hiyo ni kweli kwa malaria duniani.

Most of the world's malaria comes and goes on its own.

Malaria sehemu nyingi huja na kuondoka.

It's just, there's so much malaria

Ni kwamba,kuna malaria sana

that this tiny fraction of cases that end in death

kwamba sehemu hi ndogo ya matukio yanayopelekea kifo

add up to this big, huge number.

yanaongezeka kuwa katika namba kubwa.

So I think people in malarious parts of the world

Kwa hiyi nadhani watu katika sehemu zenye malaria

must think of malaria the way

wanatakiwa kufikiri malaria katika njia

those of us who live in the temperate world

ambayo sisi tunaoishi kwenye baridi

think of cold and flu. Right?

tunafikiri kifua na mafua.Sawa?

Cold and flu have a huge burden on our societies

Mafua na kifua vina mzigo mkubwa sana katika jamii yetu

and on our own lives,

na katika maisha yetu,

but we don't really even take

lakini hatuchukui

the most rudimentary precautions against it because

tahadhari zozote kwa sababu

we consider it normal to get cold and flu

tunaona ni kawaida kupata mafua na kifua

during cold and flu season.

wakati wa nyakati za baridi.

And so this poses a huge cultural challenge in taming malaria,

Hii inaleta changamoto kubwa ya kitamaduni katika kupambana na malaria

because if people think it's normal to have malaria,

kwa sababu kama watu wanadhani ni kawaida kuwa na malaria,

then how do you get them to run to the doctor

sasa kwa nini wanaenda kwa daktari

to get diagnosed, to pick up their prescription,

kwenda kupimwa,kuandikiwa dawa wanazotakiwa tumia,

to get it filled, to take the drugs,

kuchukua dawa zao,

to put on the repellents, to tuck in the bed nets?

kuweka vifukuza mbu,kutumia chandarua?

This is a huge cultural challenge in taming this disease.

Hii inafanya kuendelea kuifuga malaria

So take all that together.

Kwa hiyo chukua yote hayo.

We've got a disease. It's scientifically complicated,

Tuna ugonjwa.Kisayansi umefumbika,

it's economically challenging to deal with,

una changamoto ya kiuchumi,

and it's one for which the people who stand

na ndiyo watu ambao wanaosimama

to benefit the most care about it the least.

kufaidika wanaujali kwa hali ya chini sana.

And that adds up to the biggest problem of all,

Na hiyo inaongeza tatizo kubwa sana katika yote,

which, of course, is the political problem.

ambapo,kiukweli,ni tatizo la kisiasa.

How do you get a political leader to do anything

Unampata wapi kiongozi wa siasa kufanya chochote

about a problem like this?

kwa tatizo kama hili?

And the answer is, historically, you don't.

Na jibu ni kwamba,kihistoria,huwezi.

Most malarious societies throughout history

Jamii nyingi zenye malaria kwa kipindi chote

have simply lived with the disease.

wameishi na ugonjwa.

So the main attacks on malaria have come

Kwa hiyo mashambulizi halisi kwenye malaria yametokea

from outside of malarious societies,

nje ya jamii zenye malaria,

from people who aren't constrained

kutoka kwa watu ambao hawalazimishwi

by these rather paralyzing politics.

na hizi siasa zilizokufa.

But this, I think, introduces a whole host of other kinds of difficulties.

Lakini,nadhani,inaongeza aina nyingine za ugumu.

The first concerted attack against malaria

Shambulio la kwanza la kuangamiza malaria

started in the 1950s.

lilianza mwakani 1950.

It was the brainchild of the U.S. State Department.

Ilikuwa ni mpangi uliosimamiwa na serikali.

And this effort well understood the economic challenge.

Na hizi juhudi zingekuwa na gharama sana kiuchumi.

They knew they had to focus on cheap, easy-to-use tools,

Walijua wanatakiwa kutumia zana na njia nafuu,

and they focused on DDT.

wakawaza kutumia DDT.

They understood the cultural challenge.

Walielewa changamoto ya kitamaduni.

In fact, their rather patronizing view was that

Kiukweli,mtazamao wao badala shupavu ulikuwa

people at risk of malaria shouldn't be asked to do anything at all.

watu waliopo katika hatari ya malaria hawakutakiwa kufanya chochote kabisa.

Everything should be done to them and for them.

Kila kilitakiwa wafanyiwe.

But they greatly underestimated the scientific challenge.

Lakini walididimiza sana changamoto ya kisayansi.

They had so much faith in their tools

Walikuwa na imani katika zana zao

that they stopped doing malaria research.

ambapo wakaacha kufanya tafiti za malaria.

And so when those tools started to fail,

na wakati zana hizo zilipoanza kufeli,

and public opinion started to turn against those tools,

na maoni ya watu yakaanza kuziponda zana hizo,

they had no scientific expertise to figure out what to do.

hawakauwa na wataalamu wa kisayansi kugundua ni lipi la kufanya.

The whole campaign crashed, malaria resurged back,

Kampeni hiyo ikaharibika,malaria ikarudi tena,

but now it was even worse than before

lakini sasa ni mbaya sana kuliko mwanzoni

because it was corralled into the hardest-to-reach places

kwa sababu ilifanyika katika sehemu ngumu kufikia

in the most difficult-to-control forms.

katika njia ngumu za kudhibiti.

One WHO official at the time actually called that whole campaign

Mmoja wa wafanyakazi wa WHO aliita kampeni yote hii

"one of the greatest mistakes ever made in public health."

"moja ya kosa kubwa lililowahi fanyika katika sekta ya afya"

The latest effort to tame malaria started in the late 1990s.

Juhudi ya hivi karibuni ya kudhibiti malaria ilianza mwaka 1990.

It's similarly directed and financed primarily

Iliongozwa na kupewa msaada wa kifedha

from outside of malarious societies.

kutoka katika jamii zisizo na malaria.

Now this effort well understands the scientific challenge.

Juhudi hizi sasa zinatambua kabisa changamoto ya kisayansi.

They are doing tons of malaria research.

Wanafanya tafiti nyingi sana za malaria.

And they understand the economic challenge too.

Na wanaelewa changamoto ya kiuchumi pia.

They're focusing on very cheap, very easy-to-use tools.

Wanatumia vifaa nafuu sana na rahisi kutumia.

But now, I think, the dilemma is the cultural challenge.

Lakini sasa,nafikiri,njia panda ni changamoto ya ktamaduni.

The centerpiece of the current effort is the bed net.

Juhudi za sasa ni chandarua.

It's treated with insecticides.

Kinawekewa dawa ya kuua mbu.

This thing has been distributed across the malarious world

Hiki kitu kimesambazwa kote katika sehemu zenye malaria

by the millions.

kwa mamilioni.

And when you think about the bed net,

Na unapofikira kuhusu chandarua,

it's sort of a surgical intervention.

ni aina ya kuingilia upasuaji.

You know, it doesn't really have any value

Unajua,haiongezi kitu chochote

to a family with malaria except that it helps prevent malaria.

kwenye familia yenye malaria bali inasaidia kujikinga tu na malaria.

And yet we're asking people to use these nets every night.

Na tunawaambia watu watumie vyandarua kila usiku.

They have to sleep under them every night.

Wanatakiwa walale kwenye vyandarua kila usiku.

That's the only way they are effective.

Na hivyo ndiyo njia pekee bora.

And they have to do that

Na wanatakiwa kufanya hivyo

even if the net blocks the breeze,

na hata kama chandarua kinazuia upepo mwanana,

even if they might have to get up in the middle of the night

hata kama watatakiwa kuamka katikati ya usiku

and relieve themselves,

na kujipooza,

even if they might have to move all their furnishings

hata kama watatakiwa kutoa vyombo vyao vyote

to put this thing up,

ili kuweka chandarua,

even if, you know, they might live in a round hut

hata kama,unajua,wanaweza kuwa wanaishi kwenye nyumba za tembe za mviringo

in which it's difficult to string up a square net.

ambapo ni ngumu kuweka chandarua ya pembe nne.

Now that's no big deal if you're fighting a killer disease.

Sasa,hiyo haina maana kama unapambana na ugonjwa unaoua.

I mean, these are minor inconveniences.

Namaanisha,huu ni usumbufu mdogo.

But that's not how people with malaria think of malaria.

Lakini sivyo watu wenye malaria wanafikiri kuhusu malaria.

So for them, the calculus must be quite different.

Kwao,itakuwa tofauti kidogo.

Imagine, for example, if a bunch of well-meaning Kenyans

Fikiri,kwa mfano,kundi la Wakenya wenye nia njema

came up to those of us in the temperate world and said,

wakaja kwa sisi tuliopo katika nchi za baridi na wakasema,

"You know, you people have a lot of cold and flu.

"Unajua,nyie watu mna mafua na kifua sana.

We've designed this great, easy-to-use, cheap tool,

Tumetangeneza hiki kifaa bora kabisa ambacho ni nafuu na rahisi kutumia,

we're going to give it to you for free.

tutawapa bure.

It's called a face mask,

Inaitwa kinyago cha sura,

and all you need to do is

na mnachohitaji ni

wear it every day during cold and flu season

kuvaa kila siku wakati wa kifua na mafua

when you go to school and when you go to work."

mnapoenda shule na mnapoenda kazini"

Would we do that?

Tutafanya hivyo?

And I wonder if that's how people

Na nashangaa kama ni hivyo kwa watu

in the malarious world thought of those nets

katika sehemu zenye malaria wanafikiria hivi kwa hivyo vyandarua

when they first received them?

wanapovipokea?

Indeed, we know from studies

Tunajua kutoka katika tafiti

that only 20 percent of the bed nets

kwamba asilimia 20 ya vyandarua

that were first distributed were actually used.

ambazo zimesambazwa ndiyo zinazotumika.

And even that's probably an overestimate,

Na hiyo imepigia hesabu za juu sana,

because the same people who distributed the nets

kwa sababu watu haohao wanaosambaza vyandarua

went back and asked the recipients,

walirudi na kuwauliza watumiaji,

"Oh, did you use that net I gave you?"

"mmetumia vyandarua nilivyowapa?"

Which is like your Aunt Jane asking you,

Ni sawa na shangazi yako Jane anakuuliza,

"Oh, did you use that vase I gave you for Christmas?"

"Umetumia chombo nilichokupa kwa ajili ya Krismas?"

So it's probably an overestimate.

Kwa hiyo ni makadirio ya juu.

But that's not an insurmountable problem.

Lakini si kwamba tatizo suala la kupuuzia.

We can do more education,

Tunaweza kutoa elimu zaidi,

we can try to convince these people to use the nets.

tunaweza kuwashawishi hawa watu kutumia vyandarua.

And that's what happening now.

Na hicho ndicho kinachotokea sasa.

We're throwing a lot more time and money

Tunatumia muda na hela nyingi sana

into workshops and trainings and musicals and plays

katika warsha na mafunzo na matamasha na michezo

and school meetings,

na vikao mashuleni,

all these things to convince people

haya yote kushawishi watu

to use the nets we gave you.

kutumia vyandarua tulivyowapa.

And that might work.

Na hiyo inaweza kufanya kazi.

But it takes time. It takes money.

Lakini inatumia muda.Inagharimu pia.

It takes resources. It takes infrastructure.

Inatumia rasilimali.Inatumia miundombinu.

It takes all the things that that cheap,

Inachukua vitu vyote nafuu,

easy-to-use bed net was not supposed to be.

ambazo vyandarua havikutakiwa.

So it's difficult to attack malaria from inside malarious societies,

Kwa hiyo ni ngumu kushambulia malaria kutoka ndani ya jamii yenye malaria,

but it's equally tricky when we try to attack it

Lakini inakuwa kidogo changamoto unapojaribu kushambulia malaria

from outside of those societies.

kutoka nje ya jamii hizo.

We end up imposing our own priorities

Tunaweka vipaumbele vyetu

on the people of the malarious world.

katika jamii ya watu wenye malaria.

That's exactly what we did in the 1950s,

Na hiki ndicho tulichofanya mwaka 1950.

and that effort backfired.

na hizo juhudi zilishindikana.

I would argue today,

Nitasema leo,

when we are distributing tools that we've designed

tunaposambaza vifaa ambavyo tumetengeneza

and that don't necessarily make sense in people's lives,

na ambavyo havina maana katika maiasha ya watu,

we run the risk of making the same mistake again.

tunajiweka katika hali ya kufanya kosa lingine.

That's not to say that malaria is unconquerable,

Hiyo si kusema malaria kwamba hatuwezi kuishinda Malaria,

because I think it is,

kwa sababu nadhani tunaweza,

but what if we attacked this disease

lakini inakuwaje kama tukishambulia gonjwa hili

according to the priorities of the people who lived with it?

kutokana na vipaumbele kwa watu walioishi nao?

Take the example of England and the United States.

Chukua mfano wa Uingereza na Marekani.

We had malaria in those countries for hundreds of years,

Tulikuwa na ugonjwa huo katika hizo nchi kwa mamia ya miaka,

and we got rid of it completely,

na tukaondokana nalo kabisa,

not because we attacked malaria. We didn't.

sio kwamba tulishambulia malaria.Hapana.

We attacked bad roads and bad houses

Tulishambulia barabara mbovu na nyumba mbovu

and bad drainage and lack of electricity and rural poverty.

na utoaji majitaka mbaya na ukosefu wa umeme na umasikini sehemu za vijijini.

We attacked the malarious way of life,

Tulishambulia maisha ya kuwa na malaria,

and by doing that, we slowly built malaria out.

na kwa kufanya hivyo,taratibu tukaondoa malaria.

Now attacking the malarious way of life,

Sasa kushambulia maisha ya ki-malaria,

this is something -- these are things people care about today.

hiki ni kitu-hivi ni vitu watu wanavyojala leo.

And attacking the malarious way of life,

Na kushambulia maisha ya kuishi na malaria,

it's not fast, it's not cheap, it's not easy,

sio haraka,sio nafuu,sio rahisi,

but I think it's the only lasting way forward.

lakini nafikiri ni njia pekee ya kusonga mbele.

Thank you so much.

Asante sana

(Applause)

(Makofi)