
Meant to Keep Mosquitos Out, Nets Are Used to Haul Fish In - danso
http://www.nytimes.com/2015/01/25/world/africa/mosquito-nets-for-malaria-spawn-new-epidemic-overfishing.html
======
nostromo
Sometimes I feel that the western fascination with Malaria is a little
misplaced. Actual Africans speak about Malaria like we speak about Influenza:
a treatable illness that only kills the very old and very young.

Actually Flu and Malaria kill roughly about the same number of people globally
each year. Imagine if African billionaires showed up on our shores one day and
started handing out respirators and face masks to Americans. "Just everyone
wear these all winter and you won't catch the flu! So many lives would be
saved!" We might use them to go fishing as well.

~~~
samirmenon
According to the WHO, malaria kills almost 500,000 children under 5 each year
globally, though the vast majority (~90%) of these deaths are in Africa. [1]

In the US, 3,000-49,000 people die each year from the flu.[2]

Clearly, the scales are not comparable.

[1]
[http://www.who.int/malaria/media/world_malaria_report_2013/e...](http://www.who.int/malaria/media/world_malaria_report_2013/en/)

[2]
[http://www.cdc.gov/flu/about/qa/disease.htm#deaths](http://www.cdc.gov/flu/about/qa/disease.htm#deaths)

~~~
nostromo
> globally

vs.

> in the US

Speaking of incomparable scales...

~~~
rev_bird
Time to break out some napkin math:

627,000 malaria deaths * 90% in sub-Saharan Africa[1] = 564,000 malaria deaths
in sub-Saharan Africa.

564,000 deaths / population of Africa (~815 million) = __69.2 African malaria
deaths per 100,000 people __.

\--

About 32,743 U.S. flu deaths per year, recently.[2]

32,742 deaths / population of U.S. (~316 million) = __10.4 U.S. flu deaths per
100,000 people __.

\--

It looks like, by these numbers, that malaria in Africa is about 6.7 times as
deadly as the flu in America.

[1]
[http://www.who.int/malaria/media/world_malaria_report_2013/e...](http://www.who.int/malaria/media/world_malaria_report_2013/en/)

[2]
[http://www.npr.org/blogs/health/2010/08/26/129456941/annual-...](http://www.npr.org/blogs/health/2010/08/26/129456941/annual-
flu-death-average-fluctuates-depending-on-how-you-slice-it)

~~~
adventured
Not to mention, we can eliminate an extreme majority of malaria deaths, and we
can do so at a relatively low cost per person. Something the parent is
ignoring entirely.

------
scott_ci
I've heard public health people talk about the problem of giving away nets for
free before, and that charging some amount of money seems to improve usage. It
may be more than just the decision between starving and malaria, but also some
psychology involved with getting free things.

~~~
schiffern
How about… address the food insecurity first?

The symptom is that people are misusing nets. The problem is that they have no
sustainable food system.

~~~
vinceguidry
That turns out to be surprisingly hard to do as well. You can't just ship free
food in, strongmen will capture it and put it to their own use. Nets, being
less fungible in their value, are ultimately less likely to be misused.

~~~
schiffern
>You can't just ship free food in

Agreed, that doesn't qualify as a sustainable food system.

~~~
vinceguidry
We need easy solutions because hard solutions won't scale. We can't create
modern economies in places that don't have the infrastructure. We tried doing
that once, it's called colonialism and it generally sucked. Your "sustainable
food system" is something we can't give to people.

~~~
schiffern
>Your "sustainable food system" is something we can't give to people.

No argument there. They need _their own_ sustainable food system.

We all do, if humanity is to continue (which is all "sustainable" means — able
to continue).

How could humanity possibly continue without a sustainable food system? Am I
missing something? This seems pretty uncontroversial.

~~~
vinceguidry
I'm having trouble understanding what you're hoping to bring to the
conversation. The basic problem is this. There are a great deal of resources
that can be brought to bear on solving problems in the world. There are lots
of philanthropists in the world, with lots of money.

The problem is picking the right problem. There are big problems, like hunger.
No matter how many resources you have, you're never going to make a dent in
world hunger.

There are smaller problems, like dam building. One could, conceivably, build
all the dams in the world that need to be built. But just like the big
problems, there's never going to be any shortage of these smaller problems to
solve, and each effort needs to be managed and championed.

So you can't just solve all of them. You have to pick one at a time and throw
everything you have at it. The problem is not resources, but ideas. We need
really good ideas for how best to go about making the world a better place. A
good idea needs to be simple, because it has to be scaled.

HN is a forum where one good idea could inspire someone to make a Kickstarter
campaign, that could attract the attention of someone like Bill Gates, and
could improve the lives of potentially millions of people. I wish more people
took that seriously.

Malaria nets have their problems. But they've also helped eradicate malaria in
many places. People look at stories like this and they think, "aww that was a
stupid idea anyway! Silly billionaires." It's not a stupid idea. It's a great
one that we need more of.

~~~
schiffern
Sorry if I was unclear. I'm not blaming the billionaires _or_ the users of the
nets.

You seem to be viewing the less-industrialized world as a philanthropic
playground for the rich. Naomi Klein's comments about Richard Branson's
climate prize seem especially pertinent here.
[https://www.youtube.com/watch?v=Jdaxehd0cF0#t=2m44s](https://www.youtube.com/watch?v=Jdaxehd0cF0#t=2m44s)

~~~
vinceguidry
> viewing the less-industrialized world as a philanthropic playground for the
> rich

So, you have nothing to bring to the discussion other than some silly
moralizing.

If Richard Branson could fix global warming while keeping a silly grin on his
face, tossing around a beach ball, would you pat him on the back like he's
expecting you to do and tell him how great he is, or would you rather he just
sit down and shut his stupid face because obviously global warming won't
respond to such a simplistic approach? Even if it does?

~~~
schiffern
Morality does play a part here, but what you took for "moralizing" is me
pointing out how the framing of the question constrains the answer.
Specifically this passage:

>>>The basic problem is this. There are a great deal of resources that can be
brought to bear on solving problems in the world. There are lots of
philanthropists in the world, with lots of money.

Yes, those things are true. There are also _people_ over there, and their
participation matters at least as much as (and I would argue much more than)
that of the wealthy elite.

In the case of the "carbon-sucking gizmo", the cure is worse than the disease.
Even Branson-level cash can't change thermodynamics and evolution.

The Virgin Challenge finalists are conspicuously absent in their energy and
land use analyses. I expect they suffer from the same problems as previous CCS
"solutions" — energetically they can't compete with simply shutting down a
coal plant, and in land use they can't compete with reseeding farmland to
forest. So when you understand why those simpler methods aren't done, you'll
understand the finalist's actual scaling problem.

It all washes out in the lifecycle analysis. Anything else is feel-good.

------
amelius
Solution: besides giving out mosquito nets, also give out fishing nets...

~~~
Ygg2
That's a non solution. Giving them nets and fishing nets will only make then
sell the fishing nets and using the mosquito nets for their fishing needs.

One solution is to look for another solution. Like a genetically modified
mosquito that is inhospitable to malaria and outcompetes regular mosquito.

Other is to try stabilizing the region.

~~~
maaku
Or destroy all mosquitoes.

~~~
DanBC
You don't even need to do that. It's only one species of mosquito that is a
problem.

------
swatow
I studied health economics a bit, and the article does a really good job of
covering all the bases. This really isn't a question that can be answered with
grand theories e.g. "Just give them money", "Africa needs low tech solutions"
or "White people always create more problems" (actually the first theory might
be true, I just haven't seen much specific evidence regarding malaria).

A summary of the background facts are

\- Malaria is a big problem. \- Mosquito nets prevent malaria \- It's hard to
get people to use mosquito nets.

I think the key takeaways from the article are that (1) the proponents of
mosquito nets aren't convinced that the scale of this problem is big enough to
offset the overall positive effect of free mosquito nets. But (2) critics of
mosquito nets suspect that proponents have too much psychologically (and
financially?) invested in the mosquito net solution to consider alternatives.
E.g. this interesting quote:

 _> Dr. Lehman, the American physician on Lake Tanganyika, wonders if there
might be better malaria solutions for waterside communities. Specially treated
wall coverings? Custom-fit window screens? “Why is this question not being
asked?” she said, a bit exasperated. “Is it that we don’t really want to know
the answer?”_

------
cmsmith
It seems like there is an opportunity here for a mosquito net that won't work
as a fishing net. Could a finer mesh be air-permeable enough but not water-
permeable? Or a fabric which degrades in strength when saturated with water?

~~~
nn3
Or just dissolves itself when soaked for too long. I'm sure there are
technical solutions to this.

Of course the problems first has to be acknowledged.

------
qj4714
I have travelled throughout Africa and looked at malaria activities and based
on my experience using malaria nets for fishing is purely anecdotal. It is
obviously not a good thing, but it is not a pervasive thing.

Of interest, people also use malaria nets for gardening. They are used as a
means to keeps bugs out of crops.

The more complicated issue is whether people are using the nets properly. It
takes discipline to correctly put the net over your body the entire night and
sleep under it.

------
intopieces
"The leading mosquito net manufacturers insist that their products are not
dangerous. Still, many nets are labeled: 'Do not wash in a lake or a river.'"

I'm interested to know what language this label was written in. Bemba? Nyanja?
Moreover, where did the manufacturers intend for Zambians to wash the nets?

~~~
sangnoir
Generally nets are not supposed to be washed with untreated water (doing so
will wash away the infused chemicals). If you are going to wash the net, you
are supposed to wash it in a bucket or any small container with treated water
to maintain potency.

------
Luyt
Would this be a solution to the problem? -> Make mosquito nets that
disintegrate when soaked in water.

~~~
backlava
Rain?

------
sighsighsigh
Sigh. SIGH.

How dare our charity be used for practicalities! We must over-engineer harder!
Only our brilliance can save poor, poor Africa!

Same nonsense I've been reading about since the 1800s. The Africans figured
out how to deal with public health a long, long time ago: spread your villages
and use air and time to isolate outbreaks. This has worked for longer than
human history has been recorded. And this technique has survived countless
imperial collapses as well.

We simply wish to mold Africa into an urban scheme because we don't know how
to bring "progress" without packing millions of people into city blocks. That
causes disease spreading, which puts diminishing returns on the urban scheme.
There's one city in Africa who loses about 1% GDP from city-based malaria
alone.

If you want to over architect something, the net isn't the problem. Learn to
engage in feel-good progressivism without the dependency of industrial
organization models. Billions of dollars to whoever figures it out first.

~~~
themodelplumber
As many problems as this particular net situation brings, it would be foolish
to step back and blame first world efforts. Further education is sorely
needed. As education seeps into these system, corruption and foolish decisions
are eventually called to account.

Africa is not a monolithic problem with identical inputs and outputs
everywhere. Assistance from first-world countries does actually make a
difference, and comes in many, many forms, from medical care to microloans to
security assistance and psychological trauma support.

------
Havoc
Welcome to Africa - one step forward two steps back.

~~~
perlgeek
Welcome to the wealthy nation's interactions with Africa. To think "we" can
tell people what problem they should solve (Malaria) when not even their food
supply is secured, that's just hubris.

Knowing Maslow's hierarchy of needs, it's Physiological needs (food) vs Safety
needs (Malaria protection). And the former are more basic, so expecting
anything else shows little foresight (easy to say in hindsight, I know).

~~~
frozenport
We solved other diseases without solving the food problem.

~~~
erroneousfunk
Yes, but you couldn't eat the vaccinations. This particular problem is caused
by the safety solution also, accidentally, doubling as a means to procure
food.

