Rolling out the nets
The last time I saw David was six months ago; he's now swapped Ghana's coastal, cocoa-growing Western region for the arid savannah of the Upper East region, but he's still doing the same job: getting DFID funded mosquito nets to some of Ghana's most remote and poorest communities.
Two children who will benefit from new mosquito nets
When I first met David last year, I was tracking the distribution of some of the 2.35 million mosquito nets DFID had provided in Ghana's Western and Central region (read my blog about it here and watch a video about the campaign here).
Most of Ghana's cocoa, and other resources like gold and timber, come from these two regions in Ghana, and their coastal location and large forested areas mean malaria is an ever-present problem.
As David explains as he takes me around Upper East, the story here is very different. For several months a year, the dry desert wind (known as the Harmattan) blows down from the Sahara into Northern Ghana and mosquitoes are therefore not as prevalent. But when the rains come, malaria returns, and these inaccessible communities in the poorest regions of Ghana are those that are worst affected.
An extended family in Namologo outside their house where their new nets have just been hung up
David takes me to a village called Namologo and I speak to Francis, one of the volunteers from the village who has been helping distribute the nets there. He explains what happens when he gets malaria: "I have difficulty breathing, my body is weak and cold, I can't eat".
Awuni Margaret has been the Community Health Nurse for Namologo and nine other villages for the last ten years. She's run outreach programmes and immunisation programmes, and is now supervising the mosquito net distribution. She continues Frances' story: "Malaria is the main problem, ahead of all the other cases". Even for those who get it in mild form and can try to go to work or school, "their productivity is low... and students are not able to catch up with their friends."
Francis' clinic has run out of rapid diagnostic tests for malaria, and severe cases have to be referred to the regional hospital, several hours' travel away. For those who don't have health insurance, or can't afford to pay the medical bills, this is a journey that might not even happen.
Eva and her child Sapana in front of her new net
Prevention then, is better than cure, and David explains to me how UNICEF and the Ghana Health Service have been working to distribute the 700,000 nets DFID provided for Upper East region, and make sure people use them.
The key to the campaign's success, he explains, will be social mobilisation. Not just telling people that they will be receiving nets, but actually getting volunteers to put them up inside people's houses and make sure recipients know how to use them, and why they are important.
Radio, word of mouth, even getting volunteers to stand on the rooftop of the tallest house in the village and shout - every method has been used to try and get the message across.
David's area of expertise is logistics and he relishes the challenges of working out how to get mosquito nets to Ghana's most inaccessible regions. He draws up microplans for reaching the farthest flung communities, and tells me about how he and his team "had to climb over rocky mountains to get to remote villages where vehicles can't go."
One mosquito net recipient peers out of the window in front of his new net
There's no doubt that these are the communities most in need of this protection from malaria. Most of those I spoke to had never had a mosquito net before, or if they had it was several years old or broken.
Eva is another beneficiary in the village, who received a net for the first time, and proudly poses in front of it for a photograph, holding her baby, Sapana. It's thanks to the work of people like David, Frances and Awuni Margaret that the net is now up inside her home. Hopefully, Eva and Sapana can sleep safely, protected from malaria beneath it.