SummaryA Peace Corps Volunteer and her host community reduced the incidence of malaria in the village of Ndiago by 90% through the use of locally made neem lotion in conjunction with her anti-malarial measures.
Context
Peace Corps Volunteer Kari Nelson lived in Ndiago, a small village of about 300 people, from 2007 to 2009. Though she had done various projects in her village – health lessons at the school, baby weighings, and a local radio show, among others - the most effective project with the most visible results was her anti-malaria campaign. There were a number of factors converging on her village regarding malaria prevention: mosquito net distributions by both the World Bank and USAID, the new availability of a rapid test for malaria at the health post so that only actual cases of malaria would be treated as such, and the beginning of a new locally instigated village cleanup project.
The Approach
 While Nelson believed the anti-malaria campaign would be effective, she wasn’t convinced that it would lead to a villager’s understanding as to why the rate of disease went down (and thereby give people a reason to continue these methods in the future). She also believed that further measures such as neem lotion (a local mosquito repellent made from neem tree leaves) and educational activities could bring down the rate even further. So, she hatched a plan to piggy-back off of the already occurring projects. She collected data on the prior year’s malaria rate as well as the direct costs of those cases of malaria.
It turned out that there had been 50 cases of malaria in Ndiago in 2007, costing villagers approximately 60,000cfa (about $135) in medical costs to cure these cases. She brought this information to the village’s attention and proposed a way to save them money. If they could pay 50cfa per person (about ten cents), they could make enough neem lotion mosquito repellent for the entire village. That, combined with the already mentioned efforts and some additional educational activities on her part, could reduce the malaria rate dramatically. The village followed through on their part of the bargain and Kari did hers. Several hundred individual sachets of neem lotion were made, weekly village cleanups were held, mosquito nets were distributed, and educational events were held.
Results
 By the end of the rainy season, the people were able to see the benefits of their work- there were only 6 cases of malaria diagnosed from my village- a 90% decrease. Now that is cause for celebration in Ndiago!
 Neem Lotion: A Project Evaluation
This study, by PCV Kari Nelson, based on her experience using neem lotion as mosquito repellent in her village in the Kaolack region, provides support to the proposition that neem could be used as an inexpensive, yet effective anti-malarial agent. For the villages included here, the use of neem lotion led to a significant decrease in the number of malaria cases, saving lives as well as livelihoods through the prevention of lost productivity due to illness.
There are both research and programmatic implications for these results. For researchers, it indicates that there is a great potential for further study into the effectiveness of neem based mosquito repellents and their applications in the fight against malaria. There is also the implication for more study of the surprising finding that even short distances from a health clinic might negatively impact a person’s willingness to seek medical assistance. On the programmatic side, there are implications that, if used in a wide-scale manner such as was done here (reaching the majority of citizens), neem lotion could prove to be an inexpensive but effective solution to high rates of malarial infection. | 
