The pesticide DDT, long banned in the United States, has made something of a comeback in Africa. DDT can be an effective weapon against malaria. The U.S. government, and the World Health Organization are encouraging African countries to use the insecticide, and say it is safe when handled properly. But in the East African nation of Uganda, DDT has provoked a fierce political battle. And the experience has taught a hard lesson: effective malaria control involves more than just fighting mosquitos.
"The World" reporter Alison Hawkes filed this report from northern Uganda.
Frogs signal the approaching dusk in the Ugandan district of Apac. The land here is flat and swampy, the climate equatorial. People here farm, and they fish from the wetlands that surround their mud and thatched houses.
The swamps are also a breeding ground for mosquitoes. The malaria rate here ranks among the highest in the world.
"It is one of our main, main killer diseases. And we cannot continue with this situation," said Alex Jurua, the local district representative for Uganda's President. "So we thought we needed to find a very quick way of destroying malaria -- totally. And that's why we went for DDT."
DDT. That's the pesticide made infamous by Rachel Carson in her 1962 book "Silent Spring." Back in the 1940s, '50s and '60s, the U.S. and other countries sprayed massive amounts of DDT on crops. The practice decimated bald eagles and other wildlife. DDT was then banned in most of the world.
But a half century ago, DDT had also been used to combat malaria. And in recent years some African countries have revived its use. The idea is to spray small amounts of the insecticide on the inside walls of homes, to kill the mosquitoes where they land before and after biting people.
The deputy head of Uganda's malaria control program, Myers Lugemwa says DDT was a logical choice.
It's effective, and it's cheap, he said, "To protect one person using DDT it costs $1.02 per year which is comparatively smaller if we were to use these other insecticides."
So with encouragement and financing from the United States, Uganda's government sent out spray teams last year to the swampy northern districts of Apac and Oyam. They wanted to see how this pilot project worked before taking DDT nationwide.
But what was intended as a campaign to protect the locals, the locals didn't perceive that way.
"They came with their chemicals and they were asking us to open our house, that they want to spray," said Betty Okullu, a second-hand clothing merchant in Apac. "I asked them, why do you want to spray my house? But they did not explain. Then I refused. I rejected. I told them I am not ready for it, unless you explain to me and I understand."
Okullu was far from the only person to be wary. Many farmers feared the DDT could ruin their livelihoods. A lot of farmers here grew organic cotton and sold it -- at a premium -- to the international market. After harvesting, they stored the crops in their homes -- in the very same space where the DDT was to be sprayed.
Alex Fokkens is a Dutch organic cotton buyer. He's worried the spraying would mean he'd no longer be able to sell the cotton to his European customers, "If they find out there are any traces of DDT, it would be sent back, and it would be a very big claim on us."
So proponents of organic agriculture mounted a vocal campaign to thwart the government's DDT plan. They took to the airwaves.
Journalist Ronald Odongo had some of the organic activists on his local radio show. He says they warned about more than just economic harm, "Women, they were told that if you allow DDT to be sprayed in your house in the next few years you would not be producing children. And they said DDT can make a man not produce."
In other words, they said DDT would make men impotent.
The health effects of DDT are not entirely clear. One study did find that it can cause impotence in laboratory rats. And some studies in people suggest it may decrease the quality of a man's sperm and increase a woman's risk of miscarriage. But other studies do NOT find those effects. Public health experts generally believe that if DDT poses potential health risks, they're far smaller than the known risks posed by malaria. But the Ugandan government didn't paint this nuanced picture of risks verses benefits.
Government officials portrayed DDT as completely harmless.
Alex Jurua, the president’s representative in Apac district is convinced of this, "My father actually tells me that in '60s they used to swallow DDT in order to kill worms, intestinal worms. I mean people could drink DDT and they are still living today."
Jurua said his father is still alive and well.
Many villagers didn't buy what the government was saying. They considered DDT an unacceptable risk, says radio journalist Ronald Odongo.
"In fact, according to them, they said they’d rather die of malaria than DDT."
As public concern grew, it wasn't long before politicians stepped into the fray.
"Your President wants to kill you all in broad daylight. I say this because DDT is a highly toxic chemical," said Ken Lukyamuzi.
Lukyamuzi is the charismatic leader of the conservative party -- a small but vocal opposition party in parliament.
On a YouTube video of one of his rallies, Lukyamuzi said, "You have fundamental human rights. You can fight for your freedom. You can protect yourself.
"Stand guard at your house, Get a saw, get a machete, get your axe. Don't attack anyone. Don't attack anyone -- but take a battle posture and see if the spray teams will dare to enter your house. And if anger should happen to seize you, who knows, the wind may even sweep your saw or machete out of your hands and hack whoever is trying to access your house."
In the end there was no violent uprising against the spray teams, but there was considerable resistance. And a group of organic companies sued the government. They won a court injunction that forced the DDT spraying to stop. And that means the malaria control effort was halted before it reached the entire district of Apac. The whole experience left government officials baffled and frustrated.
Myers Lugemwa of Uganda's Malaria Control Program is one of those frustrated officials, "The Ministry of Health is not naive. It's not a killer. There's no single reason why I would go in and kill people. For what reason?"
Those who fought DDT are also frustrated by the experience. Just the one round of spraying was enough to ruin the export market for the area's organic cotton, possibly for a decade or more.
"People are not happy. There is no money," said Richard Adoko.
Adoko, a struggling farmer, says he wishes the government had considered alternatives to DDT. He says the government could have handed out mosquito bed nets. Or it could have sprayed a different insecticide that wouldn’t have caused his crops to be rejected by the European cotton buyers.
But government officials, he says, never asked what people like him wanted, "They never consulted. It was only dictated. I would really advise them that please go by the majority. In a democratic society, you have to go by the majority."
The government hopes to begin another round of DDT spraying as early as this fall. But Adoko says if the government wants a different ending this time, it should begin by listening to what the locals have to say.
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