Azerbaijan: Preventing Measles and Rubella
By John Wendle
Two young boys run out to pull open the bright blue steel gates of the Zardabi Boarding School in the village of Zardabi in the Guba district in northern Azerbaijan.
Pulling into the school’s square of tired concrete, the children are shy until the driver, Ilgar, gets out and the kids recognize him. They all run over, surrounding him, shouting "salam!" and "hello" just as the bell rings. Waving to a girl of about 14, he asks, "up for another round of ping pong?" Explaining, he says, "I played ping pong with that little girl for three hours the last time we visited here."
Of 63 children at the orphanage, 54 of them had been vaccinated by March 1, the third day of the two week long immunization campaign against measles and rubella being carried out across Azerbaijan by local health services through the funding and direct support of UNICEF, the government of Azerbaijan, USAID and the Vishnevskaya Rostropovich Fund. The other nine children had been picked up by their parents. The director said they would be vaccinated when they returned to the orphanage.
The village of Zardabi is about a 20 minute drive from the center of Guba, the district capital. The rural community lies on the Guba-Hachmaz road and is surrounded by thousands of apple and alcha trees, lined in neat orchards. With winter’s cold and fog slowly burning away, young men work, turning over the earth at the base of each tree, or lie in the grass, talking to friends during lunch.
The boarding school lies just past the mosaic-covered arched gate that is the entrance of the village. The school is a whitewashed two story building sitting back from the road surrounded by a grassy and muddy yard and some tall pine trees. On one side of the front door hangs a "Xosh Galmishsiniz!" sign lettered in red, while an identical sign, reading "Welcome!" hands on the other.
Though the building is freshly painted and the sign in English gives the exterior a slightly optimistic appearance, the condition of the interior of the orphanage is deplorable. Though the front door was closed, the main hallway was as cold as outside, with the director’s breath puffing in the air as he led us to his office. Not only was it cold, but the floor of the orphanage, made of painted wood planks, is rotting. In the director’s office, heated by a coal burning stove and a hotplate, a police officer sat along with two women and another man.
Two of the oldest-looking boys from the yard came into the director’s office. Namik Husseinov, 16-years-old, is in the tenth grade. His friend Anar Fataliev, the same age, is in the ninth grade. They have both been in the orphanage for eight years. The two were the last to receive their rubella and measles vaccination.
In good spirits, as all the children seemed to be – even with dirt on their hands, Namik said that he was "happy to get the shot." He also said that although Anar didn’t want to get the shot, he talked his friend into it, saying "it’s important to get vaccinated."
The director of the orphanage smiled approvingly at his children. "Every day we have a short period of time during class where we talk about health issues. We have even educated the children about the dangers of bird flu."
Clad in an old sport jacket that mismatched his trousers and sporting large plastic-rimmed glasses in the Soviet style, the director said "We are also parents, so we know how important it is to get the right vaccinations." The rest of the adults in the room nodded in agreement.
With the collapse of the Soviet Union and the independence of Azerbaijan many social services have fallen away. However, during the Soviet era vaccinations were commonplace. For this reason, though there is excitement about the fact that international and national organizations and the government are funding a vaccination campaign, there is also a high level of education about what vaccinations are and people are willing to get them.
The children at the orphanage all knew why they had to get the vaccination, that it was against measles and rubella and that it was a good thing to do – some just did not like the idea of a needle being put in their arm.
Behind the school, one street down and tucked up a small road, sits the Zardabi Rural Health Clinic. The two story building is also cold but clean and orderly and though the wooden floors are painted Soviet orange, the doors Soviet blue and the walls Soviet white, everything is well maintained.
Dr. Merid Kahramanov, chief doctor of the health clinic, was in charge of vaccinating people the portion of the population not in schools but still within range of vaccinations. "We have vaccinated only 11 people over the last three days between the ages of 18 and 23. This low figure is a result of the fact that the recent campaign’s first priority was the schools and other institutions where children are concentrated, such as the Zardabi Boarding School. However, I think this number is reasonable and to be expected for such a small village."
Dr. Karahrhamanov also said he believed that the initiative to educate the population about the benefits of having their children vaccinated against measles and rubella had been successful. He said this partly because the adult population was educated in Soviet times about the advantages of getting vaccinations and partly because of what he saw during the first few days of the campaign, saying that one woman from the village "brought her two sons in because she had heard about the vaccination campaign on the TV."
After speaking in the hall under the watchful and smiling gaze of three nurses in their white lab coats and hygienic hats, Dr. Kahramanov went into his office and proudly pointed to his new UNICEF-provided cooler full of as-yet-unused vaccine. After showing the contents off and explaining that it ran off the town power supply and was backed-up by a generator, he said that he "wished to express his gratitude for the great contribution UNICEF has made to the children of Zardabi."