In Tajikistan, diphtheria vaccination reaches every child
By Parveena Muhammedkhajaeva
DUSHANBE, Tajikistan, 12 October 2012 – On an autumn afternoon in one of the most remote valleys nestled high up in the peaks of north Tajikistan, children rode on donkeys to help their families bring grass and wood for the winter.
Naumetkan village in Yaghnob Valley is located around 3,000 metres above sea level in Ayni district of Soghd province. It is virtually inaccessible for six months of the year. Only 22 of 170 villages still exist as many people have left the area. None of the villages have a school or a health clinic.
The only possibility to get education is placing children at boarding schools but families are reluctant to do so. When a child gets sick, it takes long hours to walk and, if any transport is available, to drive. Vaccination happens only with an effort of mobile teams facing a big challenge of walking and climbing into mountains to reach children.
Upon arrival at the end of September to Naumetkan, the vaccination mobile team was warmly greeted by the oldest member of the community, Sattorov Mirzo, aged 60 years. When he heard of the team’s mission, Mirzo called his grandchildren to get off the donkeys and get a life-saving vaccine against diphtheria. “This is a very busy time for us. Harvesting has started and we all work on the field. The best time to reach families here is early morning”, Mirzo reminded the health team.
Reaching the most disadvantaged children
Today, even Mirzo delayed the start of his working day. It was time for Sanginjon, his granddaughter, to be vaccinated against diphtheria, a deadly scourge that is easily preventable through immunization.
“Sanginjon has some speech disability. Her stepmother will have to help explain to her why she needs this immunization,” Mirzo said. He proudly recalled how he also arranged for Sanginjon to get social support to help her cope with her disability.
Initially, his granddaughter was reluctant to come out of the house. When her stepmother explained to her the purpose of the health workers’ visit, she extended her left hand to get a vaccine shot.
This year, UNICEF is closely working with the Government and other development partners to raise public awareness about the diphtheria vaccination campaign. Various social mobilization activities, including broadcasting of public service announcements on TV and radio will help to ensure every child and young people aged 13-21 years in the country is reached. UNICEF has also contributed with procurement of auto-disabled syringes and safety boxes, to ensure safe, single-time use for syringes or needles, as well as provision of additional cold chain equipment for safe storage and transportation of vaccines.
The Government of the Russian Federation made a generous grant of US$1 million through UNICEF, thus matching the Government of Tajikistan’s own allocation to this campaign amounting to TJS 5 million (equal to approximately US$ 1 million).
Focus on Equity: Door-to-Door Vaccination
Arriving in the mountainous areas of Tajikistan takes a lot of energy. The professional devotion of Dr. Soatov was crucial for the team`s success. With his 45 years of experience reaching the most remote areas of the district, he knows every household by name and easily counts how many children live in each village.
“We should come in the early morning to get the maximum number of children. But with Mirzo’s help, we can call children to come for vaccination at other times as they all listen to him with great respect”, said Dr. Soatov.
Thanks for Dr. Soatov’s efforts and dedication that every member of this community warmly received the mobile vaccination team.
“The only way of communication with this community is by door-to-door visits and through word of mouth. It remains the most effective way to ensure that each child is immunized with life-saving vaccines, both for routine immunizations and during the national campaigns,” he said.
A Promise Renewed: Immunizing Every Child
This effort dovetails with a global call to action A Promise Renewed to end preventable child deaths. Governments around the world, including Tajikistan, will boost their commitment to accelerate progress on new-born, child and maternal survival by providing high-impact interventions and tools, notably new vaccines and improved health care practices.
In the mid-1990s, an outbreak of diphtheria started in the southern part of Tajikistan and spread across the country with more than 4,000 cases, including 265 deaths. The surveillance system was strengthened in the aftermath and a mass immunization campaign against diphtheria was carried out in 1995-96.
More than half of population surveyed has no protective immunity against diphtheria, a 2010 survey of populations’ immunity levels against major vaccine-preventable diseases revealed.
The findings of this survey highlighted the need to improve routine immunisation delivery, and support a one-time diphtheria-tetanus (DT) supplementary national immunisation campaign to rapidly close immunity gaps and prevent diphtheria outbreaks.
In 2012, the Government of Tajikistan in close cooperation with UNICEF and WHO launched the National Diphtheria Immunization Campaign and worked with public health agencies and other partners to design and implement communication activities to ensure success of the campaign.
The first round of the campaign was held this year in April for all children aged 3 to 6 years and covered almost 700,000 children. The next round was held in September and targeted all children and young people aged 7-21 years.
An additional round of vaccination for all children and young people aged 13-21 years will start on 29 October and will last until 3 November. As a result, 2.5 million children and young people in Tajikistan will be vaccinated against diphtheria.