|Left to right: Anahita, Hamida, and Pashtougal during a debriefing session for their 'Women Courtyard', Jalalabad.|
JALALABAD, Afghanistan, 19 August 2009 – Jalalabad city is considered as a high risk area for polio. The three risk factors that characterize the area are massive and continuous population movements from and into polio infected areas, a large presence of Afghan returnees from Pakistan and high population density.
50-year-old Pashtougal is a mother of five children. She is part of the ‘Women Courtyard’ initiative – launched by UNICEF and the Department of Public Health Nangarhar in 2008.
The aim is to give local women an understanding of polio as well as other vaccine-preventable diseases and related issues such as hygiene and water-borne illnesses.
“Usually, tradition-bound families believe that babies should not be taken to the door before their 40th day after birth. This is a major barrier preventing many newborns from being immunized,” explains Pashtougal.
Women gathering together
In clusters where the vaccintation coverage rate is reportedly insufficient, ten to twelve women community health workers create a ‘Women Courtyard’. As members of these Courtyards, it becomes the health worker’s responsibility to spread the word by visiting each household in their area and meet with the mothers, sisters or grandmothers of young children.
“Once we are selected for the Women Courtyards, we go to the local health facility where we get training about polio, how to use the sensitization material and, most importantly, the list of houses that we have to visit,” explains Pashtougal. “Together, we visit 25 families per day."
This is Pashtougal's seventh immunization campaign as part of the Women Courtyard initiative.
“It is not always easy to get the permission of our husbands to get out of the house and into the homes of other women, but usually they accept because we have children ourselves, who are less at risk if the children in the neighbourhood are immunized.”
Sustained interest, sustained communication
Six National Immunization Days and four Sub–National Immunization Days are being organized in 2009, with the goal to vaccinate all children under five years of age.
“Women face many barriers in our society but progress is happening," says 32-year-old Hamida. "When we started the house-to-house visits two years ago, it took about ten minutes until finally a man would come to open the door – in order to chase us away! Now, the mothers come to the door and let us in, sometimes they invite us for lunch."
To inform families of immunization dates and to sustain their interest during every single campaign round requires continuous communication. Community mobilizers, including village elders, religious leaders, teachers and community health workers work tirelessly to reach out to families, educate them and build trust.
“We take the time to put in plain words the importance of vaccination and answer their questions. We use this occasion to also attract their attention to the necessity of routine immunization in the health centers, to protect their children from diseases such as diphtheria, tetanus or whopping cough,” explains Pashtougal. “We have to succeed and we will! This is our reason to be here.”
About the Global Polio Eradication Initiative
The Global Polio Eradication Initiative (GPEI) was launched in 1988 and is spearheaded by the World Health Organization (WHO), Rotary International, the US Centers for Disease Control and Prevention (CDC) and UNICEF. Since the initiative was launched, polio cases have been reduced by more than 99 per cent from an average of 350,000 per year in 1988 to 1,660 cases in 2008.
For more information go to www.polioeradication.org.