Namibia

Nationwide polio immunization drive under way after recent outbreak in Namibia

UNICEF Image
© UNICEF/Namibia 2006/Tony Figueira
The children of Katutura, Namibia turned out in strength for the official launch of the national polio immunization campaign, held in the UN Plaza auditorium.

By Patricia Lone

Namibia is in the midst of a three-day, nationwide polio immunization campaign launched in the wake of a recent outbreak of the disease. Here is a firsthand account of the drive’s first day.

KATUTURA TOWNSHIP, Namibia, 22 June 2006 – It was 4 p.m. at Okuryangava Health Clinic in Katutura Township, a community on the outer edge of the capital city of Windhoek, and the nursing sister leading the polio immunization team had the dazed, weary and yet immensely satisfied look of someone who had just won an extremely hard race. In fact, she and the other five members of her team had done much more.

If gold medals were given for public health heroism, then many Namibians today would be on the winners' stand.

The two nursing sisters at Okuryangava had managed to immunize more than 3,000 people against polio in about eight hours. The four other volunteers on the team had ushered the crowds through, recorded each immunization and marked one finger of those receiving the polio drops.

"Lunch?" Sister Shikongo echoed when asked whether she and her team had managed to have anything to eat. "Not really," she said, smiling, "but we each took about 10 minutes to get something quickly to drink."

UNICEF Image
© UNICEF/Namibia 2006/Tony Figueira
Cargo staff offload the 2.5 million doses of oral polio vaccine UNICEF procured for the first round of Namibia's nationwide polio immunization campaign.

High demand, unflagging response

All over Windhoek and all over Namibia, the high drama and personal heroism and generosity of an immense polio immunization effort played itself out at immunization posts, health clinics, schools, crèches, homes, farms and factories. If early indications are borne out, Namibians came out in record numbers on the first day of the polio immunization campaign’s first round – and health workers and volunteers outdid themselves in response.

The high demand combined with the unflagging responsiveness of the health care workers and volunteers may give the country a critical boost in its effort to quell the polio outbreak it has been battling since the disease was confirmed by laboratory tests on 6 June. The number of suspected cases reached 109 (13 of them confirmed as polio) as the first immunization round began. There are now suspected cases in all of the country's 13 regions, and the deaths have risen to 14.

At Katutura Health Centre, Dr. Sarah Shalongo was still patiently and carefully instilling two drops into the mouths of men, women and children at 5:30 p.m. She and the two nurses and two volunteers who made up the team had been at it since 4 a.m., when they arrived to finalize preparations for the big first day of the campaign.

Opening delays were reported at a number of immunization posts around Windhoek, but definitely not at the Katutura clinic, which began immunizing promptly as announced at 7 a.m. More than 10 hours later, team members were still there, immunizing, recording, counting and indelibly marking the fingers of the thinner but still steady stream of people appearing at the door.

Tally sheets showed that the immunization team had reached a quite staggering figure of 4,500 people on the campaign's first day.

UNICEF Image
© UNICEF/Namibia 2006/Tony Figueira
The First Lady of Namibia, Penehupifo Panamba, receives oral polio vaccine drops at the 20 June launch of the immunization drive.

2.5 million doses of vaccine

The logistics of immunizing an entire population are the logistics of massive deployments, grand and sweeping scale and big-picture plans juxtaposed with human-scale issues of hard, hard work, unpredictability, repetition and fatigue.

Two drops per person of the vaccine must be given. Vials contain enough vaccine to immunize 20 people and need to be carefully maintained in cold boxes and only removed and opened when they are needed. Then they must be paired with the separately packed dropper. So immunization teams need to constantly manage the vials and droppers, as well as the people arriving for their doses. 

And throughout the day, vaccine vials have to be delivered to busy immunization posts from the campaign's central hub.

While the 2.5 million doses UNICEF bought for the first round of the campaign are more than enough to vaccinate every person in the country and then some, there is always the problem of vaccine wastage – not all the vaccine in a vial being used or too many vials opened and unused.

Massive distribution challenge

Then, just getting the right amount of vaccine to the right places is a distribution challenge probably unmatched in most individual experience, at least civilian experience. 

Planning where people may go to get their dose (near home, near work, near their children's school?) isn't possible. So the last thing the exhausted army of Ministry of Health and Social Services staff, vaccinators and volunteers found themselves doing this evening of the long first day was gathering to collect and count remaining stocks at central depositories – so that unopened vials could be redeployed and redistributed for tomorrow's immunizations. 

Despite the challenges and glitches, or maybe because of them in some cases, a wonderful atmosphere of camaraderie prevailed in Windhoek, even when lines snaked around corners and progress towards the vaccinators was slow.

It was, all in all, a day for the record books – an exhilarating, frustrating, humbling and inspiring time when Namibia took on the wild poliovirus and did itself and us all proud.


 

 

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