Reaching the hard-to-reach with disease-preventing vaccines
By Daisy Serem
NYANZA, Kenya, 9 October 2012: Milka Rachilo is a dedicated Community Health Worker in Nyanza Province, western Kenya. She traverses the hilly slopes of Nyabera village, visiting homesteads and knocking on doors to ensure the people there understand the importance of proper healthcare for their families.
Twice a month Milka visits about 150 households in her catchment population to discuss key health messages such as immunization, maternal healthcare, family planning, HIV/AIDS and much more. As she climbs the hills through the difficult terrain the challenges abound but nonetheless she keeps pressing on.
“It is very tiring and challenging doing this work,” she says. “Sometimes the people do not follow our advice and this can be discouraging but we have to be persistent.”
It is Milka’s persistence that has won the heart of Doreen Gerizu, a mother of two who lives in Nyabera village. Doreen’s ten month old daughter, Betty, had missed her immunization dates for over a month.
The closest Maternal and Child Health (MCH) centre at Chulaimbo Sub-District Hospital is a two hour walk from Doreen’s residence. As Doreen did not have enough money to pay for public transport and the distance being too far to walk, she was reluctant to visit the health centre to get Betty immunized.
In addition to that Doreen was afraid that the health workers would admonish her for defaulting on her daughter’s lifesaving vaccination. But the consequences of not immunizing little Betty nagged her constantly and she feared for her daughter’s health.
“I was scared that she might get problems with her health if I did not immunize her fully,” says Doreen. “So when the Community Health Worker visited my home I decided to follow up on my daughter’s immunization and now she is much healthier.”
Challenges in accessing health facilitiesThe difficult terrain and scarcity of health facilities in this region has resulted in a high number of immunization defaulters due to the challenges in accessing healthcare. Nyanza and Western provinces account for the lowest immunization coverage in Kenya with only 64.6 per cent of under-one year olds in Nyanza fully immunized and 73.1 per cent in Western province.
Health facilities therefore carry out outreach immunization alongside other health services to the hard to reach communities. Community Health Workers such as Milka also play a significant role in follow up defaulters, convincing and sensitizing them on the benefits of proper healthcare.
“Community Health Workers are key in bridging the gap between the health facilities and the communities,” says UNICEF Kenya’s Chief of Health, Ketema Bizuneh. “They are our significant partners in increasing the coverage of lifesaving health interventions in hard to reach areas of Kenya.”
Meeting communities halfway
Chulaimbo Sub-District Hospital has organized a health day in the nearby Mpaka Oromo village and the Community Health Workers help to mobilize the residents to meet them halfway at the designated health outreach site. This helps the mothers who would otherwise have to walk for hours to reach the health centre.
At the outreach site they receive basic health services and education on immunization, family planning, HIV/AIDS, Antenatal Care (ANC) and hygiene. Three nurses from the hospital have set up camp under a tree, their cold boxes packed with the vaccines and some medication to serve the mothers who have come with their young ones.
Nurse Rolleen Miruka is hard at work administering vaccines to the children. As she injects baby Priscilla who is only a month old the infant cries out in pain. Nurse Rolleen smiles; this is a familiar and welcome cry in her line of work.
“Even if the child is crying I am happy because my work is done!” She says.
On this particular day Nurse Rolleen has some visitors from the United Kingdom. Comic Relief, an international charity is on a visit to follow and film the immunization activities supported by UNICEF in Nyanza province.
Comic Relief has donated 5 million pounds to the Global Alliance for Vaccines and Immunisation (GAVI) to provide vaccines worldwide. GAVI then provides these vaccines to UNICEF who in turn supplies them to the Government of Kenya. This chain of supply is what makes Nurse Rolleen’s work that much more cheerful.
Making a difference through lifesaving vaccinesComic Relief Chief Executive Officer, Kevin Cahill closely observes the immunization process and talks to the mothers and their children. He is happy to see the difference his organization’s contribution has made to the health and wellbeing of the children in Kenya.
“A vaccine is like a miracle intervention,” Mr. Cahill says. “With the money we donate we are giving children the best possible chance to grow up to be healthy and to become productive members of the society. It is very gratifying to see the children vaccinated today have now reduced their chances of contracting immunizable diseases.”
The contribution from Comic Relief includes a 2.5 million pounds donation from the Gates Foundation. This has enabled the supply of Penta Vaccines (for Diphtheria, Tetanus, Whooping Cough, Hepatitis B and Polio) and Pneumococcal vaccines (for Pneumonia) to the Kenyan Government through the Ministry of Public Health and Sanitation.
As the nurses pack up at the end of the day Milka follows up with Doreen on her daughter’s next immunization dates. As a mother herself she knows the value of good health for children and her mission is to ensure that all the children in her community are fully immunized.
“Our children are the people of tomorrow so from conception to labour and growth I have to ensure that they develop well and reach their full potential,” she says. ‘If we do not treat the children then we do not have the next generation.”