Real lives

UNICEF reaches out to all of Angola’s children in National Measles Campaign

LUENA, July 2003 – The road to Lumege Kameia, in Angola’s isolated Moxico province, shifts from broken tar to dust tracks to dust where we make the tracks.

Lumege Kameia is about 120 kilometres from Moxico’s capital, Luena, though here – as in most parts of Angola – it is meaningless to measure distances in kilometres. Given all journeys are determined by rains, flooded rivers, fallen trees and de-mining activities, time is the only relevant guide. And Lumege Kameia is six hours drive away.

Measles campaigns have been launched before in Africa, but all utilized some basic infrastructure and existing medical personnel. Angola’s National Measles Campaign, now in its third and final stage (accessing rural areas), is complicated by post-war difficulties of poor access and damaged transportation routes. At a time when bridges are broken, roads are ruined, mines ubiquitous and populations are on the move, the challenges of the operation cannot be underestimated.

Less than an hour out of Luena we begin passing through tiny villages. From Mussamba to Sakabundo to Mocosio then Tchitapa. All united by their identical clay huts with thatched rooves, multitudes of barefoot children and general hardship. But all now have something else in common: they have been reached by Angola’s Ministry of Health and UNICEF mobile immunization teams.

“They were here yesterday,” enthuses Elisa Sabina in Sakabundo, still clearly agog at yet another round of visitors to this far-flung place. “First we had people come through, ahhh, maybe a month ago, to tell us that this campaign was happening. And then they came back yesterday! I have three children and they were all vaccinated. Last night we ate rice – it was a special day in my home.”

Thousands of villages just like Ms. Sabina’s are currently being accessed. Many by four-wheel drive vehicle, some by helicopter, some by army personnel carrier, some by plane …but all by great flights of resolve and co-ordination by UNICEF and its partners.

An Angolan child dies every hour from measles, many in remote regions such as Lumege Kameia, where we arrive in the middle of the day. This is no time to be outside, for now the African sun scorches. Yet there is nowhere to hide.

Lumege Kameia is responsible for mobile immunization teams reaching villages between here and Zaire. However Lumege Kameia’s public health administrator tells us they are three days late in starting phase three.

This is the reality of the campaign: forging and then maintaining the supply of vaccines to the most remote areas of Angola is paramount if the campaign is to achieve its ultimate goal of immunizing 7 million Angolan children. The target for the final phase is 1,750,000 children, most of whom are in isolated areas like these.

Yet vaccines require fridges and the fridges require kerosene, so the kerosene simply must reach the most inaccessible areas. At the onset of phase three in Lumege Kameia, roads thought to be accessible were flooded by late rains, bridges down for repair had been overlooked, and planes promised to fly essential vaccines and fuel were cancelled. And of course the devastated ‘road’ system offers no solution.

“We expected problems,” says Marcelino Canhanga, head of UNICEF’s Moxico office. “And we got them. This is an area that suffered greatly during the war and so we expected all manner of difficulties for this stage of the campaign, but we had planned for them.”

And so in a series of rapid-fire two-way radio discussions, meetings with the provincial government were arranged and UNICEF lobbied, and then lobbied some more, for extra government cargo planes and army personnel carriers. Using its leverage and goodwill, it secured the planes and over the next 72-hours vaccines would fly to their distant destinations.

Given one 200 litre drum of kerosene will charge a refrigerator for up to eight months, the measles campaign is unique because it not only save lives now, but creates infrastructure, thereby doubling as a lifesaver and a developer.

“The establishment of a cold chain of supplies across Angola, together with the huge task of training health workers, will act as the foundation to rebuild the basic health care infrastructure throughout Angola,” says UNICEF Angola Representative, Mario Ferrari. “The campaign is the first critical step to developing the capacity within Angola for ongoing routine measles vaccination.”

Of course not all villages will retain cold chain equipment – there are simply too many of them. But all have now experienced the peace dividend of bringing health to their people.

“I am very proud to have helped my community,” says Quintesh Chuma, a traditional leader in Camanongue, speaking in the local Cokwe dialect. “Now I want to do more.”

Two days later, on our way back to Luena, we take a different route, passing through villages currently being reached by immunization teams in four-wheel drive vehicles. At the makeshift clinic inside one of the huts, Gabriel Augusta talks to another mother waiting in one of Angola’s shortest lines, while their children play football with refuse rolled into tight little balls and held together with string.

As they draw nearer the mobile fridge and white-coated vaccinator, both children turn their heads and look worryingly toward the door. Pedro, 9, tells his mother he doesn’t want to have his injection. I don’t hear what his mother says, though it seems to have the desired affect. He continues playing and a few minutes later a brave and tearless Pedro has his injection.

I ask Gabriel whether she promised her son anything if he didn’t cry …perhaps sweets? Though as I ask I realize it is a ridiculous question. The children are barefoot and in rags. There is no money for treats and there are no sweets here to buy. But as I am thinking this Gabriel responds, “Yes, I promised him good health.”

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