Striving for immunization for every child during the COVID-19 pandemic

SORONG, Indonesia – The sun is shining through the tall palm trees in Bambu Kuning, a small remote village in Sorong, West Papua Province, as health worker Magdalena Saribu arrives on foot and greets residents with a lively smile. 

“Good morning everyone! How are you today?” she calls out to them. “Bring your children to Marisa’s house and we’ll start the vaccinations!” 

Magdalena, or Lena, as she is called, knows these communities well. She was born and raised in Sorong and works at the local Malanu Health Centre. A midwife by training, she has spent the past seven years working as the immunization focal point at the health centre, where she is responsible for providing vaccinations to over 600 children in four villages.  

Even in the face of a pandemic, Lena continues her work undeterred. She points out that any disruptions could leave children vulnerable to other deadly diseases. Last year in Sorong, there was an outbreak of diphtheria, prompting her and her team to lead the first immunization outbreak response, which was completed this year. 

“The pandemic won’t stop me,” she said. “If we stop the immunization services, I am afraid there will be outbreaks of diseases. Therefore, it is important that we continue to make sure that children are protected with vaccines.” 

Today, Lena is preparing to hold a mobile session to deliver tetanus, diphtheria and pertussis vaccinations to over 50 children in Bambu Kuning at the home of Marisa, a local mother of two. While the house isn’t far from the main road, the path to get there is narrow and thick with mud, making it impossible for cars or motorbikes to pass. As Lena sets off, treading on a makeshift wooden path placed on top of the mud, three children walk ahead to show her the way. 

West Papua’s remote areas, like the heavily forested regions of Sorong, pose extra challenges for health workers to administer vaccines to the small and dispersed populations. As a result, the rate for basic immunization among infants in the province was only 80.9 per cent in 2018, lower than the national target of 92.5 per cent.  

In an effort to reach isolated communities, Lena usually visits the posyandu (community health post) twice a month to deliver immunization services. As part of the UNICEF immunization programme in West Papua, the Malanu Health Centre also planned to link their immunization services with nearby early childhood development (ECD) centres in April to further expand their reach. 

But since the COVID-19 pandemic, all posyandus in Sorong have closed. Due to the rising number of COVID-19 cases, schools have also remained shut, which has delayed the immunization programme in ECD centres. 

To learn how to adapt to these challenges, Lena attended an orientation session supported by UNICEF and the Public Health Office. During the session, she learned how to identify children who missed out on their routine vaccinations by targeting them individually by their names and addresses. As a result, she now goes from village to village to ensure that children living there complete their immunizations. 

"In West Papua, there are more than 331,000 children representing 38 per cent of the total population, which makes immunization services critical for local communities,” said Mohammad Ruhul Amin, UNICEF Indonesia Immunization Specialist. “But as of today, the immunization coverage rate is 30 per cent lower compared to the previous year. If anything, the ongoing COVID-19 pandemic is a reminder of the importance of vaccination to prevent outbreaks of deadly diseases, so continued efforts are needed to sustain routine coverage to keep children healthy.” 

After hearing from their community leader that Lena would hold the mobile immunization session in Bambu Kuning, more than 50 families came to Marisa’s house and patiently waited outside to have their children vaccinated. Irianti, a mother of three, said she was grateful to see Lena come to the village.  

“The health centre is far from our house and we don’t have any posyandu here,” she explained. “My youngest children have not received any vaccinations during the pandemic. I am afraid to bring my children outside of our sub-village, so I am happy that the mobile immunization sessions are close to my house.” 

Despite the setbacks caused by the pandemic, Lena continues to serve her community and looks forward to delivering immunization services through the posyandus and ECD centres when they eventually reopen. Until then, she is committed to doing whatever it takes to reach the children in her district.  

“Looking back at 2020, we never could have imagined that this year would have turned out this way,” she said. “But I hope we can still do what matters during the COVID-19 pandemic in Sorong: making sure that every child is immunized.”