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Cross-border immunization programme protects Namibians and Angolans

© UNICEF Namibia/2011/Figueira
Nurse Magdalena Kaute provides vaccinations at the Oshikango Border Post on the Namibian-Angolan border.

World Immunization Week takes place from 21-28 April 2012. UNICEF offices around the world are engaging in immunization campaigns and raising awareness about the importance of vaccines to child survival. UNICEF is the world’s largest buyer of vaccines for the world’s poorest countries, and has been supplying vaccines to children for over 50 years.

By Elizabeth Terry

OSHIKANGO, Namibia, 26 April 2012 – The Namibian-Angolan border post at Oshikango is hectic on a normal afternoon. Since the conflict in Angola ended, trade between Namibia and Angola has flourished.

While this busy cross-border movement is great for the shop-owners in Namibia, it comes with at least one problem – contagious diseases can also cross over the border. Namibia was polio free for almost 10 years up to 2006, but then a deadly outbreak of imported wild polio virus struck.

Namibia’s Ministry of Health and Social Services (MOHSS) urgently mobilized a response, with technical, financial and logistical support from UNICEF, the World Health Organization (WHO) and other partners. The entire population of over 2 million Namibian was targeted for vaccination, with an estimated 95 per cent reached.

Cross-border immunization

Even after these impressive results, Namibia cannot become complacent. The risk of importing wild polio virus from Angola persists, and so health officials must be vigilant to keep the country polio-free.

Dr. K. Kashaija, the principal medical officer for Engela Health District, explained that there is a cross-border forum that brings Angola and Namibia together to discuss the problems of diseases crossing borders.

MOHSS set up an immunization outreach post in front of the Namibian immigration gate, where people arrive from Angola, targeting women of child-bearing age and their babies for vaccination. Kristine Hamalwa, who supervises the cross-border immunization programme, said that children under age 5 receive various vaccinations including an oral polio vaccine, and women between 15 to 49 years of age are vaccinated against tetanus.

Namibia, with the support of UNICEF and other partners, is making great strides in addressing polio and other childhood diseases. But the cross-border campaign is still new and faces a variety of challenges.

Challenges remain

Nurse Magdalena Kaute provides vaccinations at the Oshikango Border Post. On average, she vaccinates a 20 women and babies each day, but she could vaccinate as many as 50. Without a prominent sign promoting the service, and without knowing any of the languages of Angola, Ms. Kaute has difficulty people drawing in as they hurry past.

“There is no money to pay for a translator,” she said. “I want to learn Portuguese so I can communicate better with the women coming for vaccinations, but there is no money for lessons.”

© UNICEF Namibia/2011/Figueira
Angelina Mariana has brought her child, Bartolomeu, to be immunized at the Oshikango Border Post on the Namibian-Angolan border.

The language barrier is also problematic for those seeking to get vaccinated.

Joventina Gasper and her 9-month-old daughter, Zulmira, arrived at the post. Both were vaccinated by Ms. Kaute, but Ms. Gasper did not know what kinds of immunizations they were receiving.

“I don’t speak Oshiwambo and that woman [Ms. Kaute] doesn’t speak Portuguese so she couldn’t tell me,” Ms. Gasper said. “My home language is Umbundu, which is different from Oshiwambo.”

Even so, she said, “I feel very good that my child has been vaccinated!”

Assessment and improvement

The programme is now coming under review. Ms. Kaute says, “It is now the time to assess the border post operation” to address its shortcomings.

It is clear that the programme must be visible and readily accessible to those who need vaccinations, but without hindering the flow of cross-border traffic. The language barriers must be broken down so patients are informed about the services they are receiving. And clear guidelines need to be established on which vaccines are priorities and who should be vaccinated.

In addition, Dr. Kashaija said, there are simply not enough medical staff to provide the level of service required. “In Ohangwena we only have one doctor per some 25,000 population, where the average for Namibia is one doctor per about 7,500 people. The ratio of nurses to people is also poor here, with one nurse to about 2,500 people, compared to 1,000 people as a Namibian average. This is a big problem for Ohangwena Region.”

In spite of these challenges, the efforts are helping keep children safe.

“We are proud to say we have covered 80 per cent of our under-5 children with immunizations here in Ohangwena Region, and continue to ensure that children crossing over from Angola do not pose a risk to Namibians,” Dr. Kashaija said.



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