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Breaking Social Barriers to Reach Every Child

 5th June 2014, Sa’ada. As 7-month old Sami gets his first round of vaccinations, children waiting for their turn peer in through the windows and records are checked to see if anyone else is missing. This is day seven of an integrated health campaign to reach all children under the age of 5 in the community. All 3,000 of them. And almost all of them have now received their vaccination cards.

“We went to each house beforehand” says Abeer Abdu, one of just eight community health volunteers who support the health workers to make sure everyone accesses the service. ‘We told the mothers and fathers that we have this campaign and encouraged them to come.”

Abeer volunteers for the Al-Wehda Association in Sa’ada and this is the first time that these health services have come directly to her community. Until this week, mothers had to go to the hospital to get their children vaccinated. “Most people said it’s too far…before there were probably only about 15 per cent who went.” Says Mohammad Ibrahem, Head of Al Wehda.

Some of them felt it was too far, for many it was costly, but most didn’t realise it was that vital. “The number of people who understood the importance of vaccinations was very low in the past, but after the volunteers started to make home visits, it became much higher” says Mohammad.

Abeer, Mohammad and the community they live and work in are known by much of the country as Muhamasheen (marginalized). Estimates of the number of marginalized people living in Yemen vary, but as a typically less wealthy segment of society, Muhamasheen are often subject to discriminatory attitudes and treatment and are less able and likely to access basic social services.

Health services have always been available from the local hospital, but distance, travel costs and lack of awareness prevented the community from accessing them. So Al-Wehda took a different approach and brought the health services to the community. With health care available round the corner from every home, cost and distance would no longer be a problem, but awareness could still be an issue.

Just last year, Abeer was the only volunteer, but over the past year, she has been joined by seven more, all from the Muhamasheen community and all trained to raise awareness. “At the beginning it was difficult” she says “the mothers just listened a little bit. But with repeated interventions, especially on Fridays, they started to learn.”
The volunteers are a very dedicated team. “We have regular meetings on Fridays but we also talk to people during regular events, if there’s a meeting, or even a wedding for example!” Between them, they have mobilized a whole community.

“The City Health Director informed the community leaders in advance and they went on to tell people too” adds Mohammed. “The community leaders told the fathers, and the volunteers told the mothers, so together everybody knew.”

They also use evidence to teach the mothers they meet. When one child got measles, Abeer said to his mother “this is because you didn’t take the vaccines, he got sick!” and with that she convinced her to vaccinate her other children.

What makes a difference for Abeer is that she is from the community itself. “They accept us! They listen to what we say, they believe us. The mothers say ‘this girl is one of us, she will not lie!’” She is confident that they reached everyone, “but some people didn’t care” she says, without any sign of defeat. “Repeated education! In the end you will get something!”

Their dedication seems to have paid off so far, as Mohammad estimates that more than 90 per cent of the community are now getting the vaccinations they need. But the team haven’t finished yet. What started as a five day campaign was extended to seven and will start taking place again every month. “If we find there’s children still left tomorrow we’ll extend again, keep going until we get everybody!”



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