Village by Village, District by District

It takes a village to immunize a child

March 2016: It was an overcast morning in Barpak Village Development Committee (VDC). Clouds hung low in this VDC perched in a mountainous ridge of northern part of Gorkha District, almost 180 km away from Kathmandu. As a shrill voice of village messenger (locally known as katuwal) resonated the cobbled streets of the village, Manush Ghale, female community health volunteer (FCHV) of ward number 6 Barpak hurried to finish her morning chores to attend an important event.

Barpak was being declared as fully immunized VDC amidst a fanfare on 13^th March. Fated to be the epicentre of the April earthquake- the VDC suffered death of 72 people, many more injured, displaced and there was a huge damage of buildings and properties. Despite the loss, the VDC was bustling with positive spirit of Barpakians committed to ensure that all the children in Barpak survive and thrive, safe from vaccine-preventable death and disease.

Local community workers, health workers, volunteers were busy putting up flags and festoons, decking the stage, making flower garlands in a large ground at the middle of the village. They occasionally looked up at the sky, wishing the clouds to go away.

In no time, men and women from all the nine clusters (wards) gathered in the ground flagging the banner of each ward. They are joined by prominent personalities including the Member of Parliament, government officials, development workers, media persons and others from outside the VDC and the mass rallied into the village in a procession. Then they settled into the ground making a large human chain.

As the formal ceremony kicked off, it started raining. Despite the heavy downpour, the people of Barpak and guests waited in rain and took an oath to uphold the fully immunized status of Barpak VDC.

In the leadership of government-run primary health center in Barpak, the FCHVs, health workers, women’s group, community forest users group, youths, teachers, politicians and various other stakeholders of Barpak worked collaboratively to spread awareness, mobilize resources, conduct surveys and perform various activities to make Barpak a fully immunized VDC.

Manush Ghale, seemed very happy to witness this day. ‘When I first started working as FCHV 10 years ago, it was very difficult to convince people on the benefit of vaccines” she recalled. Following the earthquake, despite their personal grief, FCHVs, health workers and other stakeholders worked doubly hard to administer additional MR vaccine to the children besides the government-prescribed vaccines. “For last three months we visited door to door, asking to see immunization card and vaccinated spot of every child” said Manush.

“Against all odds, all of our children are vaccinated and are safe now. It would not have been possible without the joint effort of all in the village.”

Earthquake No Bar for Immunizing Children

Dolakha District is the epicentre of another big Nepal earthquake of 12 May 2015. When the earthquake struck, Sajina Khatri Shrestha’s daughter Monishka was 3-month-old. Too scared to stay inside her house in Charikot, Dolakha, Sajina’s family took refuge in a nearby school building. Everything was destroyed by the earthquake- houses, schools, health posts. Sajina was consumed by worries of her daughter’s health.

While still living in the school building, Sajina looked into her daughter’s immunization card. It was a day for her routine immunization. There were incessant aftershocks and people were too scared to move around. Sajina was worried whether she would be able to immunize her daughter or not because she knew that health center in Charikot was destroyed by the earthquake. “I went to the health post wondering whether there would be health workers or not” Sajina recalled.

“When I reached there, I saw huge tents written “UNICEF” outside the destroyed health-post. Inside it, some health workers were vaccinating children while others were busy treating people,” she said. A health worker administered vaccine to Sajina’s daughter and she came back, assured that Monishka will not have to suffer any vaccine-preventable disease.

Despite the earthquake, its recurring aftershocks and extremely difficult geographical terrain, - the government of Nepal and its development partners were able to ensure that each one of children in Dolakha was immunized and 1^st April was the celebration event of the full immunization declaration.

As a mother, Sajina was very happy to see the event taking place to mark the fully immunized status of the district. So were other stakeholders and health workers who worked tirelessly day and night during the earthquake to make this happen. Everyone was excited that no child of Dolkaha will have to succumb to vaccine preventable disease now onwards.

Among the excited and happy health workers was Mr. Gaya Prasad Chaudhari, who hailed from Saptari district, southern plains of Nepal. He was actively campaigning for creating awareness on immunizing children in his previous workstation Chankhu Village Development Committee (VDC) of Dolkaha district. He was constantly motivating his colleague and FCHVs to leverage the campaign forward.

It was not an easy task to reach every household of the remote Chankhu VDC. “It was difficult to convince the uneducated people in the village to prioritize immunization of their children in the beginning” He said. Earthquake struck in the middle of his campaign. Many houses were destroyed in the village, including the health post. Their attention averted towards treating the injured people but they still continued their mission of immunizing all children of the VDC.

Mr. Chaudhary was injured in the earthquake of May 12, while he was still at the immunization site. He got his leg fractured and later on after treatment he was transferred to a VDC closer to the district headquarter. Even after that, he worked tirelessly on his part to fully immunize the Sundrawati VDC, his new working station. “As a result of everyone’s collaborative effort, we are able to declare Dolkha a fully immunized district today” he beamed.

UNICEF Supports the Contagious Campaigns

UNICEF is supporting the government of Nepal to strengthen its immunization system and to achieve full immunization status by 2017. Barpak is among 1332 out of almost 4000 VDCs and Dolakha is among 17 out of 75 districts of Nepal which are declared fully immunized so far. UNICEF is working side by side with the government and other development partners to bolster these community-led campaigns by contributing to maintain effective cold chain, garnering local commitment, leveraging local resources and fostering a spirit of ownership and volunteerism at the local level by conducting Appreciative Inquiry-based workshops at different level. With joint efforts from all level, the campaign for declaring fully immunized VDCs and districts are contagiously expanding.

Following the earthquake, UNICEF further bolstered these campaigns by procuring and installing ‘disaster-resilient cold chain equipment’. The equipment enhance disaster resilience of the cold chain system, keeps the vaccine safe for as long as 10 days without power back up. This will enable the continuity of regular immunization programme even at times of disaster.