Immunization for all

No child too far from a vaccine clinic

UNICEF Tanzania
18 June 2019

Families pack the building, spilling onto the grass under towering mango trees. What looks like a community picnic day is actually clinic day at the Itete Lutheran Hospital in Busokelo in the Mbeya region, where parents have brought their children for vaccination and check-ups.

They’ve come from five or six kilometers away, most of them by foot. The hospital is located on a high hill over 1000 meters above sea level.

Mary Joseph walked for two hours from her village in Itete with her three-month-old daughter Eunice Emmanuel, escorted by her brother, a community health worker who didn’t want her to walk alone.

“I am used to the walk, I have already come three times with Eunice,” says Mary. It’s not easy but she knows vaccines are a must. “Awareness is high and almost everyone knows the benefits of vaccination”, she adds.

This awareness saves lives. Today, Tanzanian children stand a better chance of surviving past their fifth birthday than ever before. Immunization rates have been maintained at a high level – Diphtheria-tetanus-pertussis-Hep B HiB (Penta 3) coverage was 98 per cent in 2017, and the number of unvaccinated children has gone down from 47,013 in 2014 to 30,662 in 201745. 

Coster Rueben Mwakeleja (30) and his wife Angela (26) have come from even farther. The 10 km walk from Busoka took them three hours, with Coster carrying their two-year-old daughter Edita most of the way. Angela carried herself, mostly. She is six months pregnant. It’s her first prenatal visit and she knows she should have come sooner, but avoided the long walk. Coster says if they had more money, they would have hired a pikipiki, as the popular motorbikes are called in Tanzania. But this costs Tsh5000, same as a couple of kilograms of sugar or rice in the area.

“I wish we had services closer to our house, very much,” Angela says, preparing for the second half of the challenging journey, the walk back home. “It’s easier going down”, her husband adds. 

mother and child

The area is beautiful. Abundant rivers and rainfall make the ground fertile, the water is clean and safe and reduces occurrence of waterborne sanitation diseases like cholera, and the elevation and climate reduce mosquitos and malaria, says Dr. Lee Mwakalinga, the hospital’s chief physician and director.

But this beautiful scenery and climate won’t vanquish measles, tetanus and other diseases that kill. “If we didn’t have the vaccines here, we’d have outbreaks of fatal communicable diseases,” says district nursing officer Betty Mangula. “Ten years ago, the situation was terrible,” she says, with outbreaks of preventable diseases.

Today, people themselves demand the vaccines. “We don’t have to remind them, they remind us.”

However, not everyone lives at a walkable distance. Some villages are too remote, others are on the other side of a river with no bridge. If they can’t come to the hospital, the hospital goes to them.

UNICEF aims to maintain and increase immunization coverage above 95 per cent with a “Reach Every Child” approach and has donated an ambulance that is used sometimes for immunization outreach. UNICEF has also supported the renovation and refurbishment of 214 strategically-selected health facilities in Tanzania and Zanzibar, while providing essential equipment, and has built capacity of health workers. Once a month, nurses Betty Mangula and Wema Asajente get into the UNICEF-donated ambulance and take the clinic on the road to serve five remote communities. They take with them a vaccine carrier packed with vaccines for TB, pneumonia, whooping cough, diarrhea, among others, and also HPV for 14-year-old girls. They also carry syringes as well as malaria drugs and iron tablets for pregnant women, delivery kits and family planning packages.