“We cannot afford to be complacent”
Dr. Pierre Somse, Health and Population Minister
World Polio Day is celebrated on the 24th of October each year. Central African Republic (CAR) elected to launch this year’s nationwide campaign in the town of Sibut, located about 200 kilometres north-east of the capital Bangui, led by the Minister for Health and Population in CAR Dr Pierre Somse, in the presence of WHO Representative Dr Ngoy Nsenga, the Deputy Representative of UNICEF Paolo Marchi and the local authorities.
The country has been declared “polio-free” since June 2020, meaning that no case of wild polio virus had been recorded for the five years prior to the date. However, Dr Pierre Somse, Minister for Health and Population, warns that it is difficult to maintain the polio-free status and so there should be no room for complacency.
In CAR, the national campaign seeks to vaccinate about one million children, give each one a Vitamin A supplement and a deworming tablet – from newborn babies to children aged 59 months.
The launch ceremony was short, and the accompanying message was clear. The 14% of children in the CAR who are not, or have not been fully, vaccinated against polio, risk being infected by the virus, with lifelong consequences for them, and exposing the entire country to the disease. There is no room for complacency, not while the wild polio virus is still ravaging some countries in the world and the circulating vaccine-derived poliovirus, due to low immunisation rates within communities, is present on the African continent. The same message was drummed home by every group that participated.
The local theatre group was present to reinforce the messages with some humour.
To protect an estimated one million children across the country, the Central African Republic has mobilized as many as 4,000 mobilisers to go round their neighbourhoods.
In Sibut, there were about 30 mobilisers in all - NGO workers, local chiefs and leaders of women’s organizations. They were supported by volunteers from the Red Cross Society and town criers.
Hugues Bagaza and Benjamin Baïdo are young residents of Sibut. They are both fathers and have young children who are not yet five years old. Their own children were among the group to benefit from this campaign. Hugues is a mobile phone and radio repairer, while his partner Benjamin earns his living farming cassava and groundnuts. Each of them worked as a mobiliser for this campaign that lasted three days.
It is important that households receive all the information destined for parents and caregivers of very young children. For three days, mobilisers moved from house to house in their commune to make an inventory of the number of children to be served in each household.
Even in the absence of household members, the mobilisers left a trace of their visit. They used a code to indicate that no-one was home when they got there, so they plan another visit for later.
The core of their conversations with the caregivers they met at home were eloquently summarized by the theatre group at the official launch ceremony. When the vaccination team visited the house, their interest was to meet every child that had not yet attained the age of five.
“They will give each child a droplet of the Polio vaccine, a tablet of Vitamin A and a deworming tablet"
They then marked a finger with ink to confirm that the child had been served. Because of the COVID-19 pandemic, everyone who entered a home for this exercise was wearing a face mask.
UNICEF’s Health Specialist in charge of vaccination, Dr Sylvain Djimrangar Ngardouel explained the rationale for combining many interventions at a time. “Indeed, it makes sense that the children also receive the benefits of vitamin A and deworming. Vitamin A supplementation increases their resistance to disease and increases their chance for survival, growth and development. Deworming eliminates intestinal worms that are a cause of anemia and helps to ensure good nutritional status.”
UNICEF CAR has over the years received funds and support from Canadian Funds, UNICEF National Committee for the Netherlands, International Nutrition, CDC, Rotary International, the Bill and Melinda Gates Foundation and GAVI for such initiatives that combine a certain number of antigens. This year was no exception.
Benjamin the mobiliser admitted that not all households readily accepted to vaccinate their children. “One or two out of 10 are reticent because of what they call “sicknesses introduced into the children” - referring to the rise in body temperature or the diarrhea occasionally associated with the deworming.
“But that is why we are trained – to be able to give them all the information beforehand.” Sundays are good days to meet with people at home. As far as Benjamin recalls, the campaigns usually begin just before the weekend or during the weekend so it includes a Sunday. “Most people will not be at work or on their farms, so we are likely to meet them at home on Sunday.”
The two mobilisers have been trained together with others, and they joined the vaccination teams on their door-to-door visits. There are names to reconcile and other pieces of information to glean from the caregivers when they visit those who report unusual aftereffects.
The fact that Sibut was selected to host the national launch of the campaign motivated the mobilisers more than ever to attain their highest coverage in their neighbourhood – and to maintain it.
