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Immunizing door-to-door to kick polio out of Togo

© UNICEF/Togo/2009/Bonnaud
Togo, Tsévié : Thomas, 3 years old, is immunized against polio. Just two drops of oral poliovirus vaccine are enough to immunise a child against infection. A cost-effective way to protect Thomas against a crippling and sometimes fatal disease.

VOGAN, Togo,  27 February 2009 - Beneath a blazing sun, Akuba and Afi are pounding manioc in the yard of their compound when two health workers from the Expanded Programme of Immunisation (EPI) arrive.

"Polio Vaccination! All children must be immunised!" call out the two vaccinators, Sissi and Nadou. Akuba and Afi stop pounding and go to see the two visitors.

"Hello, we have come to give all children a free vaccination against polio" Sissi explains. "Do you know about this disease?", she asks. The two mothers shake their heads, and look intrigued. "Polio is a viral infection of the nervous system" Sissi replied. "It is very contagious and can lead to paralysis or even death hours after the beginning of the infection", warns the vaccinator. "But today, we can protect our children from this disease with a vaccine."

Afi and Akuba are persuaded and call their children, playing in a corner of the yard.

Akuba introduces her two sons Thomas, one and a half, and Désiré, 4 years old, to Nadou who deftly squeezes 2 drops of poliovirus vaccine into the mouths of the two children. Désiré and Thomas grimace but Akuba is reassured: "It’s good, I’m lucky that my children are protected!." 

"We will come back a second time this month, Nadou informs them, putting her vaccination kit away. I really believe that this national door-to-door campaign will get rid of this disease for good. I can’t wait for Togo to one of the countries clear of polio again!", Nadou exclaims. 

Towards the eradication of polio
Togo is not polio endemic since 2007, however the disease reappeared in 2008 when three cases of polio imported from Nigeria were identified in the north of the country.

Faced with the threat of an epidemic, a national campaign against polio was organised by the Togolese Government in partnership with UNICEF and WHO. No less than 1,500,000 doses of the polio vaccine have been administered by the 30,324 vaccinators and 3,033 supervisors who were mobilised in the 608 health centres in Togo as well as through door-to-door activities.

The first results of the coverage of the vaccine are good: 95% of children under five, that is 1,444,950 children, have been immunised.

In a country where the mortality rate for children under five is 100 per 1,000, the vaccination campaign also provides the opportunity for UNICEF to disseminate four key messages for child survival and development.

Promoting 4 essential practices for child survival and development 
Health workers have been sent out over the entire country, even to the most isolated villages. After vaccinating the child, they educate each household on essential behaviour and practices for child survival. 

"The first important practice is hand washing: children and their parents should wash their hands with potable water and soap or ash before eating and after going to the toilet. Do you do it?" asks the vaccinator. The two mothers say they do.

"And, whenever your child has diarrhoea, you need to take action; you should feed theem well, ensure they drink, give oral rehydration solution and take them to see a doctor quickly.
The third key practice is breastfeeding. Did you breastfeed exclusively?"

"I breastfed my child for the first six months with only my breast milk," Akuba replies. Afi seems not to have heard of this practice. Seeing her friend perplexed, Akuba starts to explain the benefits of exclusive breastfeeding. She was given this information when she went to prenatal consultations. "Breast milk contains everything necessary to nourish your child. You should not give water or gruel (Togolese dish made from maize or sorghum) for the first six months" said Akuba, "She’s right", confirms the vaccinator.

"The fourth practice to adopt is for children and pregnant women to sleep under an insecticide-treated mosquito net," announces Sissi.

It is estimated that 60% of deaths among children under five could be avoided by adopting these four essential practices for child survival.

by Hadrien Bonnaud





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