In Which It’s Time To Kick Polio Out Of Sierra Leone
on Zoe Page (Sierra Leone), 29/Oct/2010 21:24, 34 days ago
As I’m driven out to a Child Health Post, I’m told I’m going to be the team supervisor for the day. I have a nice if boring image in my head of manning a table by the side of the road, reading my book in between the teams checking in. I could not be more wrong: in this context, ‘supervisor’ means trailing the team round and, well, supervising. Making sure they do it right. Funny that they managed fine without supervision yesterday... But I’m not complaining. It will be fun to do some proper field work and I went to the training (and listened) so in theory I know how it works.Our first real stop is a local primary school as the few houses we go to say all their Pickin are there. We are vaccinating babies from birth to 4 years 11 months, and indeed there are some tiny ones in school. It’s the kind of country where birthdates are a little fuzzy, so they have devised a test to determine age and therefore eligibility. If the child can reach their left hand over their head and touch their right ear, they’re too big. Throughout the day we have children claiming to be older than they are to avoid getting the vaccine, and younger than they are to try to get some, all depending on their experience of medicine so far, pushiness of parents and general fearlessness. The vaccine is dripped directly into their mouths. There’s no spoonful of sugar to help this medicine go down, butthe team rather dubiously tell the kids it’s sweet to get them to open up. It doesn’t stop many a tantrum though, and once one goes off into tears, it makes finishing off that family group a little trickier...There’s a fluid approach to child ownership too, and we see lots of extended families and children wandering from place to place. No one objects to the vaccine (probably because it’s free) but there’s no concept of consent either. I wonder how many parents will have a clue why their kids are cominghome with purple blobs on them. In the absence of medical records, the indelible ink is crucial. We mark every vaccinated child’s left little finger as a sign they’ve had this particular dose, and also write in chalk on their homes. There’s a code for everything: all children vaccinated, somevaccinated and no children in the house. Many of the houses also still have the chalk on from earlier vaccination campaigns this year and last. This appears to be the 5th set of NIDs (National Immunization Days) for 2010. I guess the ink must wash off in between, though the box of pens I have specifically denotes this as Polio Campaign ink (and also says it was best before August this year) .Our team starts out with a nurse, a vaccinator and the clinic cleaner‘who wanted to be involved’ but he drops out after a while, leaving just the other two. They do an amazing job of keeping track of where they’ve been and where they still have to go, but it’s not easy. Again, I had a quaint idea that going door to door might be like carol singing. Here mostof the houses are far from each other and there are no real paths. This is proper field work. Lots of the houses don’t really have doors, either. The first time I hear one of the team call out ‘knock knock’ I crack up because it reminds me so much of home.We go to house after house, mainly finding people around. We go to another school, full of even smaller children, and manage to knock off another batch on the tally sheet. We go to a house where the children are home alone, locked in‘to keep them safe’ by parents who have gone to town. Not being put off, we deliver their doses through the window.Everywhere we go we see dozens of chicks and ducklings, the tiniest cats in the world and mini puppies as well as over grown sandy coloured dogs, all with manky ears with open sores. The birds and cats weave around the cooking pots blissfully unaware that they will soon be ending up in there. Yep, cat is a delicacy here. For every child we see in school there is another one at home with their family, though there’s a lot of segregation and men and women rarely sit together. People seem very excited to see a Pumwi in their villages, and jump up to bring out chairs and benches for me to perch on, even though we’ve got it down to such an art that half the time we’re off again by the time they do.It is getting hot and I have finished my bottle of water, but it’s almost noon so we must be stopping for lunch soon, I think. But then 1pm passes, and 2pm passes, and 3pm passes, and I begin to think, hmmm, maybe not. I am giving up hope when, at 4pm, we stop at a house that doubles as a cafe (in the loosest sense of the word). The girls have fish and rice...but there are no drinks. So far all I have had today is a bowl of porridge with banana, and half a litre of water. Even the Marklate is looking good right about now... When my exhaustion / dehydration becomes obvious, I am told we can go and get drinks, but then will need to resume work as we’re not done yet. The drinks take a while to find, though, and by the time I get my ice cold Sprite at 5.17pm (I look at my watch and sigh) they decide enough is enough. I try to call my ride but his phone is switched off and stays that way as we sip. I can’t get a bike (no helmet) and there are no helpful NGO trucks passing for me to flag down (the theory being, it’s ok to hitch a ride in anything with a logo on the outside, or white folk on the inside). In the end I decide to walk home. It is maybe 40 minutes away, but my feet have been dead for hours. By the time I get home just after 6pm Ihave been walking none stop for approaching 9 hours without a break, I am filthy and starving, my blisters have blisters and I ache all over and have a sprained ankle, but hey, we immunised 287 children today and I got a proper farmer’s tan in the process. Plus, I really earned that Capitol pizzaI’m thinking of for the weekend...Vaccinating through the window Signing a house off for this latest NID campaign amid evidence of previous ones