I’d always thought of tetanus as something you could maybe possibly get if you stepped on a rusty nail. That’s what I learned growing up. Nothing else. I never met anyone who had tetanus and so it was one of those things I rarely thought about. I did avoid rusty nails, though.
Then I met Alizeta Sore, a community health worker in Burkina Faso. We sat under a tree, about six of us, just talking about life and work. Alizeta told us how she became passionate about vaccination work. Her first two children died of tetanus. She hadn’t taken them for their immunizations because the health clinic was so far away. Can you imagine walking over 10 miles one way to a hospital, carrying a baby the whole way? That was the scenario that kept Alizeta from immunizing her first two kids. In a way, it’s understandable. It’s also incredibly sad. In many poor countries, living in a rural area means you and your children won’t have access to facts about immunizations and the actual vaccinations. But people like Alizeta — and the organizations they work for — are trying to change that.
Alizeta now shares her story with mothers, urging them to take their children for immunizations no matter the distance or cost. Here’s a story I wrote and photographed about her for Catholic Relief Services, on behalf of the GAVI Alliance, which works worldwide to increase access to immunizations.
ALIZETA SORE hops on her grey bicycle, the tires filled with just enough air to carry her across the sandy paths of Peele (pay-lay) in rural Burkina Faso. She pedals in flip flops from one group of thatched homes to another, carrying only a sheaf of papers, a cell phone, and a ton of health information in her head.
Sore is a community health worker, and this bicycle journey is a weekly ritual. She’s checking on recently-immunized children and reminding mothers, most of them illiterate and unable to read a health record, to inoculate their children during the next morning’s immunization clinic. She volunteers in partnership with Action pour l’Enfant et la Santé, a Burkinabé civil society organization (CSO) that works with other CSOs under a GAVI Alliance grant to strengthen CSO work in immunizations. AES previously focused on other aspects of child health but now integrates immunization education and services into its work.
Alizeta is committed to keeping Peele’s children immunized not just for health reasons but for a personal one: her first two children, both girls, were not immunized and died of tetanus as infants. Alizeta was also unimmunized at the time.
“I use my personal experiences to educate the women,” she said. “Most are sensitive to my call. Some are still reluctant, though.”
“Health is everybody’s problem.”
Burkina Faso’s immunization rates are in the 90th percentile for most diseases, according to the World Health Organization. But recent reported cases of measles and meningitis are cause for concern. Just a few unimmunized children can spark a disease outbreak.
To ensure all children are vaccinated, the Secrétariat Permanent des ONG, a local umbrella NGO that coordinates CSO activities in Burkina Faso, is focusing its Health Theme Group on immunizations with funding from the GAVI Alliance grant. The group advocates for a stronger partnership with the government and filling immunization coverage gaps; Peele, is one of the group’s targets.
“Health is everybody’s problem,” said Athanase Fidele Kabore, the program officer at SPONG. “It’s the community’s problem. It’s a civil society organization’s problem. It’s my neighbor’s problem. If there is polio in my house, then my neighbor is not healthy.”
The group is working to convince the government that more CSOs can offer immunizations, which has been the government’s domain. With the government’s OK and GAVI funding, in May 2012 the group surveyed five communities, two where CSOs gave immunizations and three where CSOs did not.
The survey showed overall health was better in places where CSOs offered health services, including immunizations, Kabore said. This data convinced the Ministry of Health that a wider survey should be done and that CSOs should be integrated into and consulted on national immunization issues, though exactly what shape that will take has yet to be definitively decided.
At the same time, the Health Theme Group has encouraged CSOs already working in the health sector to incorporate immunization activities into their work. Kabore said that one year ago, of 58 CSOs working in health, nine were involved in immunization-related activities, which include advocacy, fundraising, and service delivery. Now there are 33 CSOs working on immunization activities.
“If children are immunized, it is for whole their life and we have no expense for buying medicine every time [they get sick],” said Kabore. “We can use this money for another problem in the community.”
An educated community
A chicken wanders into a room where a dozen mothers and their children sit, the buzz of talking moms pierced by the wails of a just-immunized baby. Alizeta picks up the day-old girl she’s been cradling and hands the girl and a blue health record booklet to the girl’s grandmother. Grandma is taking care of the girl – who won’t be named for another week, per Muslim custom – while the mother rests in a clinic bed.
The immunization scene is repeated over and over for close to three hours. Afterward, Alizeta leads a group discussion about immunizations.
“Do you know the immunization schedule for after the baby has been delivered?” Alizeta asks the women. She stands in the middle of the room where just minutes ago she held babies as they were immunized.
Mothers speak: polio and tuberculosis at birth; polio, hepatitis, diphtheria and tetanus at two months. Women recite the immunization schedule all the way up to the baby’s ninth month of life. After a half-hour more, the group disbands, the women walking or bicycling home.
“There used to be diseases like polio, measles and tuberculosis, which always at this time of year – the hot time – brought many people to the health center,” said Alizeta. “But today, this kind of problem is decreasing.”