As you know, we went for a monitoring and observation visit to Marracuene district yesterday.
It was a great experience and I met some very interesting people as usually when visiting the field. We went around to different health posts in the district, making sure that the children were receiving the adequate dosage of vitamin A, polio vaccine and deworming tablets, checking the expiry dates on the vaccines, and seeing to that everything was in order. I took some time to walk around and speak to parents, health workers and children, which was very rewarding.
One case that struck me was that of a blind man that came to the health post with his two daughters, they had brought him there because they had heard (from the man with the megaphone, remember?) that it was important to get the vaccine. Every time I’m out I realize the importance of communication, of keeping the communities, community leaders, parents, teachers, traditional doctors etc. informed and involved. Letting them own the initiatives, activists feeling like they are contributing, young people understanding the importance and doing their best to get the younger one’s along. And this was happening, older children came with their younger siblings because their parents were out working in the fields, some of them out of their own initiative.
There was one thing that made me think though, and it was the omnipresent detail that the parents and health workers would say “open your mouth, it’s candy!” when giving the deworming tablets to the children. They are not sweet at all, but sure, it worked – this time.
Why not focus on educating and creating a positive picture of medicine as something that helps and cures, instead of infringing the trust of and directly disrespect your children?
Anyway, that was just a detail. But do you know what else I found? A small bear.
And of course, I wrote a story about it for the UNICEF website, here it is:
Marracuene, 27 November 2012 – On the second day of the National Health Week in Mozambique, women and children in the district of Marracuene in Maputo province gathered around health centers and mobile health posts. Led by the Ministry of Health, the campaign aims to improve the health of almost four million children by giving them polio vaccines, deworming tablets and vitamin A supplements. At the main health centers, family planning counseling is also available to all people of reproductive age.
“I am confident that we will reach our targets with the children here in Marracuene,” district director Isabel Menetiane proclaimed. “The numbers are already looking great. Yesterday we surpassed our goal of vaccinating four thousand children daily, and we know from experience that people here tend to come during the last days, so I am expecting a very good coverage”.
At the Marracuene health center, the preventive medicine technician, Rosalina Fumo, fills in the health cards and takes a moment to speak to each mother, giving advice and support. Sofia Cuco, 1 year and 10 months old, is hanging in the scale, it shows 9kg.
“Your girl has not gained any weight since September,” Rosalina tells the mother, 19 year old Zahora, while pointing at and explaining the graph in Sofia’s health card. “This is very bad and can be dangerous. At this age, your girl should be growing steadily. You need to change her diet and add some vegetable oil, milk, eggs or peanut butter to her porridge for her to grow healthy and strong”.
Zahora is thankful for the advice. “I am not happy that my girl has not gained weight, I want the best for her and will follow the advice of the health worker. But I am happy and feel more comfortable now when I know how to help her and knowing that she is vaccinated.”
A bit further away in the same district, a man wearing the white t-shirt and yellow cap for the campaign is standing by the mobile health post set up in a market named Guáva. He is holding a megaphone and shouts in Portuguese and the local language Shangana, urging people to bring their children to get their essential immunizations. Mothers and children are already standing in line facing the health workers, and more children are approaching. They have understood that somebody is giving out something good and some of them are looking curiously at the bright red pills containing the Vitamin A drops, they look almost like sweets.
Nationwide, the Ministry of Justice has joined the Health Week initiative, taking the opportunity to inform mothers about the importance of birth registrations. “It is very clever to use the fact that mothers gather in one place as an occasion to mobilize and advise them to register their children.” the chief medical doctor of Maputo province, Dr. Stélio Alfredo Dimande says.
Dr. Dimande is content with how the campaign is going. “This is a great initiative and we are really covering the entire district. The impact is much greater when we mobilize the communities and make sure that people actually participate. Unfortunately, people don’t come to the health centers for routine vaccinations and controls as often as they should, it would be a cheaper solution for the country – but it’s too difficult and expensive for some people to come, so we need to be the one’s reaching out to the communities.”
A visually impaired man approaches the health post with three children holding his hands, two girls and one boy. The girls are his 8 and 5-year-old daughters, Solange and Suza. As the immunization initiative is intended for children up to the age of 5, only one of them is standing in line.
“The girls came to me saying that they heard that there was something important going on in the market and that I had to take them there,” the father proudly explains. “I don’t see very much so they had to lead me here, but I am still here as their guardian to make sure that my Suza gets her protection and I will make sure that the boy’s parents also come here later with his health card. I am very happy that we found out about this campaign.”