Immunization, Cucumbers and Civil Society

by Brenda Hegarty

I was digging worms out my cucumber (the African equivalent of ‘organic’ labelling) when my neighbor trundled into my compound with her belly as swollen as a gestating giraffe’s.

“Foreign girl,” she said (a term of endearment…I’m told). “I’m dying. You’ve got to help me.” She sat down on my compost heap and started moaning. “The doctor says I have malaria and typhoid. My head hurts. I’m exhausted. And I can’t move myself in any sense of the word.”

I was surprised. I told her she was the first person I had ever met who had typhoid.

She stared at me. “What are you talking about, you strange creature? Everyone gets typhoid.”

Alizeta Sore, a community health worker at the Peele Health Center in Peele, Bogodogo Health District, Burkina Faso, bicycles through her community to visit mothers at home and discuss immunizations and to remind some to visit the clinic for vaccination day the next day.  Photo by Laura Elizabeth Pohl/CRS.

Alizeta Sore, a community health worker at the Peele Health Center in Peele, Bogodogo Health District, Burkina Faso, bicycles through her community to visit mothers at home and discuss immunizations and to remind some to visit the clinic for vaccination day the next day. Photo by Laura Elizabeth Pohl/CRS.

“I don’t.”

“Of course you do.”

“No, I can’t get typhoid.”

She narrowed her eyes at me. “Because of why? Because of witchcraft?” She snatched my cucumber away. “Everyone in my family has typhoid. I want your witchcraft!”

“It’s not witchcraft,” I explained. “It’s a vaccine. I’m vaccinated against typhoid.”

“That’s impossible. There isn’t any vaccine for typhoid. If there was, then no one would get typhoid. But everyone gets typhoid!”

“Not me.”

She stuck my wormy cucumber in her skirt. “I’m keeping this ‘til you give me your foreign-girl witchcraft.”

Thus inspired to do both my civic and culinary duties, I went to my local health clinic and asked them if they had a typhoid vaccine.

“There’s no such thing as a typhoid vaccine,” the doctor told me.

“Of course there is.”

“Listen, I’ve been a doctor for twenty years and I’m telling you no one has a discovered a vaccine for typhoid! If there was such a thing, I would be giving it to everyone in town, because I see a hundred cases every month.”

“But,” I protested, “I’ve been vaccinated against typhoid my entire life! How can your clinic not have a vaccine? How can you not even know that the vaccine exists?!”

The doctor’s breathing grew funny. “But we only see vaccines every few years, just when you foreigners bring them, and I’ve never seen more than two or three kinds.” He paced. “How many are there? How do we get them? Do you know that tens of thousands of children die every year here because we don’t have vaccines?”

So I explained to the doctor—and later to my neighbor—that because so many health systems around the world are dysfunctional, an estimated 22 million children are unimmunized. About 2.3 million die every year from vaccine-preventable illnesses (WHO/UNICEF, 2012). A health system, of course, is not just government-run clinics and hospitals; it is also the services provided by the many non-government actors we term “civil society.”  These community-based actors undertake vaccination campaigns, educate communities, collect information on health needs, and hold the system accountable for providing essential services and spending public money transparently.

Children in a rural community of Ghana, receive vaccinations during a monthly health clinic in April 2013.  Catholic Relief Services administers a GAVI Alliance grant that aims to strengthen vaccinations systems in 14 countries, including Ghana. In Ghana, the strengthening work involves civil society organizations collaborating and communicating more openly with the government on immunization activities. (Laura Elizabeth Pohl/CRS)

Children in a rural community of Ghana, receive vaccinations during a monthly health clinic in April 2013. Catholic Relief Services administers a GAVI Alliance grant that aims to strengthen vaccinations systems in 14 countries, including Ghana. In Ghana, the strengthening work involves civil society organizations collaborating and communicating more openly with the government on immunization activities.  Photo by Laura Elizabeth Pohl/CRS.

Not everyone can become a doctor or get into government, but everyone can contribute to a stronger health system.

My neighbor, my doctor, and everyone in my little town who is motivated to save lives with a simple jab can now get involved in the vaccine movement thanks to funding from the Global Alliance for Vaccines and Immunization (GAVI). With support from Catholic Relief Services, the GAVI Civil Society Constituency Project is helping civil society organizations create and strengthen national platforms that advocate to their governments for a strengthened health system that provide vaccines for all. The project has strengthened immunization programs in fourteen countries so far and just last week Catholic Relief Services extended their support to nine new countries.

I gave all this information to my friends and neighbors and was then so happy to have done my part in building the civil society platform for child survival that I let my neighbor keep my cucumber—worms and all.

Brenda Hegarty is a Technical Advisor for the GAVI CSO Constituency Project managed by CRS. She is based in the Democratic Republic of the Congo and travels to all project-participating countries to provide support in advocacy, communications, and health system strengthening.

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