Today marks the start of World Immunisation Week, an initiative by the World Health Organisation to raise awareness around the importance of immunisation. It is an injustice that each year, 1.5 million children under the age of five will die from diseases that could be prevented by existing vaccines. To try and put it in context, 1.5 million is roughly the population of Uganda’s capital, Kampala. It is especially frustrating when we know that the immunisation of children and infants is one of the most successful and cost-effective health interventions, preventing between 2 and 3 million deaths every year globally.
Uganda has the lowest number of fully immunised children in East Africa, and has the highest infant mortality rate in the region. According to the 2011 Uganda Demographic and Health Survey, 48% of children under the age of five are un-immunised or under-immunised – meaning they start an immunisation cycle but do not complete the schedule. There are many reasons for these low numbers – such as an under resourced health sector and cultural and community reluctance, but one of the biggest factors is the difficulties faced by rural populations in accessing health services, which are often very far from people’s homes.
In an attempt to counter this, ISIS supported the relaunch of Kiwoko Hospital’s Community Based Health Care (CBHC) programme in the Nakaseke district of Uganda. Health outreach clinics have been established in total reaching 44 different villages which they visit on a monthly basis. The outreach clinics provide antenatal and prenatal care, health education programmes, support for people with chronic illness and a safe motherhood programme that work on improving immunisation rates in the district. Under the programme, children are vaccinated against measles, polio, TB, diphtheria, whooping cough, tetanus, hepatitis and influenza, and in 2012, a whopping 6,500 children received immunisations! By returning regularly to the villages, the CBHC team can ensure that children receive a full course of immunisations, as many vaccinations require multiple doses.
The outreach service has proved to be very effective because mothers and caregivers walk much shorter distances to the local immunisation clinic than they would to the regional hospital, and they can receive multiple health services on the same day. At a recent clinic, we met Sarah a 70 year old great grandmother who brought her one year old grandchild, James for his vaccinations. James’ mum was very young when she gave birth and is still in school taking a certificate course in primary education, leaving Sarah as James’ primary caregiver. When James was born, Sarah was too old and frail to walk the long distances to the hospital each month to get him immunised, and before she knew it, James was one year old and had never received a vaccination. This left James completely unprotected from many potentially fatal diseases.
Sarah was relieved to hear about the community clinic because she was finally able to get James the protection he needed. She brought James to the clinic to begin his vaccinations and explained to us how she had been physically unable to undertake the long journey to the hospital through the bush and had been wracked with guilt and worry about his vulnerability to disease. She was very grateful to have a clinic so close to her home.
We are very proud of the success of our CBHC programme. In the last two years, no incidence of polio has been reported in our area of operation, and we have only witnessed one measles outbreak in the last 10 years. Children are healthier and more resilient now that they are protected from many more diseases. We have even seen reduced monthly bed occupancy in Kiwoko Hospital’s paediatric ward.
Immunisation saves lives. It helps children to stay healthy, go to school, and grow up stronger. Without needing to care for sick children, parents can lead more productive lives and invest more in their children’s futures. ISIS and Kiwoko Hospital are pleased to be bringing immunisation services to our community, to help ensure more of our local kids live to see their fifth birthday.