DRC diary: The last day has come and gone

With other expatriates, Lina is going to coordinate a large-scale measles vaccination campaign. A measles epidemic outbreak started a few weeks ago in Mbuji Mayi and MSF has taken the decision to vaccinate all children aged between six months and five years. In total, 550,000 children will be vaccinated. Working at the heart of this initiative, Lina tells us about her experience, her work and her life on the field. March 24 Pipo is one of the children that we have vaccinated against measles here in Mbuji Mayi in DRC. Pipo had never been vaccinated against measles before, but now he will hopefully have a life-long protection against a disease that otherwise can be lethal.

Today was the last day of the vaccination campaign and it ended well. Initially we were a bit worried about not finding all the children we were supposed to vaccinate but we actually managed to reach 97 per cent of our target group - a result we're very satisfied.

Overall, cooperation with the local authorities has worked well. Before we started we had lots of discussions with the authorities about working procedures and I was very frustrated at times. Some people have difficulties seeing outside of their own reality. But all's well that ends well. What matters is really that everything runs smoothly with the ones you work with on a daily basis.

All participants in the vaccination teams have done their utmost. It's wonderful to see a nurse talking to the children before they give the injection, or another colleague explain to me how he wants to install the vaccination site, completely according to what we discussed at the training. When I see that everything that I've been nagging about actually has had an impact and positive effect at work as well as the individuals my heart warms.

So, what happens now? We will take care of all the material left. Syringes, megaphones, garbage bags, helmets - all sorts of things. Some of it we will donate to a selection of health clinics here and some will be brought to Kinshasa and put in stock in case there another vaccination campaign is undertaken in DRC.

Myself, I will stay for another week then I'm off home to Sweden and the cold. At home I think I will relax for a while until the field starts to tempt me again. What will be my next halt? India, Russia or why not DRC again?

March 21 I've had a great day today! It started at 5am with a short run with Joka, one of our guards. We have two night guards and one guard during the day who make sure that no unfamiliar people enter our compound. Joka and his colleagues are not armed and I prefer to call them screeners, rather than guards, as they screen who can enter and direct visitors to the right person. At 6.30am Clement, the driver, arrived and we went to the MSF warehouse where we keep all the materials needed for the vaccination campaign. It's an energizing place to pass by in the morning. All the people and motorcycles on their way out to work on the campaign are there to pick up materials. The place is noisy and filled with excitement and anticipation. I then continued to a new section of Mbuji Mayi, where we were starting the last phase of the vaccination campaign. If everything goes according to plan, we will be done by Friday. The new area is called Lubilanji and I am very impressed by the work there! At 7am, everyone was there and the vaccination site had been set up already. When the materials arrived, they were ready to start right away. I feel so pleased when I see that the instructions we repeated over and over again during the training have been effective. The teams have understood how, together, we can simplify the job while at the same time keep high standards of quality. The day continued in the same great fashion and the sun shone the whole time, which made things even better. The only less positive thing that happened was that I almost fell of the motorcycle because I was falling asleep. Now I am going to bed to wake up to what I hope will be another good day tomorrow! March 15 Tomorrow is the last vaccination day in the Mpokolo district of Mbuji Mayi. I think that by tomorrow afternoon we will have vaccinated all the children that we aimed to reach in this area. We are aiming to cover 95 percent of the children in the target group, aged between six months and five years. We’ll have to see how close to that figure we will get. We have moved some of our vaccination sites to reach the children better and that has worked very well. I’m very happy when we move sites because that means that I get to see more of Mpokolo which is a beautiful place. It is located in the outskirts of town and today I was out in the countryside. We even found a lake. Well, not exactly a lake, rather a small pond, but it was like an oasis with lots of women and children bathing and washing. A big group of us arrived to the pond at the same time and had a good laugh with a very nice woman who was stark naked. Then I sang and danced with a bunch of children. Even if you can’t speak the same language, it’s easy to communicate with song, play and dance. I always sing “Brother John” in Swedish with the kids and they have a really good pronunciation. “Morning bells are ringing” seem a bit difficult to say, though! The energy that this gives me is wonderful. It’s hard to explain but the warmth in my heart remains for a long time and I can bring it out when things are tough. I leave you with these words and hope that some of you will consider working as a volunteer. It’s amazing! March 14 We had our first motorcycle accident today! The driver Clement and I almost made a complete loop and landed on our backs. Everything happened in slow motion and afterwards we just laid on the ground, laughing. Clement and I spend all day with each other so we experience a lot together. He was hired to be a driver but in practice he is my personal assistant. He is the translator, the secretary when I can’t answer the phone, my diary when I forget things, and a great help in my work. It would be more complicated, difficult and above all more boring if I didn’t have someone to talk to and joke with during the day. Other than that, it’s been a good day. After two days we have vaccinated 62,000 children! Not bad, is it!? The noise level at the vaccination sites is very close to what my ears can bear. If one child in line to be vaccinated starts crying, a chain reaction begins and suddenly you have 50 children who are crying their eyes out! I can leave but the poor nurses have to be in the middle of this all day long. Otherwise the children are wonderful. When I travel around on the motorbike in Mpokolo, all the children come running. Until recently they shouted “matuka!” (the white one) but now they have started to yell “Lina, Lina”! Even if the day has been hard and frustrating it cheers me up and all the difficulties disappear when I hear them.

March 13 After almost 11 hours of jumping on and off the back of a motorcycle, I've now cleaned up and am ready for some well deserved dinner! We don't have running water here so "showering" is done with a bucket of water and a plastic cup.

The first day of vaccinations is almost over and we have vaccinated close to 34,000 children. What's left to do now is a rundown of the day with the MSF team. How did it go? Overall, I feel it went well but there are of course things that we can improve tomorrow.

Some of us were up at 4.30 this morning. At 5.00, our fantastic logisticians were ready to start loading the motorcycles and send them out to the different vaccination sites. Measles vaccine has to be kept at between 2 to 8 degrees celcius and so it is extremely important that the cold chain works.

Each vaccination site received a large cold box with all the vaccines, in addition to four smaller cold boxes with icepacks to use during the day. In addition, each site is provided with all the syringes, needles gloves, pens and other materials that will be needed during the day.

I left our base shortly after 6.00am to be in place when the vaccination teams began their work. The first and most important thing to do is to set up the site. If the vaccination site is not well organized it will make work more difficult for everyone and increase the risk of accidents, with syringes and needles for example.

I'm impressed with how well everyone who's working with us has understood the importance of keeping good order. The teams are working well together - after all we are all here for one reason, to vaccinate the children in Mbuji Mayi, which is a big job! Overall, it's been a good day. I feel very pleased but also very tired and very sunburned.

Now dinner is ready and after that we will get ready for tomorrow. It's eight o'clock in the evening and almost all of us are here so with a quick and efficient run-through of the day perhaps we'll be done before 10! Let's see!

March 12 It's the night before the launch of the vaccination campaign. Everyone is a bit anxious but at the same time enthusiastic and excited. Will all the motorcycles be ready for departure tomorrow morning? Will the vaccination teams be in place and will the children who need vaccination be there?

I think that all will go well since we have organised trainings for everyone involved. Altogether, my colleagues, Judith and Stina, and I have trained 1,500 people.

A vaccination team has nine members: two registrators who fill in the child's vaccination card, two nurses who prepare the vaccine, a nurse who vaccinates the children, a "counter" - a person who fills in tally sheets so that we can keep statistics, and last but not least the three people who are in charge of keeping order.

In addition to the vaccination team, each vaccination site has one or two 'mobilizers'. Their role is to inform the public about the campaign. When, where, why and for whom, are the important messages that they deliver. The city of Mbuji Mayi is divided into 10 zones and tomorrow we begin to vaccinate in three of them.

I will supervise the activities in one of the zones, Mpokolo. We have eight vaccinations sites there and in four days we will vaccinate around 47,000 children. My role as the supervisor is the make sure that all goes according to plan and that those who work there handle their responsibilities properly. Of course I will also vaccinate some children, that's part of it all. Now I have to go to sleep to be in great shape tomorrow. Departure is at 6:15 am so that we can be in Mpokolo by 7 am. Good night!

March 8 "Today I turn 29 and I have spent my birthday in the best way one possibly can. The day started with a downpour but who cares when you're in Mbuji Mayi in southwest Congo! We are a team from MSF who are here to provide assistance to the local health authorities during a vaccination campaign.

"Mbuji Mayi has between 2.5 and 3 million inhabitants and the goal is to vaccinate all children between six month and five years of age against measles, which means carrying out around 500,000 vaccinations!

"Right now we are in the preparation phase which means that we are identifying the places where we will vaccinate, setting them up and training all the people who will work for us. We also need to plan the logistics of the campaign which includes putting all the refrigerators, freezers and ice packs in place and organizing the many cars and motorcycles that we will need. The roads here could do with some improvement.

"During the day I have visited eight of the first 31 vaccinations spots and none of them are reachable by car. The roads are in reality paths. Each place will carry out vaccinations during four days and all together there will be three rounds of vaccinations. The first child will be vaccinated on Monday the 13th of March and according to our plan the campaign will be finished on the 24th of March.

"During my trip in the countryside today, my phone rang. Yes, we have mobile phones like almost everyone else here. It was my cousin Anna who called to say 'Happy Birthday!'. She was in Stockholm and I was under a tree in Mpokolo in Mbuji Mayi in Congo and it sounded like she was next door. It's amazing that you can be so far away and yet so close!"