DRC Diary VI: Vaccinations reach 122% and counting

Jessica Nestrell, a Swedish nurse volunteer, has been coordinating a measles vaccination campaign in the north eastern region of the Democratic Republic of Congo. Over 100,000 children from five months to 15 years are scheduled for vaccinations which will bring the total to over 600,000 since this campaign started.

ALT MSFThe paths connecting villages are often deep enough to take a pirogue.

A better route turned out not to be such a good plan since the river was an extremely narrow maze, with roots and fallen trees everywhere. We soon got lost and, when the paddlers had to start using a machete to get through, we gave up altogether.

We have now finalised the statistics of the coverage having completed the vaccination of the first two pools. Amazingly, 122% of the population has been vaccinated! Which explains why we were running out of vaccines and syringes - the population count we had been given by the authorities was well under the true figure.

For the last stage of the campaign, one group was leaving Basankusu to head east for Djombo port and the other for Iaka. These were the two preparation sites for this pool. With six pirogues and all the people on top of the luggage, as usual the departure was slightly chaotic.

After all the rain that had fallen recently, when we arrived in Iaka we found that it was almost completely flooded. Our intended vaccination point was also submerged so we spent what seemed like hours staggering around in the water trying to organise ourselves and the material on the small patch of dry land remaining before the rain started again.

First we had to carry all the freezers, cool boxes and medical material by hand over the water and set up camp. Some of us immediately took off by motorcycle to check out the state of the trail leading inland from the port. As it turned out the whole area was just one huge swamp, so we had to abandon the motorbikes and continue barefoot. The trail itself had turned into a little river.

Sailing down the road

The next day we heard from the locals that it was smarter to take a small river route instead of the trail to the next village. I took off with the village chief to check it out. It turned out not to be such a good plan since the river was an extremely narrow maze, with roots and fallen trees everywhere. We soon got lost and, when the paddlers had to start using a machete to get through, we gave up altogether. In the end we decided that the best option was to use the pirogues on the water-logged trail instead.

Iaka - where we stayed - is a very small village and the camping situation was probably the worst so far. And the food was not much better. A little area of the jungle had been cleared just by the river and there are only three families. It was difficult to take a bath in the big river because of the interest of the villagers, so the next day I decided to begin taking my baths in one of the small forest rivers that cross the trails heading towards the health posts. I waded up stream in the clear brown coloured water and chose a beautiful spot for a little swim. It is really amazing with the dense forests creating a wall and roof of leaves. My own private swimming pool with a little orchestra of insects and birds!

After one day of awareness raising about the campaign and more work on the statistics, I left with two drivers and a pirogue to do supervision on the river Matoko, which is a very small bi river to the Lopori. This turned out to be a very small river indeed and we had a lot of difficulties getting through, but there is no other way.

There is also no access to it by land up stream since the forest is so dense. The population calls it black forest and black water. There are however quite a lot of people living in the area so we had to try and get there somehow.

We ended up in a very small village and vaccinated another 12 children. These people live in such extreme isolation that they were really surprised to see us. But they were very cooperative and seemed to have nothing against giving us their children for a few minutes.

The accommodation

We continued until dark. There are hardly any villages close to the river so it was difficult to find somewhere to camp for the night. We finally found a village with two houses of about 5 square meters on poles over the water. When I got off the pirogue I expected to find some dry land, but there was just a swampy area with the jungle creating a dense wall. I desperately needed to go to the toilet, but there was no way of getting through to any dry land. In the end, one of the women in the village realised the problem and signalled to me to come with her in the pirogue.

We went into the forest by the pirogue and I jumped onto a small island of some bushes. When we came back I decided to put some energy into trying to put something in my poor stomach. Since we left so early in the morning I had only had half a banana that day, the other half was rotten. One of the villagers gave me a cooking pot and then the whole village watched as I made my tortellini over the open fire. It was definitely the best meal I had had in the long time and I am forever grateful to my friend who sent them over from Sweden.

After that they helped me to tie my little tent onto one of the little pool houses. Its not actually a house, but a bamboo floor topped with a grass roof. Since I had accidentally left some parts of my tent in Iaka, it was quite difficult to put it up. In the end, we had to tie it to the roof. It was sort of hanging from there leaving me with very little space to sleep on. The villagers watched me with completely astonishment when I crawled in. I was probably the best entertainment they had had for ages.

One of the teams vaccinated the seven children in the village and then they took off up the local streams. I was able to explain to them about the cold chain and also correct them on their vaccination technique and organisation of the vaccination site in the pirogue.

I jumped into a small pirogue and continued with the other team into the forest on a small river to supervise the vaccination with this team as well. It was a beautiful trip and we ended up in a very small village and vaccinated another 12 children. These people live in such extreme isolation that they were really surprised to see us. But they were very cooperative and seemed to have nothing against giving us their children for a few minutes. They even gave me some much appreciated bananas for breakfast.

Tracking down the other team

When we came back to Boso Ngubu we took the motorbike and did some quick land supervision to supervise the team that did the villages around the health post.

When we started to head downstream we tried to look for the team that did that part of the Matoko. It turned out to be difficult since they had not marked out where they had been. We stopped every now and then to shout for them. In the end we met some people on the river who said they knew where they were. I jumped into their pirogue and continued on the small river where our pirogue could not continue any further.

Luckily it was a short walk and we arrived at the village to find the team in action vaccinating the children. All the children who had been vaccinated held on to their vaccination cards as if they were their most precious possession. It was very cute. I watched the team vaccinate the last children and then they headed off on by foot to the next village.

Much to my relief, the first days of vaccination passed smoothly.