"We vaccinate everyone - Baolé, Malinké, Christians, Muslims, Animists - it doesn't matter to us ... we're like a rainbow here in Ivory Coast", says Solange, a mid-wife with one of the UNICEF-supported Mobile Medical Teams based in the city of Bouaké. "I've counted about 200 vaccination cards so far, so it's going to be a long day of vaccinating for measles, polio, yellow fever, BCG, DPT and tetanus for women." It's another hot, humid morning in the small, poor village of Tollakouadiokro, located on the outskirts of the rebel-held, central Ivory Coast city of Bouaké. A living rainbow of over 200 coloured-clothed, head-wrapped women and children stand, babies strapped on their backs, waiting patiently for their names to be called so they can be vaccinated.
Six days a week, Solange kick-starts her UNICEF-supplied moped and, joined by a doctor, a nurse, 2 health assistants and 2 social mobilisers, heads out to the village scheduled for vaccinations that day. "Our 3 Mobile Medical Teams are a real mix of ethnic and religious backgrounds. It wasn't planned that way, it just happened," says Koné, a Muslim social mobiliser. Father Henri of the St Martin's Catholic Mission in Bouaké, co-ordinates the Mobile Medical Teams which consist of 2 ambulances, 3 vehicles and 5 mopeds. "I've worked in Bouaké for 12 years and this is the worst it's ever been. People are really suffering. The factories and stores are closed so there's no work, and salaries for government workers aren't paid. That's why the fact that the vaccines and health care interventions that are provided free by the Mobile Medical Teams are so important."
Bouaké and most of northern Ivory Coast have been in MPCI-rebel hands since a rebelled coup attempt on 19 September 2002. "People can't buy nutritious food or pay for health care, so we are seeing a real decline in health and nutrition", says Father Henri. "The Mobile Medical Teams help to not only treat diseases, but also to prevent diseases through our mobile vaccination activities. Particularly measles epidemics which can often prove tragically and unnecessarily fatal for unvaccinated children."
Seated in front of the rainbow of women, children and babies, Solange and the health assistants register the vaccination cards. At the next table, Dr Michel, patiently listens as the health assistant calls out the vaccinations needed for the next baby, child or mother. "Polio, yellow fever and measles", shouts the health assistant. Dr Michel reaches over to the tiny vaccination bottles resting on ice packs in a metal container. The labels and the life-saving vaccines are a rainbow of colours themselves. As the vaccinations begin - oral drops for polio and needles for the other vaccines - the inevitable symphony of crying babies begins. To help calm their babies, some mothers begin to breastfeed them as they sit down to get their shots. The babies aren't the only ones who need soothing - some mothers also wince as they get their tetanus injection in the upper arm. The next name and vaccinations needed are called out as Dr Michel tosses a used needle into the disposable syringe box and tears the plastic wrapping off a new one.
"In an emergency like the Ivory Coast, where you have large displaced populations; reduced access to health care, adequate water and sanitation; and, reduced coping mechanisms, an absolute priority must be given to immunising children against measles as quickly as possible. It's the most effective, preventive health care activity you can do to save children's lives", says Dr Agostino Paganini, UNICEF's Senior Health Adviser, Emergencies. "At the same time, we will also assist in the re-establishment of regular immunisation services." From 14-18 Jan, Dr Paganini conducted a health assessment mission in Ivory Coast, including field missions to rebel-held Bouaké and government-held Yamoussoukro where he met with partners to discuss emergency health activities.
At the end of the long day, Solange, Koné, Dr Michel and the rest of the team double-up, kick-start their mopeds and head back to Bouaké. Tomorrow morning, their Mobile Medical Team will once again begin its life-saving work in N'goutanoukro village, helping to vaccinate even more Ivorian children against measles and other often fatal, but easily preventable, diseases. At the same time, the other two UNICEF-supported Medical Mobile Teams will continue to provide a rainbow of health care interventions - from assisting in childbirth deliveries to treating malaria to providing oral re-hydration salts for diarrhoea to helping people cope with the stress of war - in the villages around Bouaké.
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