Feature N° 201
OUT OF THE MOUTHS OF BABES
July 2001, Kolwezi, Katanga Province, Democratic
Republic of Congo
"New babies need to be vaccinated so that they don’t fall ill. Between zero and 59 months, they need four types of vaccine which protect them against six diseases, and they need them at special times. For example, they have to have measles vaccine when they are nine months old and they have to have three doses of polio vaccine before they are 11 months."
A paediatrician explaining the principles of the expanded programme of immunization? No, 10-year-old Mademoiselle Omba of class 5C, Mandeleo Primary School, Manieka Commune, Kolwezi Town, Katanga Province, Democratic Republic of Congo, Africa, the World, the Universe…
Omba and her classmates are the new not-so-secret weapon for raising rates of routine immunization and spotting cases of the infantile paralysis which can signal polio in this southern Congo mining town, 300km and six jolting hours by pot-holed road from Lumbumbashi.
In a programme introduced in January last year, fourth and fifth graders - nine to 12-year-olds - in five schools have been learning all the details of childhood vaccination, including disease symptoms, doses, dates and why they are so important, and going out into their own communities to make sure new babies are getting the protection they should.
"We ‘adopt’ up to five babies - but actually I have six," says Omba. "We help the mothers remember when vaccinations should be done, and tell them why it is important. We write all the details down exercise books and go to visit often to see how the baby is."
The programme is organized by a local committee which includes school director Madame Eugenie, Dr Illunga, chief of the health zone, Dr Menongo, WHO’s district epidemiologist and health workers from the local clinics. Materials like exercise books have been given by UNICEF which is also renovating the school and training teachers in a new curriculum which includes at least an hour a week on health.
The pupils’ knowledge is impressive. When Madame Eugenie runs them through the routine vaccines, their uses, their doses, most are word perfect, chanting in unison, and leaping up to answer individual questions.
In the five months to May 2001, class 5C has adopted 164 infants, 162 of which have had their BCG (99% compared with national coverage of 30-50%). 105 have had their first dose DPT and oral polio vaccine, 105 their second dose and 66 their third. Only 19 out of the 164 have had a routine measles vaccine but this, explains Mademoiselle Omba carefully, is because most of them are not old enough yet.
In total in the year 2000, Mandeleo pupils adopted 1849 infants, and according to Dr Illunga routine vaccine coverage in the health zone increased from 50 to 70% between 1999 and 2000 - much of which, he says, is due to the child to child programme.
The children have taken to the routine immunization information so enthusiastically that this year they’re expanding their reach to include watching out for acute flaccid paralysis or AFP in their area, a crucial aspect of the global campaign to eradicate polio.
In class, Madame Eugenie leads 5C in chanting the new
Charlotte has already found a child with paralysis. "I asked the mother if the child had been vaccinated and took the name and address of the family to give to my teacher. He talked to the health centre and now they are helping the baby. Polio can make a baby handicapped and that’s not good," she says, adding that she intends to be a nurse when she is older.
Children are a good channel of communication says Madame Eugenie. "They can reach their own parents and others and make them enthusiastic, sometimes much better than adults. They tell other children whose schools aren’t doing the same thing about their ‘job’ and these go back to their families and ask if their small brothers and sisters have been vaccinated. They are very observant to detail."
And there’s a long-term benefit, says WHO’s Dr Menongo, who is now helping to expand the project into all 11 schools in the zone. "If you have the child, you have the adult - this is a way to change behaviour for the future."
The only problem right now is a shortage of exercise books, and some gold stars for good work done.
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