See the French version of the blog here.
One foggy morning, I stood on the bank of the Mwabuka River in the Ankoro Health Zone, Tanganyika Province, watching villagers build a makeshift bridge using bamboo and ropes. I was there on a VillageReach immunization mission to the health zones of Manono, Ankoro and Kiambi. The mission: to provide high-quality technical and logistical assistance in implementing the activities of the special immunization strategy, helping to halt the circulation of variant type 1 poliovirus in the provinces by reaching children in areas of difficult access, including islets, mines and rural camps of displaced people.
Impassable roads (often flooded by rainwater), dense forests and overflowing rivers further complicated my travel. As I prepared to cross the Mwabuka River with a field team of technical specialists and vaccinators, a woman arrived at the bridge with her child on her back. She walked for hours to arrive at the vaccination clinic.
This simple but symbolic moment made me realize the importance of not leaving these populations isolated due to a lack of adequate health infrastructure, far from major urban centers, without access to essential health care, including vaccination. Faced with this population’s difficulties, we, as VillageReach health specialists, have no choice but to cross these rivers, forests and hills to meet them. Improving vaccination coverage in these remote areas is not just a matter of providing doses of vaccine but of deploying real, adaptive field strategies.
Vaccine hesitancy and community leadership
Working with the hardest-to-reach communities in DRC to improve immunization rates. (Photo Credit: VillageReach)
During our visit to the Manono, Kiambi and Ankoro Health Zones, we vaccinated many children and met with community leaders to encourage them to raise awareness of vaccination. It was a total immersion in the heart of complex health and humanitarian challenges in a region beset by multiple crises. Our experience was marked by moments of hostility but mostly of hope, thanks to the efforts of local and provincial leaders.
As soon as we arrived, the stage was set at central offices and health centers to welcome us. Some health zones lacked information on the benefits of immunization and its likely side effects, leaving a lasting distrust of vaccination programs. While the overall perception of immunization is positive, it remains fragile due to the difficulty of sustaining activities after support from partners.
Most people perceive vaccination as beneficial, particularly for protection against serious diseases such as “Vundjavundja” (polio in Swahili) and “Bulebe” (measles in Kiluba). The acceptance rate is higher in areas where village chiefs or religious leaders actively support vaccination campaigns. On the other hand, where these leaders oppose or remain silent, mistrust is higher, as in the case of the Steward religious sect.
Technical and logistical challenges
Scarce and unstable internet connection, combined with incomplete or inaccurate reports, made extracting vaccination and epidemiological information difficult. Scorching heat, long distances on foot in areas inaccessible by car, and unexpected encounters with wild animals, such as two gigantic elephants that blocked my way, added to the challenge.
During a visit to the village of Busolo in the Manono Health Zone, torrential rain turned the roads into rivers of mud. We completed the journey on foot, carrying the Indigo vaccine carrier, designed to transport vaccines in temperature-controlled conditions to ensure vaccine safety and efficacy. In other villages, we applied the “Hibou” approach of nocturnal vaccination, to ensure that the children of parents who labored in the fields by day could benefit from vaccination.
This mission was an intense mix of challenges, emotions and lessons to ensure effective coordination of activities, the sensitization of communities on immunization and the involvement of local leaders. We encountered a resilient population, determined local groups working in a context of limited resources and an urgent need for coordinated support to sustain these special immunization strategies in hard-to-reach places.
Health care is a profoundly human experience
Every piece of data gathered through rapid surveys or interviews, every report written, every action plan drawn up has a human face behind it. This experience reminded us that special vaccination strategies are more than a technical discipline; they are a profoundly human experience.
The special vaccination teams have not only improved acceptance of vaccination, but they have laid the foundations for lasting trust between health services and communities. This pragmatic and humane approach can serve as a model.
Beyond the figures and statistics, I now understand the strength and resilience of communities who, despite natural and human obstacles, fight for their health and their future. Vaccination, far from being an isolated act, is a collective struggle that requires the involvement of everyone in the continuous mobilization of resources and know-how.
I return convinced that every difficulty overcome, every child vaccinated and every local leader involved is a step towards a future where access to quality health care is assured for everyone, wherever they may be. Together, we can cross these rivers, forests and hills for a safer, healthier and fairer world.