Sometimes it only takes the dedication of one person to make a big impact.
In the Kinkuki health catchment area in the province of Haut-Lomami, Democratic Republic of Congo (DRC) the head nurse of this area, Pierre Dibwe, is that person. Even though Kinkuki is only 7km from the city center of Kamina, the area itself covers a wide range of communities, some over 60km from the health area, often separated by rivers and mountains that considerably complicate access to primary health care services (PHC), including vaccination.
To reach more children for routine immunization in this area, Pierre must walk several kilometers on foot, take a bicycle or cross dangerous rivers, sometimes balancing on fallen tree trunks. However, with 11 years of experience as a nurse, he is ready and willing to bring vaccination services to every child, wherever they are. Even when some of those communities are resistant to routine immunizations.
Managing Measles
Student receiving the measles and rubella vaccine. Photo credit: Betty Nyange
With recent outbreaks of measles and rubella in Kinkuki, and across DRC, VillageReach has been providing technical support to the Haut-Lomami provincial government (as well as three other provinces) to introduce and administer the measles and rubella vaccine. Through this partnership we help provinces with logistics and demand generation activities – things that help health workers like Pierre do their jobs.
In a recent effort from the government to reduce infections, Pierre was asked to participate in a catch-up campaign for the measles and rubella vaccine in Kinkuki. Pierre knew he had an important job to do, and he put several strategies in place to effectively implement this campaign and stop outbreaks in his health area.
First, he needed to map where these outbreaks were occurring, and with technical assistance from VillageReach, he was able to narrow down target areas most in need of the vaccine. Next, he needed to engage communities with high numbers of unvaccinated children. Even before the official launch of the campaign, Pierre was resolutely involved in mobilizing community and religious leaders. With support from the provincial governor and school administrators in raising awareness among parents and students about the importance of vaccination against measles and rubella he created a climate of trust and acceptance, which was essential to the success of the campaign.
“We met with religious leaders, community leaders and activity leaders. We visited markets and other public places to educate parents about the importance of the vaccine,” said Pierre. “We met some resistance, but the fact that measles is a known disease in the community allowed us to achieve our goal. Today, since the [measles and rubella] vaccine is part of the routine vaccination, parents must take ownership to fight against these two diseases.”
Finally, Pierre had to establish rigorous coordination to carry out the campaign. Every day, surrounded by his team (social mobilizers, community relays, teachers, religious leaders and health workers), he organized planning and data analysis meetings, to identify what improvements could be made in terms of technical, logistical, vaccine management and communication objectives of the campaign. He also set up rapid monitoring in households, identifying unvaccinated children, and immediately organizing corrective actions with the teams the next day. These daily exchanges made it possible to adjust strategies before each field visit to more effectively reach more children.
Changing Perceptions
As a result of Pierre’s efforts, parents in this health area are starting to change their perceptions. Parents have a better understanding of the risks associated with these diseases and have made informed decisions to protect their children. Community engagement has been strengthened at all levels: in households, schools, health facilities and places of worship.
“This vaccine helps our children stay healthy. Here at home, some children are affected by measles, and when this vaccine arrives it makes us feel good., “said Isabelle Mukumb a mother from the Kinkuki area. “When there is a vaccination campaign, it is important that we are always well informed. A vaccinated child is a protected child. Even if he catches the disease, he will not develop serious forms.”.
Beyond individual acceptance, some mothers have become true ambassadors for vaccination in their communities.
“I encourage other mothers to accept this vaccine for the sake of their children. A vaccinated child grows up without major problems,” said Liliane Kasongo a mother from the Kinkuki area. “Despite some customs or churches that refuse vaccination, women must not give in to these pressures, because the health of our children must always come first.”
These testimonies illustrate the gradual change in mindset and the increased understanding of the benefits of the measles and rubella vaccine, and it is thanks to Pierre’s dedication and persistence that these perceptions are changing. Through his leadership, his proximity to the community and his strategic vision, Pierre has truly made PHC more responsive to the communities he serves, demonstrating that even the most difficult contexts can be transformed.