Nurse Doma Guere manages the crowd at the Koubri health center.
It takes dedicated health workers to get a vaccine to a village
On the first day of the meningitis A vaccination campaign in Burkina Faso, a small team of health workers in the Koubri region vaccinated 4,916 people—about one person protected against the deadly disease every 9 seconds of a 12-hour working day. On the second day, the team rose in the dark to set up a vaccination station at a village health center. They gave their first shot shortly after sunrise.
As the afternoon shadows lengthen across the health center’s tidy dirt yard, nurse Doma Guere surveys the still-growing line of his neighbors. All are waiting for a dose of MenAfriVac™, the new vaccine against the epidemic meningitis that regularly envelopes Burkina Faso and the 24 other countries of the African “meningitis belt.” Vendors stroll up and down the line, carrying plastic bags of water and flavored drinks on trays atop their heads. Children fidget while their mothers hold tight to their hands. A group of teenage girls, their dresses bright purple, yellow, and blue, strides purposefully into the yard.
“We will vaccinate everyone who comes.”
—Nurse Doma Guere
“We’ve had no breaks at all,” Doma says, beaming at the crowd. “We will vaccinate everyone who comes.”
The vaccine is coming
Getting MenAfriVac™ to the field is a massive public health undertaking. The logistics of safely transporting the vaccine from its manufacturing plant in Pune, India, to a storage facility in West Africa are complex and exacting. But getting the vaccine from the facility to the people who need it most requires something more: the unstinting work of dedicated health workers and volunteers.
The real work, says Emmanuel Ouisnoma, begins before the vaccine even arrives. First, he says, you’ve got to get the word out: the vaccine is coming.
At age 50, Emmanuel is an elder in the village of Korsimoro, a man of influence who volunteers his time to help improve the health of his neighbors. When word of MenAfriVac™ reached his local health center, he recalls, he and others went to the village chiefs, the religious leaders, the local radio and TV announcers—anyone with status or methods to spread the word. Then, Emmanuel and another volunteer went door-to-door to make sure every family knew who should get the vaccine and why.
It worked. On the day the vaccination campaign began in Korsimoro, Emmanuel’s job changed from marketing to crowd control.
A Korsimoro house call
“Every day, our corridors were packed with mothers and kids,” says Dr. Mathieu Boutgma, director of the regional health center in the district of Kaya, which includes Korsimoro. Over ten days, the health workers of Kaya managed to vaccinate 98 percent of their target population—hundreds of thousands of people between the ages of 1 and 29.
Transporting vaccine in Saaba.
The people working the fields, who couldn’t get to the health center, got the Korsimoro version of a house call, says Emmanuel. Two health workers on a motorcycle rode the dirt paths to reach them, the one on the back carrying a cooler holding vaccine.
In cities and villages throughout Burkina Faso, other health workers were tirelessly working to reach their neighbors with vaccine. In the village of Saaba, nurses used their motorbikes to shuttle over the rutted red dirt roads between two vaccination sites, boxes of syringes strapped into their cargo baskets.
Since 2006—the beginning of the last major epidemic wave of meningitis A—“people have been waiting for a vaccine,” says Aristide Bazemo, a nurse in Saaba. When the vaccine became available, he and his staff vaccinated three-quarters of the people who needed MenAfriVac™ in just three days.
Life without epidemic meningitis
Now, with the lines in front of their health center winding down, Aristide and his colleague Boubacar Sawadogo have a moment to dream about life without the threat of epidemic meningitis.
They talk about what they might do if they weren’t fighting this disease. Increase vaccination rates for measles. Address the problem of sexually transmitted infections. Or simply help their clients improve their health overall.
“If we no longer have to worry about meningitis,” says Boubacar, “there are so many things to do.”
Photos: PATH/Gabe Bienczycki.