Posts Tagged ‘immunisation’

Where Minibusses Fear to Tread (and Probably Shouldn’t): NID Round One

June 17, 2011

For the first round of National Immunisation Days (NIDs) I had to stay local to Opuwo so I could kick a modem regularly. I ended up assigned to Mobile Team One which entailed doing the villages, locations and other areas immediately around Opuwo.

Unfortunately the vehicle I was given was our Toyota Quantum minibus (combi in Namlish). Though roomy and great for actual immunisations it is the least practical vehicle ever invented for going anywhere other than perfect tarmac.

Of course this being Opuwo there only is one tarmac road so we spent a lot of time bumping, bashing and bouncing through/over uneven terrain.

The Toyota Quantum 'Immunobus' used by Mobile Team One for Kunene Namibia National Immunisation Days 2011 Round One

Once at a location the Immunobus was great – we could have the vaccine chest easily accessible and use it as a table, keep the engine running for AC (it’s pretty quiet) and snooze in the fully-reclinable seats.

Thanks to the ultra-low bullbars, positioning of wheels, two wheel drive and long body getting there though was an exercise in feeling our way over stuff, gouging holes and getting beached twice (though as luck would have it we got off both times).

Queue for immunisations for Mobile Team One, Kunene Namibia National Immunisation Days 2011 Round One

As a mobile team our job was quite literally to drive around looking for children and then enticing them to our van. Any other time, place or reason and we would have been arrested.

We had success though so here are some pictures from our efforts to make lots of children cry:

A child is upset after immunisation, held by its mother while an older girl holds another small child, Kunene Namibia National Immunisation Days 2011 Round One

Child is Upset After Immunisation

Two mothers with their children watch immunisations and wait their turn, Kunene Namibia National Immunisation Days 2011 Round One

Two Mothers and a Baby Watch Immunisations

A mother holding a child watches others being immunised waiting for her turn, Kunene Namibia National Immunisation Days 2011 Round One

A mother and her child wait for immunisations

Marking the right thumb of a child immunised as part of Kunene Namibia National Immunisation Days 2011 Round One

After immunisation children are marked with ink on their right thumb

A Himba baby receives an oral immunisation near Opuwo, Kunene Namibia National Immunisation Days 2011 Round One

Himba Baby is immunised while a Herero mother looks on

Dust-covered children coming for immunisations, Kunene Namibia National Immunisation Days 2011 Round One

Dusty children come for immunisation

A dust-covered child receives a Viramin A oral booster, Kunene Namibia National Immunisation Days 2011 Round One

Dusty child receives Vitamin A booster

A child watches immunisations, Kunene Namibia National Immunisation Days 2011 Round One

A child watches immunisations near Opuwo

Mobile Team One at work, Immunisations near Opuwo, Kunene Namibia National Immunisation Days 2011 Round One

People queue at the Immunobus

Baby receiving immunisations, Kunene Namibia National Immunisation Days 2011 Round One

Baby being immunised from the Immunobus

Baby receives polio immunisation near Opuwo, Kunene Namibia National Immunisation Days 2011 Round One

Baby receives polio drops


A NIDing I Will Go

June 13, 2011

It’s that time again; the National Immunuisation Days are upon us. The yearly NID programme consists of two rounds (cryptically called NID 1 and NID 2) where the Ministry of Health dispatches just about everyone into the field to find children and make them cry (also make them safer).

This will be my third NID (not counting the emergency Measles immunisation drives) and sadly also my last.

It’s a great opportunity to get out into da bush, meet new and interesting people, camp out under the stars like a real man, do good works ™ and as an added bonus make children cry.

Unfortunately for NID 1 I’m tied to Opuwo and so will just be going out on a daily basis then returning at night (or not returning because I’m stuck in mud/water/quicksand/on rocks). Though this has the added bonus of sleeping in my bed every night it lacks the tough real manliness and camaraderie of camping out in the middle of nowhere.

I’m tied to Opuwo thanks to one thing; the naughty modem.

In April we had a lightning-caused power surge on the Telecom network in Opuwo. It took out my ADSL router, my laptop and also the work baseband modem used to connect one of our networks to head office in Windhoek.

This left nobody able to connect to the central finance, HR or intranet systems and rather than being seen as a bonus holiday was met with consternation.

Getting a new modem would take over a week but luckily Telecom had a spare second-hand one in Opuwo and was able to bring it over the next morning and after a little setting-wrangling, prayer and repeated reboots we were back online.

All was well.

But since then and with increasing frequency a red light keeps coming up on the new modem and the connection is lost.

I could bore you with details of what this light may mean or the tests I’ve performed on the line and so on in a veiled and pathetic attempt to look like I might know what I’m talking about but I’ll spare you that (this once).

Suffice to say that on a regular basis the connection to head office is lost. People will then come and see me, usually I’m already in the room with it in cursing, and ask what the problem is (no doubt assuming I’ve broken something).

Usually turning it off and back on will solve the problem (as with 94.8721% of all IT problems) but sometimes, like today, it doesn’t and I’m left trying to find someone on the phone at Telecom or our WAN company who can turn their end off and back on.

I’ve previously pointed to the modem and said ‘it may be faulty’ or explained that the line is down and I’m trying to find out which bit is broken. Mostly this was met with blank stares. Until I pointed generally at the equipment and told someone ‘it is very naughty’ at which their eyes lit up and understanding was reached. So this has now become my formal description of the problem.

“Status report Mister David?”

“It continues to be naughty Meme”

I have now managed to open a fault with Telecom for the ongoing problem (previously they would open a fault when the line was down, when I reset the modem and it was back up the fault would be closed) so I have high (no doubt foolish) hopes we can get it sorted allowing me to get out deep into da bush for NID 2.

Here’s a picture of the GRN network rack. The naughty modem is the white box in the middle:

Rack Open Showing Naughty Baseband Modem

And here it is in close-up with some detailed technical information:

Naughty Baseband Modem Close

See – I know all about the flashy lights and what about those arrows done in MS Paint? Truly I am l33t to the max.


September 24, 2010

Late last year we had a major outbreak of measles within the Kunene region, the disease having crossed over the border from Angola.

Because of the lack of immunity in the population combined with a transient lifestyle and close living conditions it spread very quickly, sadly resulting in a number of deaths of people who had underlying conditions and were in many cases already immunocompromised.

The Ministry of Health and Social Services instigated an emergency response in the region and received assistance from far and wide to help fight the outbreak.

Some of the assistance included:

  • Tents for an isolation unit provided and setup by the NDF (Namibian Defence Force)
  • NDF ambulances (tank ambulances), nurses and doctors
  • Nurses from other regions
  • Technical support teams from national level
  • Epidemiological support from the WHO

In the end we had three special rounds of immunisation – starting with children 6 months to 5 years and ending up immunising anyone of any age.

New Cases of Measles in Opuwo District (nb reports from outlying clinics often delayed)

Our biggest problem was reaching everywhere in time – the Opuwo District is particularly sparsely populated and rugged so everyone took part in the effort, I even contributed in a small way.

From the graph above you can see what a major impact the response had – the immunisation campaigns were held from around week 44/45 onwards. By the end of January 2010 new cases had dropped to almost nothing and by pushing ahead with one further round of immunisations hopefully that will be the end of it.

What this shows I feel, apart from the importance of clear focus on emergencies and prompt responses is the simple message that routine immunisation works. Other places with a much higher rate of immunisation (a higher “herd immunity” to use epi-doc-speak) simply wouldn’t have had anywhere near the rate of infection.

Prior to this outbreak we would often find some Himba communities reluctant to take part in vaccination campaigns. A post-appartheid legacy of not trusting the government, word-of-mouth tales of adverse reactions (and of course actual adverse reactions, many children will have a small and brief fever after immunisation) and a trust in traditional healers all played a part. Really it was a more forgivable version of the UK MMR fiasco.

Sad though the outbreak was the one positive result has been a marked change in attitudes in the community. Everyone knew someone who was infected and given the small population everyone knows of someone who passed away. Towards the end of our special campaign (and in routine campaigns since) we have had people queuing up to have their children (and themselves in some cases) immunised.

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National Immunisation Days

June 22, 2009

Last week (16 – 19th of June) was round one of the National Immunisation Days (NID) with a swanky launch event on held on Monday the 15th.

The focus of this round was on immunising under fives in the Kunene Region (and nationally, hence the title) against Polio, Measles and Vitamin A deficiency (though I’m not sure if this last one is strictly an immunisation or just a “booster”).

As part of this all Ministries and NGOs etc mobilise to provide a fleet of vehicles and various seconded volunteers to head out into the field and help with the actual immunisations or support administration/logistics.

Kunene has a target population of 11,241 under fives (estimated) and even with some results still to come in reached a coverage of 96.1% for Polio and 92% for Vitamim A and Measels.

In actual fact it turns out the population estimate was significantly under with the Khorixas and Outjo districts coming in well above 100% of target. This helps bring the overall figure up even through Opuwo was well below target as the helicopter didn’t turn up for the hard-to-reach area.

The programme has universally been viewed as a success and now everyone is safely back it’s clear that there were none of the adverse reactions (severe reaction always being bad but especially so eight hours away from a hospital) or logistical (running out of vaccines or simply crashing of vehicles) seen in previous years.

Now just to prepare for round two in July.

Launch of NIDs Round One

Launch of NIDs Round One

Fleet for NIDs Round One

Fleet for NIDs Round One