Sudan: Vaccines can save children’s lives

KAPOETA, South Sudan — Lotanawi was two years old when she fell ill in April. After traditional herbal medicines failed, her mother took her to the health clinic. But by then there was nothing the doctor could could do. Soon after, Lotanawi died of measles.

“I did not know there was a drug that could work,” said her distraught mother Lochoke Nakai.

South Sudan will soon be the world’s newest independent country, and one of the least developed after decades of civil war that ended in 2005. There are just 30 miles of paved road in a territory the size of Texas. One in seven newborns dies here before their fifth birthday and only 17 percent of children are vaccinated, the lowest coverage rate in the world.

Vaccines are among the cheapest and most effective ways to prevent child deaths. An estimated 2 million children die every year from diseases that can be prevented by an $8 course of basic vaccinations.

The Global Alliance for Vaccines and Immunization (GAVI) is an initiative bringing together countries, charities and pharmaceutical companies to provide vaccinations to the world's poorest. During its first 10 years, GAVI has vaccinated 288 million children, according to a recent report by Save the Children.

At a conference in London this week donors pledged billions of dollars to continue funding vaccinations in poor countries up to 2015. The global alliance sought to plug a $3.7 billion funding shortfall by holding the pledging conference. In the end the global alliance exceeded their goal by raising $4.3 billion, despite the ongoing economic crises faced by many rich nations.

British Prime Minister David Cameron emphasized the “strong moral case” for keeping promises of aid to the developing world as he pledged $1.3 billion. Microsoft entrepreneur Bill Gates, whose Bill and Melinda Gates Foundation is a GAVI member, promised $1 billion and the United States government donated $450 million.

Aid workers say that these funds will save the lives of 4 million children over the next four years, protecting them against preventable diseases such as pneumonia, diarrhea and measles.

The funding is welcome, but buying the drugs are only the beginning of the story in places like rural southern Sudan.

Lokipi village — where Lochoke Nakai lives and where her two-year-old daughter, Lotanawi, died — is in the southeast of South Sudan, close to the borders with Ethiopia and Kenya. It is home to 200 people all related by birth or marriage, and ringed with a fence of thorny acacia branches. Like other pastoralist Toposa people, the residents of Lokipi live in thatched huts, herd goats and cows and grow sorghum.

There are no roads, no electricity, no running water and little knowledge of modern medicine.

To reach the scattered communities, a team of trained vaccinators drive for an hour from the hamlet of Kapoeta North, on barely-there dirt tracks and across two rivers, before setting up a mobile vaccination clinic underneath a tree.

Dozens of children dressed in beads and colored blankets file out of a nearby village carrying their younger siblings. Each is given a drop of an anti-polio vaccine on their tongue, a measles injection, an immunization against tuberculosis and a jab of DPT3, a combined vaccine that protects against diphtheria, whooping cough and tetanus.

When no more children arrive, the health workers pick up their cooler of vaccines and packets of syringes and begin walking.

“We do this every day, but sometimes not enough people come so we go village to village to catch children at home,” said John Loreom, who works for Save the Children. On average they vaccinate 75 children every day of the week.

Over the next two months they will return to the same place twice more to give follow-up drops and injections. Save the Children estimates that once transport, staff and other costs are factored in, the price of each child vaccinated is $35.

Overcoming barriers of culture and tradition is perhaps even more difficult that basic logistics.

The loss of her oldest child drove Nakai to have her two other children vaccinated. But not everyone in Lokipi is convinced, and there is still resistance to the unfamiliar drugs and injections.

“I am ready to use the medicine not the herbs, but others in the village do not trust Western drugs,” said Nakai.

At another village some miles away, two elderly medicine women — the first port of call for most Toposa when illness strikes — sat on the ground smoking a water pipe fashioned from a gourd.

Napuyo Lokaale did not object to the vaccines, but insisted that villagers should continue to seek traditional remedies. 

“We can cure diarrhea, malaria, mental illness and many other things with [the herb] eporiang,” said Napuyo Lokaale, who had a wizened face and a mouth full of listing tombstone teeth. “Only measles defeats us.”