MARC 2010 Vaccination Campaign

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September 21st 2010

Published: September 24th 2010

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Seamus

Ivan the Vaccinator

The man's not big on needles so he doled out the Polio vaccines.

In the midst of all that is happening with our Clinic Construction Expedition there have been several side projects. One of these took the form of an immunization campaign. While building at the construction site continued, another Project MARC team assisted the Vanuatu Ministry of Health with the delivery and administering of "Stik Meresin blong Olgeta Pikinini" (Bislama for Vaccine).

The campaign itself only took a week. The preparations to make it all happen took up the week and a half prior. Here’s the story.

Earlier this month Project MARC was asked to help with the immunizations along the West Coast of Santo by the managers of Rural and Maternal Health for the province, Valma Banga and Lilly Peter. We had originally planned to work with one of their teams in the Big Bay area during the month of September for a Maternal Health Expedition. But since that program needed to be cancelled at the last minute, Lily asked us instead to assist with the Vaccination Campaign.

Lily's a pretty convincing negotiator too. The way she put it, we didn't really have an option to say no. You could say that she gave me a request that I

The starting line-up

Here's our first team for vaccine admin.

couldn't refuse...and had me laughing the whole time.

At the start, the program seemed like a simple operation. But then again, all things in Vanuatu look pretty straightforward at the beginning. The reality, however, of getting the medicine to those that needed it certainly became a bit more complicated.

The original plan had a team of nurses from Luganville and a pair of MARC Volunteer doctors sailing up the coast sticking needles into kids for the duration of a week. A volunteer yacht was to transport the teams up and down the coast and was equipped with a refrigerator for the storage of the vaccines.

This was plan A.

The first complication came when the yacht scheduled to handle transport was a little late arriving in the country, but ‘Delay’ has been the name of the game this year. Having fully expected some sort of hold up there was adequate buffer time in the schedule to accommodate a later arrival of our aquatic steed.

The second complication was a little bigger. Our volunteer yacht (a 60’ catamaran) had sustained a lot of damage during its passage from Australia and would need to stay in Port

Evening departure

Unsure of which ride this was.

Vila for repairs. This further delay was pushing the buffer in the schedule to the limits, and Plan B was created, which meant and altered schedule.

Two days into plan B, we were informed that the catamaran had cracked a drive shaft and would have to leave the country for repairs, and they wouldn’t be able to help Project MARC this year. With time running out, we needed to find another volunteer yacht. Alvei was still in town but they were headed to Australia at first availability (and they don’t have a refrigerator for the medicines), which brought us to…

Plan C: find another boat in 48 hrs.

For those of you who’ve been to Luganville, you can see that this was going to be an interesting task. I had just picked up a volunteer doctor from the airport the night before, there were supplies to be purchased, a tour of the hospital to be had, and meetings to be attended. Fate smiled on me this day however, and due to a barbeque onboard Alvei that night we managed to secure another volunteer yacht for the campaign.

This new skipper wanted to have Project MARC cover

Start-up in Wusi

Chief Puha had things properly arranged in Wusi.

the cost of fuel for the trip, which is not an unreasonable request. After working out the numbers though, he estimated the cost of running both his engines for the course of trip. And this was a bit of a problem.

The fuel cost was pretty high and we didn’t have that kind of money budgeted…which moved us onto plan C.5: Find money for fuel, find another yacht, or start digging for oil in Andrew Toyne’s backyard (Andrew was hosting the MARC team while in Luganville).

Luckily, fate smiled on us again. The captain of the ‘Plan A’ catamaran agreed to make a donation to offset the cost. He said that if he couldn’t do the job himself, he’d be happy to help another captain get the job done. Also joining the fight to get the job done were some local business owners in Luganville. Dave of the Beachfront Resort, and Rahan of AquaMarine Dive Shop both chipped in to make things work.

All-in-all, things were looking good.

Everything was lined up: The Ministry of Health was making preparations with their teams, I was set to do a publicity tour to all the villages in the

Hold and stick.

Georgi stabs some kids up in the Narumaj Valley.

sector notifying everyone of the coming vaccinations, and we were headed back to the Project site on the West Coast with a new doctor volunteer. It was pretty amazing that everything managed to happen in 72 hours. I never would have bet on that possibility.

We left on a truck from Luganville around 7AM and bumped along the road toward the West Coast. At the edge of the cell phone range I checked the messages on my phone for the last time…and received a phone call.

This one phone call, sent at the last possible moment before I would be un-contactable for a week, came from the second catamaran’s captain. He was bailing out. He didn’t want to help us anymore. He’d changed his mind. And then the phone cut out.

The dirty business had hit the fan. We needed a Plan D, which wasn’t good. Luckily I still had a few hours of bumpy truck and boat rides to figure it out.

In the end, it was Plan D that got the job done. It wasn’t pretty, it didn’t work as well as the others would have, and it cost a lot more money. It

Song-Marie, RN

Chickens are common gifts for medical help

was the option that was available to us at the time, however, so it was the plan that we went with.

Without a refrigerator available to us, Plan D required that we use iceboxes to transport the meds. Each box had a 72-hour countdown before the meds warmed to a point of uselessness. Since the area we needed to cover would take far more than three days of working, the meds would need to be brought out in multiple batches from Luganville. Our transport would be handled by chartered truck and water taxi.

The first leg of the campaign covered the Southern third of our sector. Our two doctors, Dominique Wakefield and Georgina Osborne, accompanied the Tasiriki Dispensary nurse Song-Marie. Also along for the trip was Mr. Ivan Oswald, a Project MARC operative from Port Vila for the past two years. Since I was going to be unable to accompany our doctors to the mountain valley of Sauriki, and Frank Zolnai was holding down the fort at the construction site, Ivan was invaluable as a translator and camp manager.

The second leg of the trip covered the North and Central thirds of the sector. Staffing this leg

JMC

Team takes a breather at the Jungle Mountain Clinic

of the trip were the team from the Rural Health Office (Nurses Lily, Fabi, and Mikael) as well and the MARC team (Doctors Wakefield and Osborne, Ivan and myself).

We wanted to arrive at the campaign’s Northernmost village around mid-afternoon. Due to the unreliable nature of water-taxi schedules, we arrived in the evening and had to work into the night. Thankfully the village of Vunavae has a generator and lighting for their nakamal where we set up shop. MARC had to pay for fuel, but the job got done.

Our next day was also spent in Vunavae. It was full of screaming infants, needles, and village health paperwork. Although we wanted to move onto the next village that day, the promised boat did not arrive and we were forced to stay another night.

Throughout the night and the following morning we were constantly assured that the boat was coming and would arrive soon. One of our team was even told in the night that the boat had arrived, but this proved to be false. By 730AM on the third day there was still no boat, despite the constant talk that it was only moments from arriving. We

The MoH Team

Here's our second string en route to Tasiriki

had 24 hours of chill left in our iceboxes and I felt anything but chilled out.

What came next turned into a rather interesting day.

After an hour of jogging, four hours of bareback horse riding, several village stops, negotiations, and a few more hours on foot, I managed to secure a boat. The engine was broken but some light maintenance and a jury-rig got it running. The taxi captain was grateful for the help, but he couldn’t give me the speed I needed with his craft as overloaded as it was.

Around sunset our team was picked up in Vunavae and put en route to Tasmate (our second stop). We landed ashore in the dark and set up shop once again. The clock on our medication was ticking down, but we’d made it there in time.

Ivan had mangled his toes and pinched a nerve in his hip, which left him waddling like a duck. The day also left me relatively crippled for the next 18 hours. We made quite a pair.

The next day was a Sunday and we had a truck scheduled to take us all back to Luganville. All we needed

Vunavae at night

This first stop had the nurses working late into the night. After the shots, many women still came for medical advice throughout the night.

to do was get a boat back to Tasiriki. This was fairly important schedule deadline as the nurses needed to be back in town to teach a workshop which started on Monday. Yet, when the sun came up our promised boat was nowhere to be seen.

We sent a runner to the next village to see if we could charter their boat. Apparently the captain received the message around 9, but didn’t leave until afternoon. He laughed when he arrived to pick us up and I couldn’t be angry at the guy. Time doesn’t exist here, and you don’t rush Vanuatu.

We picked up Frank on the way South but by then the waves and wind were too rough for our little boat. We made an executive decision to turn back and spend the night at the Limarua job site. The Nurses were going to be late for the workshop, which I didn’t like. But there wasn’t much else that could have been done. Logistically it was a failure on my part, but we were all still alive so I had to count it a win.

The following morning tried it’s best to change the “we were

Dr. Dom

Dr. Wakefield was prepping the injections for Nurse Mikael.

all still alive” fact. We scheduled a 4AM water taxi for a neighboring village. After waiting around to 4:45 I walked down to the village and helped the captain pull the boat into the ocean myself. Our pickup at Limarua was done in relative darkness and the sea was picking up.

After the boats were loaded, we pushed them into the water for the launch. As we pushed, the 2 feet of water below the boat disappeared instantly, and our craft hit the sand. I looked up wondering how that could have happened just in time to see the 8 foot wave drop directly in front of the boat.

The splash that bounced back up on all of us knocked a pair of people out of the boat, threw all the men pushing the boat across the sand, and filled the boat with a considerable amount of water. Frank, Ivan, and myself nearly lost our hats. Frank and Ivan lost their shoes after they were ripped from their feet. Everyone was soaked.

Our second attempt came after a hasty bailing of water from our craft. We got hit hard again, but managed to keep our act together

Getting stuck

Stick meresin blong olgeta pikinini.

to long enough to get through the surf and on our way. The sun was coming up, but so was the wind.

Everybody was drenched, some were sore, some were getting pretty cold as the boat ploughed through the waves. We made it to Tasiriki in a record slowest time, chartered a truck, and rumbled our way back into town. The nurses rushed off to the workshop, our team checked into a hotel, Ivan caught up with his gang, and I had some meetings to take.

It was long week.

All-in-all we vaccinated 230 people. Most were children under 5, but included in our target demographic were school-age children, pregnant mothers, and women of childbearing age. The sector we covered has a population close to 2000, and they didn’t get an opportunity for vaccinations last year. The Ministry of Health couldn’t get to them in 2008 and without the assistance of Project MARC’s donors, they probably wouldn’t have gotten out there again this year.

It was a lot of work, it cost a lot of money, but it was entirely worth it.

Thanks for keeping an interest in what we’re