As community health workers hop house to house to vaccinate children against polio, Unicef Malawi communication officer RODGERS SIULA follows the flow of oral vaccine doses from cold chain to children in hard-to-reach areas.

When Malawi confirmed the first wild poliovirus in three decades, Unicef supported the government to immediately procure and distribute 6.9 million vaccine doses for about 2.9 million children aged below five.

To make the vaccines safe and accessible  for all children where they live, Unicef assisted the Ministry of Health to install 223 new refrigerators, repair 51 and distribute 200 carriers and 38 cold boxes.

Unicef Malawi health specialist Ghanashyam Sethy says: “For the success of this programme, the use of potent and safe vaccines is of utmost importance.”

To ensure that all health centres have the vaccines and that health surveillance assistants (HSAs) carry the oral polio vaccine doses deep into hard-to-reach areas, it is recommended that ice-lined refrigerators, deep freezers and refrigerators maintain a temperature within two to eight centigrade.

“This is the significance of ensuring a smooth cold chain linkage from the central source to the last beneficiary,” Sethy explains.

Some refridgerators stopped operating due to malfunctioning compressors and gas leakages, Lilongwe District Health Office (DHO) reports.

Lilongwe DHO cold chain technician Boston Gwaluka said: “Repairs of the refrigerators have helped us have adequate ice banks for the transfer the vaccines to remote areas without compromising on the recommended low temperatures at health facilities.”

Lilongwe district has 60 health facilities catering for both urban and rural populations within its radius.

Unicef supported the repair of three refrigerators, which keep up to 50 000 polio vaccine doses each.

“We keep monitoring temperatures of the refrigerators manually every morning and evening using the fridge tag. This helps us track the performance and condition of the refrigerators,” explains Gwaluka.

Mitundu Community Hospital, located on the southern outskirts of Lilongwe City, caters for 13 clinics in the polio vaccination national campaign.

Agnes Mzazila, one of the 47 HSAs at Mitundu, had to overcome familiar setbacks such as long travels on rugged roads to reach the remotest villages in the catchment area.

She narrates: “Equipped with portable cold boxes, we mostly use private pushbikes, motorcycles and sometimes minibuses to reach out to the targeted 22 sites.

“Despite the poor roads and long distances, we still administer the vaccine preserved at the recommended temperature. The cold boxes perfectly maintain the temperatures of the vaccine from our health centre.”

Senior HSA McEston Kachipapa says despite the mobility challenges, the cooling facilities kept the vaccine well preserved to reach under-five children in hard-to-reach areas safe and potent.

“The effectiveness of an uninterrupted cold chain is key to making the oral polio vaccination campaign a success,” he states.

The district health office targets to vaccinate 407 000 under-five children against polio in a four-round campaign. The emergency polio vaccination campaign is also underway in Zambia, Mozambique and Tanzania following the confirmation of wild polio virus in a three-year-old girl in Lilongwe, the capital city of Malawi.

Malawi completed the second phase of the polio vaccination campaign in April. Meanwhile, all unused vaccines are collected and kept safely at the central district point of collection in readiness for the third round which  commences in June.

Polio is a highly infectious viral disease, which causes permanent paralysis mainly among unvaccinated children below five.

The polio virus enters the body through the mouth when eating food or drinking water that is contaminated with faecal matter from an infected person.

Initial symptoms of polio include fever, fatigue, headache, vomiting, stiffness in the neck and pain in the limbs.

A polio outbreak can spread rapidly and there is no cure for the disease Malawi successfully eliminated in 1992.

However, the simple, safe and effective oral vaccination is the only way to protect children against the paralysing disease.

Unicef, the World Health Organisation and other partners of the Global Polio Eradication Initiative are supporting the Ministry of Health to vaccinate all children below five in the ongoing mass vaccination campaigns.

The other partners include Gavi, the Global Alliance for Vaccines and Immunisation; Bill and Melinda Gates Foundation; Rotary; and US Centres for Disease Control and Prevention.

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