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Immunization on the Front Line

MAPUTO – Most of the news one hears coming out of Mozambique is bad – poverty, disease, conflict, and floods. But there are a lot of good things happening in my country, too.

In the past two decades, Mozambique has become a functioning democracy; grown its agriculture sector; raised literacy rates; increased water supply and electricity in rural areas; and reduced child mortality dramatically, from 219 per 1,000 live births in 1990, two years before the civil war ended, to 135 per 1,000 in 2010. I am particularly proud of the last achievement, because, by working in partnership with my fellow Mozambicans to expand immunization coverage, I believe that I have played a part in bringing it about.

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I grew up in Mozambique when the country was still under Portuguese rule, and the inequality in our colonial society shaped my view that all people have a right to health care. I remember working at a pediatric ward as a teenager and watching children die from diseases like polio, measles, and tetanus – all easily prevented by vaccines. The impact of that experience led me to spend the next 40 years working to ensure that every child in Mozambique, regardless of her ethnicity or where she lives, gets the vaccines that she needs to help her lead a long and healthy life.

In a few days, I will join 300 global leaders in Abu Dhabi for the world’s first vaccine summit – a gathering dedicated to ensuring that all children everywhere have access to vaccines. People like Bill Gates and Kofi Annan will make the case that immunization programs deserve adequate funding and political support.

I don’t have an audience like Gates or Annan, but I would like to add my voice to theirs. Millions of health workers like my colleagues and I make immunization their daily work. We have made tremendous strides in reaching more children with more vaccines, which is why more children are surviving than ever before. But there are still even more children to save, and we need help to do our work on the ground.

Because vaccines are useless if parents refuse to give them to their children, a big part of my job is to collaborate with health workers, community leaders, school teachers, and local political figures to educate parents about vaccines. But having the community’s support is not enough. It is also vital to ensure that vaccines get to the right place, at the right time, and in the right condition.

For example, in order to prevent shortages, VillageReach, the organization for which I work, helped to correct the population figures used to forecast the number of vaccines needed in each health center. VillageReach also started a company that delivers propane gas to health centers in northern Mozambique, where, like in many of the country’s rural areas, electricity is unreliable or completely unavailable to power the refrigerators that keep vaccines cool. Through the use of propane, we can ensure that the vaccines do not spoil during the journey from manufacturer to mother and child. And once a month, we make sure that health workers deliver vaccines and other health services “the last mile” to mothers and children in remote rural areas.

Finally, I have learned that meticulous record-keeping and measuring results is critical to reaching more children. That is why we are assessing different methods for gathering data from the field, including the use of mobile applications to digitize paper records.

Building these routine immunization systems has already helped us to eradicate diseases like polio and all but one type of measles. Earlier this month, we used them to vaccinate children against pneumonia for the first time in Mozambique’s history, and we hope that next year we will begin to address rotavirus, which causes diarrhea and is the number one killer for children under five years old. Our longer-term goal is to strengthen these systems enough to reach all children in Mozambique with basic vaccines and other forms of health care.

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I believe that we can achieve this goal, because I have witnessed how far we have come already, despite our struggles. Big challenges lie ahead, but I am confident that with the support of the global community, I can leave to my own children and community a thriving country where every person has the opportunity to prosper.

Read more from our "Visionary Voices" series