Drop By Drop, Child By Child

Gus Ruchman - Senegal


April 13, 2011

Take a walk through Noflaye and you will find chalk marks on the walls and doors of many homes. At first glance the circled “V7” sign might look like the warning of a plague that has swept through the village. In fact, it is just the opposite: it marks the seventh vaccination campaign against polio.

On April 1 I arrived at the Sangalkam Poste de Santé to find that doctors and nurses were taking supplies and leaving for several corners of Sangalkam and the smaller surrounding villages. I joined forces with the Noflaye team and headed back up the road.

[slidepress gallery=’gus_drop-by-drop’]

Please scroll over the images for titles and captions.

Polio has been eradicated in the United States and many other countries, but not in many developing countries. It had never occurred to me how the medical community might go about eradicating a disease, especially in a nation like Senegal where some patients are more difficult to access than others.

I was told that whenever a case of polio crops up and funding from the Senegalese government, a foreign government, or an NGO is available, a campaign is launched to vaccinate or re-vaccinate every child under five years of age. A co-worker explained that a case occurred in February, but a campaign was not financially viable. This time polio appeared in the Kaolack region, and an effort was launched.

It was my first day back to work after a monthly meeting, but approximately 150 children had been vaccinated in Noflaye the day before, according to the sheets used to mark the number of doses given. Still with a population estimated to be 2000-2200 people, perhaps 400-500 of whom are young children, there were many still in need.

Our tools were simple: oral polio vaccinations (2 drops per child), a permanent marker for coloring the left pinky finger of children who had received the medicine, a paper and pencil for recording the statistics, and chalk for marking the doors or walls of houses. Houses where children received vaccination were marked with a “V7” while those few with no children were marked with an empty circle.

In some ways I was reminded of our previously described vitamin distributions (see “Strangers With Candy”). Again, children believed we were going to give them an injection, leading to panic among the four-year-olds in the streets. Again, their mouths were forced open to drink “candy.” Again, the presence of parents was not a factor.

Many children were playing with pamphlets for antibiotics and other medicines. Apparently pharmaceutical marketing materials had somehow ended up being “thrown out” somewhere in the streets of the village. They had ended up blowing around and being taken as toys by curious kids.

As we roamed through different clusters in the village we checked children’s fingers to see if they had already been vaccinated that day or the day before. We gained a few local helpers in slightly older children who were more than happy to line up their younger siblings and friends, yank their heads backwards, and squeeze open their mouths.

We entered homes of the village middle class, those families with tin roofs and cement floors, room for the family, a few nice things  of which to be proud, and enough to get by. We entered the homes of the lower-middle class, those families with sound but small homes sometimes supplemented by thatched structures, where for whom making daily ends meet is more of a struggle.

We walked through mango groves and lots of sand. We entered the homes of those with even less to support themselves, whose homes are huts built in the shadows of wealthier neighbors and whose voices often seem unheard.

It was hot, and the work was laborious. We vaccinated about 100 children over the course of the morning and early afternoon, and the effort would continue the next day. A team of dedicated medical workers are striving to eradicate curable disease in their cities, towns, and villages. The war against polio is being fought in the streets of Senegal, drop by drop, child by child.

Gus Ruchman