Today after a long and bumpy drive from the town of Paksan to Pakse we meet Dr K. Samphan (Immunization Officer) and Oudorn Phanekham (Senior Supply Assistant) from UNICEF Laos who will be accompanying us on the rest of the trip.
We set off to meet with officials from the Provincial Health Department who are in charge of ensuring the campaign is successful in conjunction with their partners like UNICEF. It is a fairly formal but important meeting. It is key for UNICEF to work closely with the government to get the best long-term results for children – we would not be able to work in the country otherwise.
Officials from this department then join us for the drive and the subsequent short ferry crossing to Muang Khong Island – a tiny idyllic island in a remote area called ‘4000 Islands’ way down in the south of Laos. It’s hard to believe that we are literally only a few kilometres away from the Cambodian border.
On arrival we head for the Island’s health centre where the boxes of vials have already arrived and are safely stored in bright blue refrigerated units. We open them for a split second to have a look and then close them quickly before the temperature gauges change. Tomorrow we will head off at 6.30am to follow the vials to a tiny island called Don Than where we will see them in action as local children and young people are vaccinated.
UNICEF NZ’s Support in Action
On the way down to the south of Laos, I also took the opportunity to visit some amazing water and sanitation projects which UNICEF NZ and the NZ government aid program (NZ aid) funded between 2006 and is due to complete in December 2011.
Availability of safe water and hygiene is key for children in Laos where nearly half the population remains without basic sanitation.
First of all we went to visit a village called Tha Bo in the Borikhamxay province (around 2 hours South of Vientiane).
After lunch in the main town Paksan, we cascaded down a dirt track for 7km, the red dust furiously hitting the air and landing thickly on everything left in its wake – houses, cars and even people! Hard to believe that only two months ago the rain brought flooding over a metre high, with people having to reach their homes by boat and some having to leave their homes completely till the flood water subsided.
Tha Bo is a low-land community of 626 people or 121 families with the main income coming from agriculture. On our arrival we were met by the head of the village and then taken to two different homes to see bio sand filters – concrete installations with sand filters inside to clean the water, which were installed by UNICEF as part of the flood emergency response. Before they existed the villagers had to boil all their water. The difference between the water just taken from the well and the filtered water was just amazing!
The other thing to note is that 90% of homes in this village have latrines – having good hygiene is becoming more of a social prestige. In this case the head of the village heard about the benefits of latrines at a workshop in 1998 and decided that was the way forward – it took many years but the benefits for his village are significant.
This village is flourishing thanks to the help of UNICEF NZ and NZaid – it just shows that cheap interventions can make a huge difference – after all a sand filter costs only $50.
From Tha Bo we travelled another few kilometres to a school at Tha Na. The school looks after around 50 primary age children, tiny and neat in their simple uniforms, who were waiting with excitement for our arrival.
They shrieked and crowded around to gaze at the strange visitors who had invaded their playground one sunny afternoon. Two little boys played the perfect hosts, proudly showing us where the latrines are which were installed in 2009. The school is basic but the children are happy and healthy and it’s great to see so many girls in attendance (traditionally attendance for girls is lower). Projects like this can have a great impact on whole communities, with the children often educating their parents on good hygiene.
Our two hosts then ran towards the hand pump installed by UNICEF (complete with nearby borehole) and in perfect unison work the pump – the water splashing everywhere. Then, as if to say “anything you can do, we can do better”, two little girls run up and replace them doing just as grand a job as their male counterparts.
This water and sanitation project is clearly benefiting many people in the region – the two villages we visited just two examples of an extensive program which has also included a lot of education work. It’s amazing to think that a small country like New Zealand, thousands of kilometres away, is changing people in Laos’ lives for the better – not just for today, but for the long-term.
UNICEF NZ Communications Manager, Karen Gray, compares the quality of water in Laos
"I'm a UNICEF supporter, and I'd love you to join me."
Karen in Laos- Day Three
This morning it’s a bright and early start for us, but what a start to the day it is with Don Khong Island reminding us why Laos is such a magical country. We eat breakfast as the first sun of the new day hits the Mekong – monks in their bright orange robes scurrying beside its banks. But there’s no time for that second coffee, with the white UNICEF truck pulling up at 6.30am. We’re off to follow the cold chain on the final part of its journey to Don Long Island.
We hurtle along the gravelly roads towards the small jetty where we’ll find our boat to the island. Although it’s early, people are already jamming into the island’s market. Large pots of steaming food line the stalls, with vendors selling clothes and anything else you can imagine in-between!
Within 20 minutes we’re at the jetty, just in time to see a long wooden traditional boat approaching the bank. There are about 10 of us to fit in and we sit two by two for the 30 minute journey along the Mekong. It’s an amazing journey along the river, with only the odd fishing boat passing us by.
Don Long Island has a population of almost 4000 who rely on the island’s sole health centre for care – that’s our first stop. We arrive to see two people on a motorbike about to drive off. On their backs are two small cold stores filled with vaccines, ready to be given to the island’s children and young people. The rest of the vaccine is being taken to a local school which is only a ten minute walk away.
The school has been built around a grassy courtyard area with the four buildings housing different aged children. They are hanging around in large groups giggling shyly and looking in wonder at the tables and unusual boxes being set up in the middle of their school. I turn round and suddenly see a child sprinting away down the track. Very odd. The thing is the younger children have been told that today a ‘ceremony’ is taking place since the teachers don’t want to scare them, so when the rumours start to spread about what’s really happening there are some escapees who promptly leg it off home before anyone can stop them!
The tables are finally ready and the campaign can finally begin on Don Long Island. They start with the small children and there are tears immediately. The staff soothe them and try to get it over with as quickly as possible! This campaign is about measles and rubella vaccinations but it’s also a valuable opportunity to administer other essential immunizations and health care to these children. Depending on their age children are also given polio drops, vitamin A and deworming liquid.
Luckily the little girl who I am asked to give the vitamin A and polio drops to is really calm and well behaved! I don’t think I am cut out to be a nurse (!) but it’s fantastic to be able to get involved in a tiny way as well as to spectate. The children are now being vaccinated fairly quickly, so we decide to let the team get on with their job and we go to observe the outreach team.
Ten minutes away, working underneath the shade of a tree, is the team we earlier saw leaving the health centre. They are here to be accessible to the villagers whose children aren’t at school or young people who are too old themselves to be at school. There is a family who arrive with a small child in school uniform. When we ask why she couldn’t be immunized at school, we’re told that those children who ran off earlier from school are being brought here by their parents instead. No escapees after all!
I talk to one of the nurses, Khampian aged 43. She says that this is much bigger than previous campaigns and 18 children have already been vaccinated (it’s only 8.30am). She says that people want their children to be vaccinated and always come along – this gives her a chance to talk to them about any other health issues they might want to bring up too. Khampian and the team will stay here will into the afternoon, ticking the villagers’ names off her spreadsheet. If they don’t come, she says, they will go to individual homes and vaccinate the kids there if need be.
Back at the school, the campaign is almost over with the older children trying to be brave – the discomfort only showing in the occasional winced expression on their faces. As someone who hates needles I can sympathise but at the end of the day I’m sure they, like me, would rather have a moment of pain than measles or rubella.
I talk to some of the students – Suvanee (15), Sovang (15), Budavang (15) and Hosang (16). All of them have been immunized before and are pleased to be gaining the second vaccination they need against measles and their first against rubella. Hosang, who lives with the six other members of his family, is watching with special interest because he wants to be a doctor one day. A polite and confident young man, he explains that he likes learning at school and one day hopes to study in Vietnam. His classmates also want to go overseas and train to be doctors and lawyers. I wonder how many of them will make it. The sad truth is that many young people in Laos don’t progress far in the school system – with many leaving early to work in poor conditions in Thailand. (NB: UNICEF Laos is working closely with the education authorities in the country on issues like trying to get children to start school earlier and to stay for longer).
After my chat with the students, I walk back out to the courtyard and the tables are being packed away – all the students have been vaccinated. This brings the first stage of Laos’ immunization campaign to almost 70% complete – a phenomenal achievement.
But before we leave there is a couple of important things left to do! The health team and the heads of the village have arranged a Baci ceremony for us (traditional welcoming ceremony). We sit down cross legged around a shrine in the middle of the room. More and more people join us. One of the older men begins to chant and, after a few minutes, he lights incense on the shrine. Then one by one the villagers start to take long stalks from the shrine with lots of white cotton hanging from them. They bring them to us one by one and symbolically wish us health and fortune (at least, that’s the bits I could understand!) whilst tying the bands around our wrists. We all ended up with about 20 of them adorning our arms. It was an amazing experience which just goes to show again how hospitable and welcoming the people of Laos are. And the other thing we had to do? Well lunch of course! I won’t go into it, but rest assured it was delicious!
As I head back to New Zealand, I will take with me some fond memories of a beautiful country, its amazing people and an impressively well-run immunization campaign. I feel proud to have witnessed a small part of this in action and to see the important part UNICEF plays as a partner in this. The cold chain is not easy – it’s a complex series of important sequences which must be managed by a team of well-trained people. Luckily UNICEF has passionate and committed staff that have helped make this run like clockwork to ensure the children of Laos can be protected from preventable diseases.