Fieldset
Crossing the swamp forest to keep my promise

Through swamps and impassable forests, paediatric nurse Vera rides with a motorbike-mounted medical team – racing to vaccinate children against a deadly measles epidemic in DRC

An MSF mobile medical team cross a makeshift bridge in DRC

“Oswa kitonga?”

“Did you get the vaccine yet?”

My level of Lingala – the language spoken in the northwest of the Democratic Republic of Congo (DRC) – is still very poor, but the most important vocabulary I have already learned.

The children proudly show me their fingernails, which have been painted black to identify them as already vaccinated. As I move on, they are still calling for me:

“Mundele, mundele!”

This is the way I am greeted everywhere these days. “Mundele” means “white” in Lingala and after all, it doesn't happen very often that a mundele arrives in this corner of the deep Congolese forest.

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Vera is a trained nurse and also works to coordinate the vaccination campaign
Vera is a trained nurse and also works to coordinate the vaccination campaign

A severe measles epidemic has been raging in the DRC since early 2019. And, as of early March 2020, 334,578 people have been sick and 6,338 have died. The number of unreported cases is probably much higher though.

A deadly disease

In response, MSF is working in various regions of the country to fight back against measles – a disease so easily preventable with vaccines – including a project in Boende in the province of Tshuapa.

I've been on my feet since 5am and on my motorcycle for almost seven hours

The team here has been treating sick children since November – measles, malnutrition, malaria and so on.

Measles is a dangerous and potentially deadly disease, not only during its acute phase. The virus weakens the immune system in such a way that even afterwards a relatively harmless infection can cause serious complications and even lead to death. Especially, if healthcare is far away.

Mass vaccination

With the objective of stopping the current epidemic in the region, MSF launched a new vaccination campaign in mid-February.

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MSF staff vaccinate children against measles at a makeshift clinic
MSF staff vaccinate children against measles at a makeshift clinic

The goal is to vaccinate all children between six months and 14-years-old, living in the areas still being badly affected by measles – that is approximately 23,000 people!

My job was to plan, organise and coordinate this very same campaign in collaboration with the rest of the team.

Swampy forest

A short while later, I'm in the middle of the forest, wearing rubber boots and motorcycle protective clothing, standing on the edge of a small bridge made of tree trunks.

She bursts into tears, telling us about her five children she already lost to measles. She begs us to vaccinate the remaining ones.

I've been on my feet since 5am and on my motorcycle for almost seven hours – after we first crossed the Tshuapa River in a pirogue boat in the early morning.

It is a swampy forest, full of small streams and tributaries of the great Tshuapa. The path is narrow and uneven, branches and plants protrude far, scratching my arms, hitting my knee and helmet. From time to time, there is even a whole tree trunk that blocks the way. Or, just like here, a bridge made of tree trunks over which each “moto” has to pass individually.

The promise

While waiting for the last motos to pass, a woman from the next village comes by.

When she hears about our vaccination campaign, she bursts into tears, telling us about her five children she already lost to measles. She begs us to vaccinate the remaining ones.

I am deeply moved and promise her that we will vaccinate all of her children, each of them!

Shortly afterwards, the journey continues… but this woman will stay in the back of my mind during the next days.

Controlling the cold chain

Our convoy comprises 23 motos.

Some carry the vaccines, packed into large cool boxes, while others carry boxes filled with frozen ice packs. The “cold chain” (the careful process for transporting and managing temperature-sensitive medicines) must be planned meticulously and down to the last detail to avoid any rupture.

The more difficult it is for us to get somewhere, the more difficult it must be for the people who live there to access healthcare

Others transport more supplies – syringes, reserve petrol, tents for the night and whatever else is needed – and of course the teams themselves.

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The boxes that contain temperature-controlled vaccines
The boxes that contain temperature-controlled vaccines

At least we can still ride a motorcycle here at all. Some villages can only be reached by pirogue or even on foot.

The following day, one of the teams will be walking five hours until they reach their destination and vaccinate 20 children. Another team will be marching even for several days in a row and vaccinate along the way.

Then the hurting feet, the nights in the tent, the heat and everything else becomes insignificant. We vaccinate to save lives.

Exact distances and population figures in places with such difficult accessibility are usually not available. This doesn't make the planning any easier, but then again it is precisely these children that we want and need to reach… because the more difficult it is for us to get somewhere, the more difficult it must be for the people who live there to access healthcare. Not only for vaccination, but especially when someone has fallen sick.

Remembering

After 12 days of vaccination, 10,000 children have already been vaccinated.

After a short stop to catch our breath, we continue to the next region where there are about as many days waiting for us.

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A vaccination team and their bikes are transported down river in a pirogue boat
A vaccination team and their bikes are transported down river in a pirogue boat

Again, many obstacles will be waiting for us. One team will be travelling by boat for several days, others will have several walking trips ahead of them.

But, in every moment of doubt, I immediately remember the woman along the road and her five children for whom our vaccination came too late…

Then the hurting feet, the nights in the tent, the heat and everything else becomes insignificant. We vaccinate to save lives.

*Vera and her team have now successfully vaccinated 17,888 children against measles

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