It is half eight in the morning, as Ramatu Abdullahi makes its first tour along the close to each other, the stone houses. She wears a long blue robe over her colorful dress, which she covered from head to toe completely. In the air, a smell of food, sewage and faeces depends. Between the small houses, a tiny trickle of water flowing, crammed full of plastic waste.
This area here, Arbamiyya, a small settlement in the district of Kanyen of the city of Kano in Northern Nigeria, was your area of responsibility, says Ramatu Abdullahi pride and puts her blue robe on the forehead. 332 households were in the stone houses. Therein, 241 children under five years of age and a further 57 children lived less than one year.
Abdullahi, mid 40’s, is what the specialists of the “Global Polio Eradication Initiative” (GPEI) call a “Voluntary Community Mobilizer” (VCM) – a “voluntary Gemeinschaftsmobilisatorin”. As one of the Unicef women you asked six years ago whether she wanted to be VCM, hesitated for the Nigerian woman, not for a long time. You said and since then 25 Euro / month, and that they shed light on all the households in their settlement on Polio, children have to be inoculated and all of that, in many booklets, is minutely documented.
Ramatu Abdullahi in front of a small house in the Nigerian settlement Arbamiyya
VCMs were mostly women from the municipality or the settlement of the people you care for, says Anisur Rahman Siddique, the head of Unicef in Nigeria, the polio eradication campaign. Up here in the state of Kano where about 20 million people the most populous of the 36 States of Nigeria are Siddique to be in the order of Unicef 3800 VCMs in use. Because until a few years ago, the Muslim state of Kano was the epicenter of the polio outbreaks.
Especially because religious Resistances of the Islamist terrorist group Boko Haram to problems resulted by vaccination of children with the vital vaccine. Persuasion was asked – work, Ramatu Abdullahi and her colleagues took over. Again and again you a talk on families to vaccinate their children.
A small child is vaccinated
Abdullahi holds a stack of papers in her hands. It is day three of four days of the current vaccination campaign. Most of the children aged zero to five years living in the settlement, have received the oral vaccine already. Abdullahi controlled in your tables, what has been missing child at the last passage. She crosses which households have refused the vaccination. Mark writes on the walls of the houses, which can only be seen by you and your colleagues.
“I’m not talking only about Polio,” says Ramatu Abdullahi, “I’ll help with other questions.” Again and again you tell the women the importance of vaccinations in General. They also educate on proper Hygiene and checkups during pregnancy. These are all topics that are for the country and its families is essential.
This is because: Although, for example, representatives of the health sector export initiative of Germany Trade and Invest (GTAI), Nigeria’s health-care market, described as a future market for German companies, behind the screen tbevölkerung richest country in the world on several health indicators. The mother-and-child-mortality rate is among the highest in the world, Malaria continues unabated, the high number of children per woman is accepted socially and politically, but in the families themselves to even more poverty. Only about one in every third child receives all the necessary routine vaccinations.
Since October 2012, each Supervisor of a VCM-Teams will receive a Smartphone that has a GEO-App
And without the hard, daily use of women as Ramatu Abdullahi, the situation in the country would be even darker. Whether there will be a VCMs as you but in the future, is uncertain. Because soon women will no longer be able to receive the 25 Euro, you can get currently for their work. Because this money was paid out of the donor pot in the “Global eradication campaign of Poliovirus”. And this money runs out.
The reason for this is actually a positive: On 21. August 2019 to reach Nigeria, the last African country to officially have the Status of “polio-free”. This is awarded if a country was three years without a new case of the wild polio virus’. In the coming year, after more than 20 years of active campaign, free could Africa for the continent as a whole, the Polio certificate of the WHO. “We are very confident that our country will make it,” says Faisal Shuaib of Nigeria’s Ministry of health.
The in-house pharmacy a refugee camp in Abuja, capital of Nigeria
To be polio-free, but it is also: donor funds have been invested since 1996 in the country are scarce or no longer flow at all. Because the Problem is solved officially, the project of fight Polio ended.
Financial supporters of the Global Polio Eradication Initiative (GPEI) were foreign governments as well as donors from the private and public sector, as well as the Bill and Melinda Gates Foundation and Rotary International. Whose funds have financed 23,000 employees in Nigeria alone to 17,000 women like Ramatu Abdullahi, working for years as VCMs. Added to this was the payment of € 121,000 employees, the vaccination campaign were at each additional GPEI activities.
To ensure that no child during the vaccination campaign is overlooked, mark the helpers, the little Finger of his children with a black Marker
But even without the funds do not need to be vaccinated in order for Polio to come back. How is this going to go? “The gap caused by the withdrawal of this money soon, we want to close itself,” says Shuaib from the Nigerian Ministry of health with a serious face. No way his country wants to be permanently dependent on donor funds. At the same time, he adds quickly, could reduce the “shock effect”, the deduction of the GPEI financing means, characterized in that one uses the Knowledge of the specialist forces, and for other new programs.
First of all, the Polio Transition Committee – a government – appointed and-funded group of experts, wants to capture so well, who works out of the 23,000 people where and what is the cost of each, explains Ngozi Nwosu, who heads the Committee. Many to be will therefore continue to be in high-risk areas. It’s not supposed to go only to fight against Polio, but other diseases that are avoided by vaccines, such as measles, yellow fever, carry Lassa fever or Meningitis. How to come in the future, the money exactly, but it is apparently still unclear.
For the past three years, the Nigerian government is also working on so-called Chips program, the Community Health Influencers, Promoters and Services programs. This means: tasks in the health care of a parish is to be merged. In addition to VCMs as Ramatu Abdullahi, there are currently Health workers at the village level, as well as traditional birth assistants and community staff that deal specifically with children’s diseases.
“One Drop, one Life” – the Slogan against Polio: A drop of the vaccine must be poured between the ages of 0 and 5 years multiple times in the mouth
In the future, says Maimuna Sandah Abubakar, a senior Doctor within the National Primary Health Care Development Agency – an Arm of the Ministry of health to Chips across the country-agents embody all of these activities in a Person. However, Even this could appear to be driven funds are up.
It is eleven o’clock is to turn, as Ramatu Abdullahi, in a narrow corridor to one of the stone houses. You since six o’clock on the legs, a further four to five hours are still ahead of her. The sun is burning hot now from the sky. The smell from the small trickle is still sharp as a few hours before. A few meters further on, a sheep is slaughtered. The remains of the animal are lying in a pool of blood. Whose eyes are visible through the many fly-barely. Many of the children who run to the narrow houses of corridors, to wear no clothes.
“Diarrhoea and skin problems, almost all of them have here,” says Ramatu Abdullahi, while she enters the house. Your eyes Shine as she sees the newborn in the family. It is the seventh child of a woman’s mid-20s. “Most of the men here have at least four wives,” says Ramatu Abdullahi to go Out with. And with every woman they had up to ten children. “If a man has only one wife, the woman is very proud of that,” whispers the Nigerian woman.
Ramatu Abdullahi checked, whether the child was beside her, already vaccinated and enters the result in your list
The fact that it is soon to be no VCMs more, white Ramatu Abdullahi, still nothing. Also, the plans, what will become of the Polio infrastructure, are foreign to her. Ramatu Abdullahi soon will be a Chips-agent? Or you lose your Job and your monthly salary is?
“It is planned about 50 percent of the women from the VCM network as Chips agent to select. However, only those of today’s VCMs is to undergo the month-long introductory training, which can read and write,” says Akubakar. At least a good two thirds, Ramatu Abdullahi is one of them.
Abdullahi is, it doesn’t matter who organizes your Job and get paid. “It is important to me that we can all do more. We want to continue to work,” she says. The people in the settlement Arbamiyya – all of the 332 households had become accustomed to the VCMs. “You need us.”