Ending polio outbreaks in Laos

- by Simon Nazer

It’s an unseasonably cool morning in Senxay Village, near central Laos, and a good day for health teams to go door to door to vaccinate children against polio. For mothers like 25-year-old Vardy, she’s delighted to see her 5-month-old baby boy being immunized. “I’m really happy,” she says with a beaming smile while bouncing her baby up and down. “I know after being vaccinated my baby will stay healthy and safe.”

In remote ethnic villages like these, children are often the most at-risk of preventable diseases and viruses, and it wasn’t so long ago that tragedy had struck in a nearby village.

In late 2015, an 8-year-old boy suddenly had a high fever and weak limbs. Four days later, he tragically died in hospital from vaccine-derived polio virus.

“Reaching every child with vaccinations can be a challenge, but it’s critical we do to stop similar outbreaks,” says Dr. Inphone Maniseng, Director of the District Health Department overseeing a huge vaccination campaign. “Since the outbreak we’ve carried out eight vaccination rounds for thousands of children.”

However, with the support of UNICEF and WHO, one last push to ensure polio is eradicated once and for all is taking place over ten days in 13 provinces and 90 districts to vaccinate about 460,000 children under five.

Mothers like Vardy in the picturesque villages of Laos not only have their children vaccinated, but understand the need to ensure they keep up with regular vaccinations. “I now know that vaccinations are important to keep my children healthy. I’ll make sure I take them for immunization to keep them safe.”

Community participation

A big reason vaccine-derived polio broke out in this part of Laos was, according to village leader Khamphet Chansomphou, because of low awareness and lack of community involvement. “Raising awareness and explaining the importance of being vaccinated to the villagers was really important to ensure they come,” he says in the local health centre.

“They have to clearly understand that while it’s about keeping children healthy, it’s also about education and their economy. Healthy children can go to school and learn, healthy children don’t need costly medicines.”

UNICEF worked closely with partners to create educational materials in local languages to inform villagers about the importance of being vaccinated. UNICEF staff and partners travelled village to village to deliver the information, show videos using mini-projectors and hold open discussions to explain vaccinations.

“By talking to communities we also get a better understanding of how we can serve them,” says Mr Chansomphou. “It works both ways – it helps us think about how to improve our services and understand people’s needs.”

Polio has now been eradicated and children are safe again, but health providers must ensure efforts to reach every child remain to ensure similar outbreaks never happen again.

Nearby, 20 year old mother Xim Dua was just stopped by a mobile health team. “This is the first time my 5-month baby has been vaccinated,” she says shyly. “We live a long way, I didn’t know.”

Now she knows and after the health team explains to her the need to ensure her baby is vaccinated, she’ll be back. But UNICEF and partners must continue to work to ensure they reach everyone, no matter how far they are. Only then will every child be safe from preventable diseases and illness.

No mountain too high: ending polio in Laos

- by Simon Nazer

For 15 years Daeng Xayaseng has been travelling through rugged, undulating countryside by motorbike and by foot to deliver vaccines to children in some of the most remote villages in Laos.

It’s hard work but she is determined: “We have a target of children to reach and we’ll achieve that no matter how long it takes,” she says. “We’ll keep working until we reach every child.”

Today her team visits Nampoung village, 4 hours north of the capital of Laos, to deliver polio vaccines.

In 2015 a vaccine-derived polio virus was contracted by 11 children and adults, killing 2. Remote, poor and often ethnic communities such as those in this Hmong village are among the most vulnerable to the spread of disease and viruses. When dangerous viral outbreaks occur, it’s important health teams come to those most in need of health services.

“Service times depends on the season,” says Daeng. “It’s rice season right now. The villagers are all farmers so everyone will be working in the fields, a long way from their homes. That’s why our services depend on what the community asks; if they say 3pm, we come at that time. If they say night time, we’ll be there.”

The team first sets up in the centre of the village. In the local Hmong language the village chiefs calls on parents to bring their children to be immunized through booming loudspeakers. Soon, parents arrive with small children in slings on their backs, and the larger children following quickly behind. 

“For 15 years I’ve been working on campaigns like this,” she says. “Today we’re here with our outreach team to vaccinate children against polio. We’ll also go house to house to make sure no child misses out on being vaccinated.”

Once the team finishes at the vaccination point, they then go mobile and walk house to house to find children who didn’t come for immunization.

“We don’t want there to be another outbreak of polio so we have to reach everyone,” says Daeng. “In order to do that, immunizing every child in remote communities like this is a priority to ensure everyone is protected.”

UNICEF, with WHO, is supporting the Lao Government to reach nearly half a million children under five with potentially life-saving vaccines. More than 7,200 volunteers and 1,400 health workers like Daeng and her team have been mobilised to deliver the oral polio vaccine as well as other vaccinations such as measles-rubella.

After several hours, the work is complete.

“I’m very happy and proud to do this job,” says Daeng once the team has packed up. “I’m proud to do this job to serve the community and help in any way I can.”