A vibrant scene unfolds in Damangaza, an urban slum in Lokogoma Abuja, Nigeria, as a flurry of children navigate their way around makeshift dwellings, traversing unpaved lanes and open sewage. In this challenging environment, my team at the Vaccine Network for Disease Control has tirelessly worked to shield these 6,000 vulnerable inhabitants, particularly children, from the grip of diseases. Despite the absence of basic amenities like electricity, running water, and sanitation, we have endeavored over the past years to make a positive impact.
My initial encounter with this community in 2011 revealed the devastating prevalence of vaccine-preventable diseases and the resulting deaths.
Upon my initial visit in 2011, I was confronted with a grim reality—vaccine-preventable diseases and fatalities held sway. The concept of immunization was virtually non-existent. Yet, our undeterred determination, relentless optimism, and innovative strategies have disrupted the status quo for this community. We have fostered trust and equipped them with the knowledge needed to safeguard their children through immunization efforts. Being a part of the Women Advocates for Vaccine Access (WAVA), a coalition advocating for improved vaccine accessibility, our team recognized the pivotal role of empowering women.
Recognizing that women serve as the driving force for health and advocates for their children, we set out to earn their trust. However, building this trust was a gradual and arduous process. It was through women selling fruits on the roadside that I was introduced to this village. Articulating our intent for a health-focused visit, we gained their agreement to guide us back to Angwan Hausa Damangaza, a Hausa Fulani settlement located within the Garki ward of the Abuja Municipal Area Council.
At that time, over 1,000 children inhabited the settlement, with more than 500 under the age of 5. The village was reeling from a measles outbreak; the scourge of pneumonia and other environmental challenges had claimed the lives of around 50 children. The looming threat of polio further underscored the importance of our mission. The Vaccine Network team embarked on the task of educating families and connecting children to essential health services—an ambitious endeavor within the confines of a remote urban slum.
The language barrier was our first hurdle, necessitating a translator fluent in both Hausa and English. Another challenge stemmed from the cultural norm of Bashiga, which prohibited men from entering homes where women resided. We quickly learned that engaging with three key figures—the mai-angwa (chief), the mallam (religious leader), and the teacher—was imperative.
While the majority of families hadn’t pursued immunization, the village chief had. Convincing him about the significance of vaccinating more children led to a breakthrough. When a substantial portion of the community is immunized, disease transmission can easily be controlled, especially for newborns. This concept of herd immunity was crucial to safeguarding lives. Gaining the acceptance of these key figures had a ripple effect, we earned the trust of families throughout the village.
However, imparting the importance of child immunization necessitated innovative approaches. With support from the International Vaccine Access Center for our advocacy efforts on World Pneumonia Day, we orchestrated a vibrant and textured fashion show, featuring the settlement’s children as models. By allowing them to retain their traditional Nigerian attire, we forged a bond of acceptance. This event marked the turning point, as the families welcomed us into their lives, embracing us as part of their village family. This newfound rapport eased the process of introducing health workers from the Abuja Municipal Area Council for immunization sessions.
Remarkably, in a single day, the team managed to immunize 441 children under the age of 5 against measles and polio, with only a handful of families refusing. Yet the ultimate goal is for mothers to actively seek care without waiting for intervention. Financial empowerment played a pivotal role, as the Vaccine Network donated machinery and offered workshops to teach women skills such as soap and cream making, which they could then sell at markets. These workshops, while enhancing economic independence, also served as platforms for health and immunization discussions.
Innovative strides were taken to address transportation barriers. The team hired buses to facilitate the transportation of mothers and children to health centers for immunization sessions. Furthermore, the health centers provided essentials like paracetamol (acetaminophen). These ventures laid the foundation for families to navigate future logistics independently. The cumulative impact of the Vaccine Network’s tireless efforts manifested in a significant achievement: no child succumbed to vaccine-preventable diseases in the community in 2013.
Despite the inadequacy of substantial health records, our frequent interactions with the chief and families affirm a substantial shift in awareness and behavior between 2011 and 2016, with fewer child fatalities. Mothers now proactively seek routine immunizations and even express dissatisfaction when health workers go on strike. The mothers’ willingness to travel long distances to health facilities underscores their determination. As the health facility brims with patient mothers and their children, it’s a testament to their perseverance and unwavering love—a sight that validates our enduring commitment to safeguarding the most vulnerable in Nigeria.