Thursday, 24 May 2012

Article: Keira Knightley’s Diary From Chad

Keira Knightley; Photo Credit: UNICEF
Credit: UNICEF

(Kiera Knightley visited Chad with Soccer Aid to see UNICEF's work for children in the country).

27 March 2012
It’s the day after my birthday and I’m on a plane to Chad.

Chad is an African country somewhere near the middle and totally landlocked. I know that because the UNICEF pack says so and not because I actually know. I had no idea where it was when they first told me I was going. It seems rude not to know where a country is. I feel like I should apologies as soon as I land.

Why are all these people going to Chad? There’s a family of very loud Americans sitting behind me on the plane all coiffed and suited. Voices brash and hair blonde with jewels jangling and I can’t quite make them add up.

Why Chad? What are you going to do there all dressed to the nines? It’s going to be 40 degrees and dusty. I think we’re seeing immunization programmes but there’s a potential food crisis coming so we could be diverted. In my plane safe in the sky I don’t know what that means. Seems impossible people could be dying of malnutrition when the lady with the clattering jewellery and pink lip gloss is behind me. Who are these people? What do they want? What do they do in Chad?

I can see sand dunes. A vast desert sprawls out below the plane. A sea of sand.  All this way up, I can make out sand dunes. Vast cloudless sky and the patterns, snakelike in the grey sand below.
Flying over somewhere called idea.... What looks like a stream but is probably a river, glints with white sunlight. The only light in the sea of grey. Haze all around. I’ve never been to the desert.  Gopea, Gabes, Djerba, Spax.  Vast never ending desert dunes like waves rising up from the ground. 

Right now flying over, it seems impossible there’s anything else on earth but this ocean of sand. My heart’s beating and I can’t figure out if I’ve drunk too much coffee or I’m nervous. Nervous of what’s here.

I can’t figure out how to fill in the landing form so that must mean I’m nervous. I must have asked the stewardess the same question three times and I still can’t remember the answer. Heart thumping, words don’t make sense when I read them. What are you scared of? Nothing but black out the window now. Stars above and dark below. What does ‘address in the country mean’? My country or Chad country? How are you meant to know?

Lonely plane in the ink black sky. Sitting on my own, I felt someone brush my hair back off my face. Gave me goose bumps. Welcome to Chad.

28th March 2012 - N’Djamena, Chad
It’s hot. Really hot. Like the air is thick and sticking to my skin hot. The sun hasn’t properly risen yet. My room is baking.

Chad: population around 11 million. 1 in 5 children die before they’re 5 years old. 1 in 9 before their first birthday.

Oh noooo! Just realized it’s an hour earlier than I thought. Completely forgot to change my watch from French time. F**k! I've just robbed myself of an hours sleep.

So I sit for longer in the dining room... It’s filling with more men now. There seems to be a type. Men in their 50’s/60’s, mostly European and mostly in khaki shorts and polo shirts. Do I go for my third cup of coffee? Yes I think I do. Given I woke up at 5:20 instead of 6:20 I deserve it. Maybe this is the civilised way to wake up. This could be the way proper people talk about: getting up at a leisurely pace and sitting having a long breakfast. Will this make me any more awake than rolling out of bed at the last minute with a full hour longer to sleep?

My first adventure of the day. The solitary long breakfast. The Parisiennes make an art out of it, why shouldn’t I bring it to Chad. There’s a woman just come in. Hair ironed straight, lip gloss and an off the shoulder bright yellow top with butterflies on. What is she doing in Chad? What are they all doing in Chad?

Chad: 183rd poorest country out of 187 on the Human Development Index. Each year 57,000 children die before they reach their first birthday, the vast majority as a result of preventable diseases, many preventable with a simple vaccine.

Should I tell the woman in the yellow top? No, let her float around. The world needs butterflies.
UNICEF estimates that 127,000 children under the age of 5 in Chad's Sahel belt will require lifesaving treatment for severe acute malnutrition. Only 52% of people have access to clean, safe water, and the percentage is even less in the poorest parts of the country Epidemics of measles and other diseases hit every year. Yet only 30% of kids are fully immunized. One of the lowest percentages in the world. 70% of children aren’t.

Immunization is not only a lifesaver from deadly preventable diseases like measles, tetanus, measles and polio, it is also the entry point for mothers and children into the health system. The beginning is always immunization.

Currently the country has only 261 health centres, a further 500 needed. But even with these the Chad lacks crucial human resources. The country has very few doctors, very few paramedics. It has the lowest percentage of trained doctors per capita of the population in the world.

UNICEF set up a programme to take paramedics straight out of school and position them in communities. The government isn’t putting the money in. If UNICEF launches it, it will be very difficult for the government not to take over. That’s the plan.

There’s air conditioning in the room. I’m such a d**k. There was no need to boil last night. It’s the green button by the bed.

I don’t know what to write about today, don’t know how I feel. Maybe when you’re in a place like this and you have a job to do and a camera in your face you put a screen over your emotions. There’s a practical task to do and you do it: try and get this woman to talk about how her three year old will never walk again. I feel awful asking about something so tragic, so personal. I know they’ve agreed to talk and I know that’s what we’re here to do but the private nature of their suffering and the toll they bear just seems like something a stranger should never pry into.

The desert. The desert. I’ve never seen a place like this. Sand everywhere with stone and shrub thrown in for good measure. A vast sprawling dust plane with camels and trees every now and again. Our drive out of N’Djamena, the capital city is full of nomads camped out at the side of the road and men manning tiny stalls of food. Women selling mangos. There is a family of hippos in the river Chari.

We had a security briefing from Mark, Head of Security at UNICEF Chad this morning. Everything’s pretty stable in Chad at the moment. 30 years of fighting ended 2 years ago and Idris Debby, the current president (of 10 years), seems pretty stable. I got the feeling if a coup did happen anywhere, Mark, who has been stationed in most of the world’s hotspots including Haiti, Ivory Coast and Afghanistan would be pretty handy to have around. Anyway that doesn’t seem about to happen, so the problem Chadians face mainly comes from their neighbours.

Chad’s landlocked and it’s mostly desert so very little grows here. They have to import almost everything.

To the east is Sudan: there is conflict from the rebels along the border with Chad (and a load of landmines) meaning imports can’t get in. To the south west is Nigeria, which, in the north is suffering from internal strife, again resulting in closed borders. Many refugees are fleeing into Chad. But hardly any imports are coming in.

To the north is Libya, where most of Chad’s imports came from. With the overthrow of Gadaffi and the revolution many of the hundreds of thousands of Chadians who worked and sent money home from Libya have been chased out. 90,000 of them. And very few imports coming in.

And finally to the south The Central African Republic (CAR), where private militia fight for control over the diamonds. No imports can get through.

In short Chad’s neighbours have locked-in a totally landlocked country. Makes you glad to live on an island.

The task that seems to face Chad is so enormous it made my head spin. Bruno, the Head of UNICEF in Chad briefed us. There is almost no infrastructure here. Hardly any roads, barely any running water, constant fuel shortages (ironic considering they struck oil a few years ago), very few schools, few teachers, very few doctors, virtually no access to medical attention of any kind. Plus conflict zones on all sides. Bruno explained about ‘the cold chain’ needed for vaccines to be transported. Vaccines need to be kept between 2 and 8 degrees centigrade which means they have to be refrigerated. Fridges need electricity or paraffin; the vaccines need roads to transport them and they need medical staff, properly trained, to administer them. 

Hardly any of that is here. The problems are massive and daunting but what’s so incredible about Bruno and his team and all of UNICEF is they’re ideas people. Instead of running away from it, as I would, they break it all down and focus on problems bit by bit.

We drive past the camels and into the suburbs of N’Djamena with buildings like I’ve never seen before, partially woven walls and bricks made of mud dug from under the sand. You see where they’ve dug it from in the centre of the development. In one of these half woven, half mud brick houses sits Chanceline, with her mother and grandmother. She’s got a pink dress on and her hair’s woven into spikes. She’s three and she has a killer smile. She also had Polio. She sits on the floor with her useless leg crossed under her, the paralyzed limbs a constant reminder of the disease that ravaged her energetic little body. Her mother, the sole supporter of a family of 8, tells me about thinking she had malaria, getting medicine for that and then her slipping into a coma for 5 days. When she woke up, she couldn’t use her legs. How do you put the fear and terror of that into words? In the afternoon, in a different part of town we meet Houra, also three, a very shy little girl with big solemn eyes. She, too, was paralysed from the waist down. She had had a fever. Her mother took her to a local doctor who said it was nothing. Then she woke up and couldn’t walk. At one point she could hardly sit up. Until a few days before our arrival the parents still thought she might get better, not knowing about or having heard of polio. The grandmother talked of Houra being a happy lively girl before the disease struck. Both families left reeling from the shock and not knowing how or being able to afford to get treatment: physiotherapy to stop more muscle wastage or braces for the legs to help them walk. Both girls screamed with pain when they tried to use their legs. Chanceline gave her dad a huge whack for making her try. Good girl. It’s just so unnecessary. Accidents happen. There are so many diseases we can’t treat but to have these girls’ lives and their families’ lives ripped apart by something totally preventable seems criminal. If we’re all so global now, with global economics, global markets, I don’t see why we can’t have the very basics of global health for these children.

What struck me most about today, apart from this unnecessary devastation, was the amazing love and spirit from the families. Their openness in speaking so personally to a load of strangers piled into their homes and their - I can’t find a way to say it - community. They have nothing but they support each other, taking care of each other’s children. With Houra, so many people, family members and friends came in to speak about her and the impact of her illness on everyone. I remember when I was 18, walking through the slums in Addis Ababa on a charity trip and it started raining. At least 10 strangers invited us into their homes to have coffee and take shelter. These people were similar. They live in abject poverty, their children struck down by diseases but the kindness they offer to each other and to strangers is definitely unlike anything I’ve seen in London; anything I’ve ever offered or received. I don’t want to sound sentimental but it is humbling. Totally humbling.

29 March 2012 - N’Djamena, Chad
Polio is a virus that attacks and permanently damages the nervous system. The initial symptoms are negligible: bit of a runny nose; fever; headache; then paralysis. It normally attacks the feet, lower legs and hands but when it’s fatal it paralyses the lungs and the brain. If it isn’t fatal the damage done to the nerves it has struck is irreversible. Life is really hard here in Chad an amazing woman told me today. There is disease everywhere. If people can eat once a day they thank God. There is virtually no healthcare system. Life is a fight from the moment you are born to the moment you die and this woman stood in her house with the open sewer running outside, with no clean water and her great granddaughter Ashta lying paralysed from meningitis in her arms and laughed. She had what I can only describe as joie de vivre. Irrepressible, spirit-lifting, smile-making, joie de vivre.

But I’m getting ahead of myself. It was an early start this morning. On the road at 6:15 to see the mass polio vaccination drive led by UNICEF that was being launched in the city. I didn't have enough coffee. 

Volunteers, who have been trained by local health workers to vaccinate, met at the district health centre to collect the vaccine in its refrigerator box. The volunteers work in pairs, a man and a woman, so if there's a problem the man can try and explain the vaccine to the fathers and the woman to the mothers. We follow Alice and Tija our two vaccinators to three of the houses they visit. Kids from all over follow us. Nothing to do with the vaccination and all about the 6 white people walking about like idiots with a camera and a massive microphone. The vaccination takes about three seconds and is just dropped into the kids’ mouths. With polio immunisation, you have to have a booster a few weeks later, so there will be another drive like this in 4 week’s time. Alice and Tija will probably do 200 kids each day for the three day drive. It’s hot and there’s a wind so the sand blowing in your face is intense but the place is amazing. Like something out of a post-apocalyptic film. Colours muted, rubbish burning, kids with ripped clothes and not enough to eat. But there is a beauty to the place. The space and the desert, the women in their colourful clothes with babies tied on their backs.

Like peacocks in this muted world. And the children so unafraid, so inquisitive, so independent. Can beauty be desolate? If it can, this place is.

I keep coming back to the spirit of community but it really hits me. Strangely I think it’s the most foreign thing about Chad for me. The kids running together in huge gangs in the street; playing football and running in and out of each other’s houses. Doors are definitely not closed here, unless on occasion you happen to be a photographer trying to take pictures of the children without their mothers’ permission. Even in the rehabilitation centre - a centre we visit after the vaccine drive that gives physiotherapy to people with polio, meningitis, cerebral palsy and teaches the enormous amount of Chadians who have lost limbs through landmines or infection how to walk with prosthetics – the mothers of children needing physio all sit together on a large mat and massage their children, chatting as they do it; all helping with each other’s kids. It was at this centre run by an incredible doctor that we met Idris and Ashta.

Idris is four. He contracted polio at one and a half. He is paralysed from the waist down and he is the bravest, most determined little boy I have ever met. The doctor introduced us to show us how the leg braces that are given to polio victims work; how they help mobility. Idris has grown out of his current ones but the doctor shoved him in them anyway. That child had a will to walk like I’ve never seen. Stabilized by two iron bars he used his upper body to move his legs. He was exhausted by the end of it but he wouldn’t sit down. Stood and stared at us with solemn eyes and then got totally fascinated with the camera. When we visited him later in his house he wouldn’t stop staring at it, fascinated by how it worked and what it looked like. A born photographer maybe. But not here, not in Chad, not with polio. But maybe. I need to write “maybe”.
His dad talked about how lively Idris had been before, how they had received the first round of vaccination but Idris had got ill before his booster. He said that every day he came home from work he prayed he’d see Idris running around with the other kids and would then see him in the house, alone, trying to crawl. The worst part of the day came when Idris’ dad turned to me and asked why I was here; if I had come to cure his son. I’ve never felt more useless in my life. No I can’t cure him, I can’t make him walk and I wish with every fibre of my being that I could.

All I wanted to say was “Yes he’s going to be fine, Idris will walk and run and be free”. Josephine, who works for UNICEF, explained the truth. Hope is a complex thing, without it we die, but with it, it disappoints again and again. Idris the fighter, Idris the lion heart, I wish you to walk again. I will you, with your braces, to fight on.

Meningitis is a bacterial disease that infects the membrane around the brain. In many cases it causes death; in some paralysis; in some brain damage. The symptoms are normally headaches, a really stiff neck and vomiting. Little children will normally cry and cry from the headache, then stop and go floppy and sometimes dip into a coma. Ashta is 2. When she was 1 she was travelling with her parents on a bus from somewhere outside N’Djamena. She got sick on the bus, was feverish and got really floppy. Her mother phoned her grandmother immediately and took her straight to a hospital. She slipped into a coma for 15 days. They thought she would die. Her father would hold her to him as he wept. She pulled through but lost the power in both arms and legs and couldn't hold up her own head. Her grandmother moved in with the family to help out, staying up with her night after night as she screamed. This was an amazing family. A family of matriarchs. 5 generations living in the same house; Ashta, her mother, her grandmother, her great grandmother and her great great grandmother. They all had laughter in their eyes and loved each other so much.

They had a business running in the house, making cakes and incense. There was an enormous can of locusts, a local delicacy, drying in the sun. Members of the extended family all came in and out, helping with cooking or cleaning or incense making or child rearing. Ashta’s father was away. It turned out he is a footballer in Chad’s biggest team. He trained as an accountant but couldn’t get a job so he had no choice. Ashta is the most smiley baby I’ve ever met. Through physiotherapy they have managed to get a lot of movement back into her body. She can crawl now and has use of her arms and hands. She loves clapping; loves the sound and loves the motion but still can’t support her head and can’t sit up by herself. She will never fully recover, never regain full mobility, but her family are determined she will go as far as they can get her. Each member helps out with the daily exercises she needs to make progress. Her great grandmother is a force of nature so if that’s anything to go by Ashta will go far. The invasion of meningitis has ravaged her body but not killed her spirit or that of her incredible family. Today has been challenging. And I don’t mean because it’s hot and the days been long but in an “I don’t know what to think” way. It’s just luck, maybe it’s that, its luck where we’re born, where we come out. Most of the world lives in abject poverty. Most of them don’t have running water, electricity, a toilet, access to any kind of healthcare or even food. I am the unbelievably lucky cow who got born into a country with a safety net who never had to worry about something like polio or how to afford a doctor if someone got sick or, even more basic than that, how to afford the transportation to get to the doctor. There are wonderful people all over the world, amazing human beings with amazing spirits, laughter, and families desperately in love with each other, but some of these people, in Chad most of these people, live in the most desperate hardship imaginable and still manage to laugh. It’s not fair. I know it’s childish to boil it down to such a simple sentiment but it’s the only one I can think of. For these people, for Idris and Ashta it just really, really, really isn’t fair.

30 March 2012 - Mao, Western Chad
Flying from N’Djamena to Mao in a United Nations twin propeller plane that takes essential supplies to a region that is hard to access by road.

The tin shacks of N’Djamena get further and further away. Glinting silver in the sun they get swallowed up, as we rise, by the grey yellow of the desert. The desert claims back the city, the dunes take over the roads, the sea of yellow returns. Flying over Chad. I can’t describe the vastness of the yellow. On and on and on into nothing. I can’t process the colour as being that of the earth. How do people live there? How can anything survive? Photos won’t do it justice. My eyes can’t process the landscape. Yellow, burnt orange, sand. Then out of nowhere palm trees. Islands in the sand. Acute severe malnutrition occurs in children after a month or a month and a half without food. At that point the vital organs will begin to fail and the child will lose all appetite. They will suffer from diarrhoea and their immune systems will become so low that they will be highly susceptible to disease. When diarrhoea occurs they also become severely dehydrated which will mean they will also not be able to drink. Then they will die.

Approximately 1,000,000 children across the 8 countries including Chad in the Sahel belt of West Africa are starving. The desert region of West Africa has been devastated by climate change. There has been no rain, so there are no crops. Lakes that once provided fish to eat and water to drink and irrigation for crops are drying up. Whole communities who for centuries have been fishing the waters of Lake Chad between Chad and Nigeria are left landlocked with no water. Lake Chad is a travesty. If anyone ever had a question about the severity of climate change they should fly over it, or rather don’t because that’s pollution it doesn’t need, so just take my word for it. A lake that was once so large it looked like a sea has gone, overtaken by the land, leaving small islands of water with tiny patches of green.

With no water the people of the area are starving and will continue to starve to death in their thousands. Mao is remote. It may be the most remote place I’ve ever been. Looking out of the plane there’s nothing but sand as far as the eye can see. No roads at all in this vast desert belt. The runway is the only thing that could approximate a road. We are picked up in three UNICEF trucks by Dr Chris, the UNICEF Head in Mao, who is a Cameroonian man with smiling eyes. He takes us straight to the Governor of the District. 'Protocol' for him letting us come. Inside the house the Governor is sitting on sofa watching sport, with other leather sofas lining the walls. He explains about the problems of the region while we drink the greatest orange drink in existence. Apparently the last governor wouldn’t let you meet him unless you arrived by camel, no trucks were allowed, but he got ill and went back to N’Djamena and this guy has just arrived. Wish we’d arrived on camels. After many thank yous we are allowed to visit the medical centre. Normally we would have had to ask the Sultan’s permission too, but we’d arrived just as prayers were called so we are allowed to forego that one. The Nutrition Centre is in part of the hospital in Mao. As we drive in, the sick lie on mats outside under the trees or in the shade of the walk way. The Centre is a small building on one level, painted blue and white. Women come out of some of the rooms to watch us. Bright coloured robes against the dust of the walls. Curious eyes looking from thin faces.

Through a closed gate is the centre itself: one building at the back comprised of one room; two UNICEF tents and two open wooden structures with roofs for shade. There are 34 children at this centre. 14 with severe and acute malnutrition and the rest improving to various degrees. All the children have their mothers or grandmothers with them and all are under 4. The building houses all the most severe cases (14), and the two tents house the kids who are improving. The smaller one for transitional patients, the larger for the children who have come off the original therapeutic milk (packed full of nutrients, vitamins and electrolytes) and moved on to a solid food that is like peanut butter. Very high calorie and importantly no water needed, meaning that it can’t get contaminated by dirty water.

The light from outside blinds me at first as we go into the dark, one-roomed building. The smell hits before the images come into focus: sweat, bodies and faeces - not strong but there - sweet, it hangs in the air. As my eyes get used to the dark rectangular room the images become clear. Mats, with blankets on, lined one next to the other; each one with a woman sitting crossed legged, back against the wall and in front of each woman a tiny starving child lying on the blankets. Their names, ages and date of admission are stuck up on paper behind them on the wall. I can’t remember their names. I wish I could.

Shock combined with a desperation not to show it, or show any kind of revulsion at the diarrhoea coming out of them, glistening white, meant my brain can’t keep hold of a single name. Hopefully I got it right on film. The first little boy screams as his blanket is pulled away to show the diarrhoea flowing out. Crying in fright and pain. One little boy, a two year old, who had been brought in three days before is being fed by a tube through his nose because he can’t take any milk down his throat, both hands are bandaged so he can’t rip it out. He had twice before. He stares at us with streaming eyes, defiance in his tiny frame. Flies buzz around everywhere.

Next to this little one is a 2 year old girl called Mariam. I don’t know why I remember her name but not the other two. She is suffering from a different side effect of acute severe malnutrition. She has swollen up. Her face, legs, hands, stomach, everything. Her eyes are so swollen she can’t open them anymore and her skin has stretched to the point that the top layer of it has burst. All over her swollen body her skin is hanging off. The layer underneath raw and pinker than the patches of dark skin on top.

She sits, like a Buddha, trying to swat the flies from her unseeing eyes. Occasionally she turns her head in my direction and forces her swollen lids apart to try and see the stranger beside her. She manages to catch a lot of the flies crawling close to her seeping eyes. Her grandmother sits behind her in colourful robes, dark lined skin, piercing eyes watching us watch her granddaughter. It’s horror in this ward. Limp children days away from death and proud women staring. They have come up to 70km to try and save their children. All the kids in this place were taken to traditional healers before being brought here. One of the women told me how they had planted crops in her village last June; since then there had been no rain, none of the crops had come through and the whole village was starving. Her husband had walked 200km's to the next region to try and grow crops there but no food had come back to them.

This was the story again and again. Another woman’s husband worked in Libya. Like thousands of Chadians he sent money back to the family so they could live. Three months ago the money stopped arriving. They haven’t heard from him. He was caught up or killed in the conflict in Libya.
In the second ward - the first tent - you see how improved the children are. They’re alert, their eyes are dancing. I hold one seven month old in my arms and he smiles and gurgles at me. He is only the size of a new born baby but his hands are strong as he grips my finger and his eyes are focused. His mother sits smiling beside me. You can feel the energy in this tent, totally lacking in the first building. You can see these kids starting to be kids again. Little curious beings trying to learn, trying to interact with the world around them. Severe acute malnutrition normally doesn’t happen to children under 1. Normally the mother has enough milk to keep them going. If they’re severely malnourished under one and still breastfeeding it means the mother herself is starving.

The third tent, in light of the other two, is miraculous. Once the kids are in this one they are days from being released. The mothers are chatting, the kids are louder, all sitting up, all alert. The difference between this tent and the first one is so massive you forget that the children are still tiny, still with bones sticking out of their chests. They are so alive, life bubbling out of them. They are what children should be. One little girl, another Ashta, is eating the peanut butter solution. It’s all over her fingers and she’s staring at the shiny silver packet it comes in. I had one in my hand and she cried until I gave it to her. She held it to her as soon as I did, stopped crying and started beaming instead. At 2, her priorities are totally straight.

Although the images today were horrific it was easier than the other days. I think because in telling the story of malnutrition there can be, in the lamest terms, a happy ending. The child comes in on the brink of death. Through feeding, through therapeutic milk and the peanut butter solution and - I can’t find a better expression - by the grace of God, if they don’t get any horrific diseases while their immune systems are so low, they can recover. They can get fed and then go home strong. (They are out-patients after that and are given food supplies).

It is different trying to make a vaccination campaign work. The only happy ending to a polio or meningitis story is if it never happened in the first place. When you go into houses with families who have a child with polio it isn’t to help their child, to reverse magically the damage the disease has done, it’s to prevent other families, other children from suffering the same fate. Showing the illness is the only way to make people understand the problem, but for the child whose story you tell it’s too late.

Idris, the extraordinary, inquisitive boy, will be paralysed from the waist down forever but because of these foreigners going into his home the parents, just for a minute, had the hope that maybe these westerners had come with some miracle cure. That hope seems cruel even if it does save other children. It’s cruel that Idris can’t be saved. The difficulties in Chad are mountainous. To a mortal like me they seem insurmountable. There is hardly any infrastructure - almost no running, clean safe water. Very few schools. Little health care. Generally no electricity. Limited fuel. Hardly any roads. And, sorry, just to repeat, but almost no healthcare system, be that private or governmental. Because there is very little health care system there are very few doctors, nurses or paramedics. People would have to pay to go to medical school, nearly impossible because there are no jobs, then once they’ve paid and qualified they would have no job to go to because nobody’s there to hire them.

Vaccination is the way in. It’s a chain reaction. If you introduce vaccination as a norm there have to be doctors. If the medical staff vaccinate the kids there is a relationship with the doctor. If there’s a relationship with the doctor the people go to them when they are sick. Once people get used to a health programme being put in place they will demand it from the government. Once a healthcare programme is put in place 

other programmes within the infrastructure (like education) can be put in place.

Vaccination is the way in to everything.

The people at UNICEF are taking on the challenge but they need our support and our help to do this.

Keira Knightley
March 2012 

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