Hepatitis

Outside the health post

October. For me, October been defined by nippy weather, a lingering economic crisis, political heat, or a Brady-free Patriots. Rather, October in La Grama has been consumed by vaccines, vaccines, vaccines. Throughout the month the Peruvian government is holding a national vaccination campaign for the third dosage of Hepatitis B. Thinking it might be a great way to get to know more La Gramian youth, I lent my services to the health post staff and accompanied them on visits to the local schools. On my first day assisting the operation, I arrived at the Health Post promptly at 8:00 am, ready to start my day. There, I sat and sat and waited and waited. I’m not sure if I have mentioned the hora peruana in previous posts or not but it is pretty much the most frustrating thing I have encountered here to date (I have yet to witness a meeting or event that began on time—anecdotes to come). Around 10:30 am we were finally ready to head over to the school. We entered the first grade classroom where my brother, a fifth grader was seated chatting with some of his younger friends. Children were running around the schoolyard, others were playing games in their classrooms, where the teacher was nowhere to be found, and still others were straining to fit their heads through the bars on the windows, endeavoring to get a good view of the vaccination process. We set up post at one of the desks where the nurse promptly handed me a syringe and urged me to get going with the injections. I blubbered and faltered something lame along the lines of, “but, but, I’m not trained to vaccinate. I can’t do it. My boss won’t let me. I have shaky hands. What if they contract Hepatits B.” She responded with “of course, you can. It’s easy.” We went back and forth for a bit until finally I convinced her to let me do the paperwork and leave her with the inoculating—though I’m not quite sure this was a brilliant alternative. The teachers gave me their class rosters to copy onto a chart that the State provides to track age, gender, and how many doses received. The rosters, however, didn’t correspond exactly with those who actually received an immunization. Some students hid out in the bathrooms, others claimed to have already received their third dose, and others said their parents forbid them to be vaccinated. We had no way to verify who had in truth already received their third dose and moreover did not check off the names on the roster as we went along. Also, I’m not sure I understand the system the doctora had for deciding who she let get away with not getting the shot and who would be forced to get it. In the second grade classroom the three of us actually chased a little boy around the room, held him down, and tried to wrench off his shirt—though, he managed to escape and thus was not vaccinated.

When we finished up at the school, we returned to the health post to go over the paperwork where the nurse produced stacks of papers from previous campaigns for the first and second doses. The mission was to match the names from the day’s vaccinations with those from the previous campaigns and mark off the students who had received all three doses. This was no easy task. For one thing, the mountain of papers on the desk was, well, mountainous. It was all handwritten and in no particular order. What’s more, the names in the papers were not organized by age or class, but instead were grouped randomly, making the search pretty close to impossible. To make matters even worse, children in Peru have, at a minimum, four names—two first, two last—and they do not always use all four. Many names did not match up exactly, making me doubtful whether Jose Luis Vargas Velasquez and Jose Velasquez were the same person. What a headache.

The following day I showed up for the second round of vaccinations, this time in the high school. Waiting a mere hour and a half in the posta before taking off, I managed to keep myself reasonably entertained. For one thing, I had thought to bring a book with me, and for another, the staff had posted an enormous sign for me to contemplate, that read: “list of people that are putting at risk their own health and that of the community by not being vaccinated.” A list of ten names followed. I am not exactly sure how they arrived at these names, as I am fairly certain their were more than ten people who escaped inoculation, but I was amused by the sign nevertheless (can you imagine what would happen if that was posted in the U.S.?)

In the colegio, things went a bit smoother. We were a team of four and split into twos to make the venture go faster. Rather than copy class rosters, I had each student write their own name on the chart after receiving their shot. In this way, we knew definitively which students in the class were actually vaccinated. It didn’t make the following match up paperwork any easier, but at least we weren’t recording the names of those who didn’t receive their 3^rd dosage.

Friday of that week the posta organized a pregon—basically a noise-making march through town—to raise awareness of the hepatitis b campaign. The doctor and nurse made a handful of posters with slogans that read, “Indifference kills, hepatitis b does too;” “Vaccinate yourself already;” and “If you love yourself, vaccinate yourself.” They distributed the signs to the elementary school kids (who arrived an hour after the pregon was scheduled to begin) and invited the high school band to play (who arrived about 20 minutes after the elementary school kids). We paraded around town for an hour to the beat of huayno music—nobody came out to watch except the preschoolers—and then we all disbursed. We didn’t chant anything or even provide the kids with a bit of information about what they were marching for. I would say it was a very successful information-sharing crusade.

Of late, the vaccinations have started to taper off. Yesterday I accompanied the doctor around town knocking on doors to inquire whether anyone under 19 years of age lived in the household. Whenever we encountered a child in the street, the doctor would shout at him, “hey niño, come here and get a shot.” A very effective way to get kids immunized. We vaccinated a total of three people and were out most of the morning.