A simple wooden boat is key to bringing vaccines to remote areas of Colombia

“We are happy. This boat is a blessing,” says a smiling Sara Jiménez, wearing an impeccable uniform that shines in the middle of the San Juan River, in the department of Putumayo, in southwestern Colombia, near the border with Ecuador.

Jiménez is part of a team of vaccinators who sail to the Las Vegas indigenous reservation, on the banks of the river, deep in a jungle area. They are transported by a wooden boat with capacity for about 20 people, which now makes a difference in their mission to prevent diseases.

“Previously we had to pay very high costs to come“We had to get up very early to catch a boat and visit in a hurry,” says Jiménez.

One of her colleagues, Libardo Chará, adds: “Before it was very difficult, we had to do it by means of public passenger boats and, sometimes, when we had the resources we could come one or even three times a year, but the vaccination schedules were not managed as they should be, they were irregular. The children were behind.” There were older children who did not even have their first vaccination.”, says the vaccinator.

Nearly 80% of the population in the department of Putumayo lives in scattered rural areas. To reach some of them, it is necessary to navigate rivers for five to six hours.

“This makes it difficult for people to get to health centers and makes it very difficult for vaccines to reach all communities and for the regimens to be complete,” said Carolina Echeverry, the department’s health secretary.

In defense of equity

Putumayo, nestled in the Colombian Amazon, is one of the departments prioritized as part of Canada’s Global Initiative for Vaccine Equity CanGIVE.

The project seeks to contribute to equitable access to the Expanded Program on Immunizations (EPI) vaccines among vulnerable populations. The cooperation alliance with the Pan American Health Organization (PAHO) and UNICEF reaches remote areas of Colombia where additional immunization efforts are required, as well as strengthening of health systems.

In Colombia, The initiative, which has an investment of 14.9 million Canadian dollars for the years 2023 and 2024provides resources for the acquisition of equipment and supplies for the vaccine cold chain, support for immunization campaigns and the strengthening of human talent and the Program’s information system.

In consultation with the Government of Colombia, 10 departments in the country were identified with low coverage among the population under 5 years of age: Caquetá, Putumayo, Amazonas, Arauca, Vaupés, Chocó, La Guajira, Nariño, Guainía and Vichada.

Jaid Constanza Rojas, PAHO’s national immunization consultant, explains that support for the territories is defined based on the needs identified by departmental and municipal health authorities.

“In Putumayo we identified that coverage levels were low, especially in riverside areas where the population lives next to the river. We decided to give them a boat so that they could go every day to complete the vaccination schedules in a timely manner and do the required follow-up,” he says.

Echeverry, the departmental health secretary, highlights that “the help with boats and motors has allowed the biological products to be transported to remote areas, providing guarantees for the vaccines to be applied to the entire population, especially to children under five years of age.”

Vaccination teams celebrate the availability of the new means of transport.

“The motorboat is a working team. Now we arrive easily and the schedule is done on the date and at the indicated time,” says Libardo Chará. “Now we go to each house with time to talk to the families and keep up to date with the vaccination schedules. Parents sometimes do not have money to take their children to the village to get vaccinated. Now they feel very grateful,” adds Sara Jiménez, his teammate.

PAHO Colombia/Laly Malagón

Hard days

The vaccination teams in Puerto Caicedo, a municipality in Putumayo, begin their work days before seven in the morning. They enter the local Alcides Jiménez hospital to prepare their equipment, ensuring that the vaccines remain in the cold chain, and dividing themselves into zones or villages.

“They collect the vaccines and make land or river trips. They travel in search of children to monitor the schedules and in search of floating or new population to prevent vaccine-preventable diseases. They carry out vaccinations from house to house and sometimes at points where the community goes. “When care teams are organized,” says Yolanda Ortega, a vaccination nurse.

Martha Chachinoy is another of the vaccinators in the municipality. She explains that it is necessary to start the journey before dawn. After sailing along the rivers of this jungle region, the trip continues with walks between villages or hills.

“We had to get up early to get to the river. Thanks to the boat we managed to get to the riverbank in time and then we continued walking. It is very hard, but we do the work with a lot of love. and that makes us climb the hardest hill,” he says.

The morning is calm as the vaccination team arrives at the Las Vegas indigenous reservation. After getting off the boat, they approach the house under the burning rays of the sun where Angie Paí is holding her six-month-old son. They are giving him new doses to protect him from diseases.

“Every time the child has vaccinations, they come to vaccinate him. It is important to prevent children from getting sick. It makes it easier for them to come here for transportation, because they would have to go by boat from here to the village and the fare costs 10,000 pesos (about 2.5 dollars),” the woman thanks.

Stephen Lopez, Hospital manager Alcides Jiménez confirms that the delivery of the boat helped reduce gaps in access to vaccination.

“Before, the hospital had to pay high transportation costs. A transfer by private boat could cost between 800,000 and one million pesos (about 250 dollars) for each brigade. After donation, operational deployment costs are lower. We have fuel and driver supply contracts and that helps to increase the hours, achieving greater coverage,” he emphasizes.

PAHO Colombia/Laly Malagón

Public health results

According to the Ministry of Health and Social Protection, Colombia has one of the most complete vaccination schemes in the region. Through the Expanded Immunization Program (PAI), it has 22 vaccines that protect against more than 30 diseases. The target population is children, adolescents, pregnant women, adults over 60 years of age and people with comorbidities.

Elvin Janeth Botina, head of the public health office of the Putumayo Health Secretariat, explains that, through vaccination, It covers the entire life course, from children under 5 years of age to adulthood“Vaccination is very important to prevent diseases such as acute respiratory infection, COVID-19 and yellow fever, among others,” he stressed.

“We will be able to meet the vaccination target in municipalities that were not complying, with 95% coverage. This is useful coverage and we know that it is thanks to this aid,” adds Carolina Revelo, a professional nurse supporting the information system of the Expanded Immunization Program in Putumayo.

The Mayor of Puerto Caicedo, Ederth Adrián Ibarra, emphasizes that “it is very important because we can reach out to many people who cannot go out and care for them, prevent diseases and even mortality in children, adolescents, women. A child with a complete vaccination schedule is a healthier child and Many of the diseases to which we are exposed are being prevented in our municipality and in any part of the territory.”

The delivery of the bottle, as part of the cooperation work, not only makes the vaccinators’ daily lives easier. It contributes to protecting life in remote communities.

“If the children are well, the parents are well. I have been working in vaccination for 26 years and I love vaccination, it is very nice to see children grow and seeing them grow up with their families is very rewarding,” concludes Martha Chachinoy, as happy as the rest of the brigade.