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Ababacar Wade ’s eyes are luminous as he describes the fear he feels when he goes to Dakar’s international airport to meet a vaccine shipment. The shipments come in every two or three months. In the last 3 years alone, Senegal has imported more than 25 million doses of vaccines that protect infants from polio, diphtheria, tetanus, whooping cough, measles and childhood tuberculosis.
The airport is 20 kilometres from the central cold store at the National Drug Supply offices. Ababacar has travelled that route a hundred times or more, yet it is far from routine. He worries about the lack of a refrigerator van to keep the vaccines cool. He is afraid in case an accident delays him en route.
“When I carry these vaccines, I carry life itself,” he says, “and when I hand them at the central cold store, it is like the fulfilment of a prayer.”
Ababacar, who works for UNICEF Senegal, began meeting vaccine shipments in 1975 and for as long as he can remember he has been passing them on to Ousmane Cissé at the central cold store. Between them, the two men have touched virtually every shipment of vaccines to enter the country in the last twenty-five years.
Cissé is a petite, meticulous man who dresses in traditional Senegalese attire. He stocks the vaccines in giant walk-in freezers. Vaccines against polio, measles and the BCG vaccine against childhood tuberculosis go into the negative freezer (-20° Celsius). The refrigerator (2° to 8° Celsius) holds the triple DPT vaccine that protects infants from diphtheria, pertussis (whooping cough), and tetanus, as well as yellow fever and the tetanus toxoid (TT) vaccine that is given to women to prevent maternal and neonatal tetanus.
From the tiny backroom that serves as his office at the central store, Cissé records the comings and goings of the vaccines. He has no trouble locating batch numbers, expiry dates and the destination of vaccines he handled as far back as 1993 – earlier records are archived.
“I care for the vaccines as if they were intended for my own children,” he says.
In vaccine circles, Cissé has become a virtual legend. Several years ago, he reached age 60 and was forced to retire, but since no replacement could be found, he continued working without pay. Short of funds, Cissé walks the 45 minutes to and from his house to work, varying the route because he doesn’t want people to see him walking in case they think he is poor. His wife and family tell him he should give up work, but he can’t.
“It is my conscience. I cannot stay at home when there is work to be done.”
Asked if he ever dreams about the vaccines and those gigantic freezers, he laughs. “Sometimes I do not know where the sleeping world ends and the waking world begins.” His anxiety dreams are about power breakdowns that defrost the freezers and endanger the vaccines. His nightmares used to be about getting shut inside one of the old icy walk-in refrigerators, in pitch darkness. “But now we have these new freezers and the light stays on inside even if the door shuts.”
The new freezers, generators, motorbikes and other hardware provided by UNICEF and other partners are part of a major effort to help the Government of Senegal get immunization services back on track. Despite the dedication of men like Ababacar and Cissé, the nation’s immunization rates had been falling. To understand what happened and how these trends are being reversed, we followed the vaccine trail and met some of the men and women who are the driving force behind Senegal’s now reviving immunization programme.
Much of this work was originally produced for UNICEF
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