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Posts Tagged ‘remote’

Photo: Chris Bell/The Culture Trip.
Tourists in La Guajira, a remote part of Colombia. Nowadays the focus is on a vaccine outreach to wary indigenous residents.

John assures me that pandemics always peter out as variants emerge weaker and weaker. I hope he’s right. Meanwhile, some experts are saying we won’t be done with Covid until we vaccinate the whole world.

Samantha Schmidt at the Washington Post wrote recently about an effort to reach a remote corner of Colombia — one step in vaccinating the whole world.

“The vaccination team had spent an hour bouncing and bucking down a dirt road and over train tracks when the van driver issued a warning. The toughest part of the drive was still to come. The two women gripped their seat cushions as the van jolted, climbed a mound of dirt and fishtailed in the slick mud. Driver Toto Girnu honked at passing goats as he followed a path blazed only by tire tracks. In the distance, he spotted dark, menacing clouds.

“If the group was lucky, the drive through this remote desert would take four or five hours. If it rained, as it did when Girnu made this trip a few days earlier, it could take more than 10.

“But this was the only way to reach the Indigenous families who live in this arid swath of land in the northern department of La Guajira, where there are no paved roads, no electricity, no running water and no other access to the vaccines that would protect their communities.

“Travel is only part of the challenge confronting the team, one of many contracted by the Colombian government to deliver vaccines to some of the country’s remotest peoples. There is also a lack of information about the coronavirus, hesitation around vaccines and a general mistrust of authorities.

“The van, ‘Route of Hope’ written across the windshield, came upon a roadblock. Adults and children here string ropes across the road, to be lifted only in exchange for water, food or cash.

“ ‘Are you vaccinated?’ vaccine team coordinator Katherin Gamez shouted to a young man. Girnu gave the man a fist bump, tossed him a small bag of water and translated the question into Wayuunaiki, the language of the local Wayuu Indigenous people.

“ ‘For what?’ he asked.

“Across the Andes, a region that has reported some of the world’s highest covid-19 death rates, teams are traversing deserts, mountains, rainforests and rivers to vaccinate isolated communities.

“Such teams are particularly active in Colombia, a country of more than 48 million people, where about 16 percent of the population lives in rural areas that were often neglected by the government during more than five decades of armed conflict. …

“About 35 percent of Colombia’s population has been fully vaccinated, according to the Health Ministry. More than half of residents in major cities — 62 percent in the capital of Bogotá — have received at least one dose.

“But in La Guajira, home to the country’s largest Indigenous population, only 38 percent have received at least one dose. … Years of government abandonment and mismanagement have caused many Wayuu residents to mistrust the health system. Only 4 percent of Wayuu people here have access to clean water, Human Rights Watch reported last year; 77 percent of Indigenous households are food insecure. In Alta Guajira, where the largest number of Wayuu people live, there is only one hospital, and it offers only basic care. …

“ ‘By the time a lot of them get to care, they’re so near death … there’s this perception that maybe the care didn’t help,’ said Shannon Doocy, an associate professor of international health at Johns Hopkins who co-wrote the Human Rights Watch report. …

“ ‘We’re getting close,’ Girnu told Gamez and Eliana Andrioly, the team’s Indigenous leader. They sped down a salt flat, their view miles of sand and the distant bay. …

“A team of nursing assistants and a doctor were waiting. The providers spend 15 days at a time living in a dormitory next door, sleeping in hammocks and showering with buckets of water, to stage daily medical missions to the surrounding communities.

“The organization, IPSI Palaima — ‘land of the sea’ in Wayuunaiki — was founded in 2007 by an Indigenous woman who grew up in the area. It is one of the only providers in Alta Guajira with a permanent vaccine refrigerator, in a medical center powered by solar panels.

“The team member in charge of shots this week was Daniela Vergara, a 21-year-old nursing assistant who had never been to AltaGuajira before she applied for the job. Each day, Vergara aims to vaccinate at least 10 people — a modest goal that often requires a massive effort.

“On this Monday, she had not yet reached her target. She packed her cooler — a blue backpack filled with vials of the single-dose Johnson & Johnson shot that has been a godsend to rural vaccine teams — and set out for a community across the bay. [Then] they drove to a gathering place where they hoped to meet people interested in the vaccine.

“ ‘There’s no one here,’ Vergara said. ‘We got here too late.’

“A local leader suggested they go house to house. As darkness fell, the team members asked anyone who looked 18 or older if they wanted the vaccine. Soon a woman recounted a rumor they had heard many times: Outsiders were pushing a vaccine that was sickening members of the Wayuu community.

“The woman, a teacher who spoke some Spanish, knew what was at stake. She had contracted the virus a few months earlier, after a trip to the town of Uribia. For a month, she suffered chest pains, headaches, an intense cough and the loss of taste and smell. … She worried about a 66-year-old neighbor who had no interest in getting a shot.

“ ‘Many people are dying from this disease,’ Juan Larrada, a Wayuu doctor in the group, said in Wayuunaiki. He said the vaccine could have side effects, but it would protect them from serious illness. He asked Amaita Uriana why she did not want it.

“ ‘Because I was afraid of getting sicker,’ she said. ‘I really feel very sick. I carry pains in my body. That’s why I refused when a girl came here for the same reason. Besides, she was very pretentious. And we had already heard about the experiences of other Wayuu who had been vaccinated and become ill.’

“ ‘The vaccine can have those effects,’ Larrada agreed. ‘Fever, muscular pains, that’s normal.’

“Understanding the doctor as he spoke to her in her own language, Uriana assented. She closed her eyes; Vergara emptied the syringe into her arm.”

Read about the many Wayuu who cannot be persuaded and why that is, here. The photos in the article are terrific, but I can’t share them because they’re blocked. If you have a subscription, you are in luck.

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You’ve heard of TED Talks — interesting people lecturing about amazing work?

Well, there is also something called a TED Prize, and medical entrepreneur Raj Panjabi will receive it in April. The TED website provides background.

“Raj Panjabi grew up in Liberia, but at age nine, his family fled a devastating civil war and relocated to the United States. He studied hard, and in 2005 returned to his native country as a medical student. He was shocked to find a health care system in shambles.

Only 50 doctors remained to treat a population of four million.

“Raj founded Last Mile Health to expand access to health services for those living in Liberia’s most remote regions. The nonprofit partners with the government to recruit, train, equip and employ community health care workers, empowering them to provide a wide range of services.

“In 2016, Last Mile Health deployed 300 community health workers, who conducted more than 42,000 patient visits and treated nearly 22,000 cases of malaria, pneumonia and diarrhea in children. The organization also helped tackle the Ebola epidemic in southeastern Liberia by assisting the government of Liberia in its response and training 1,300 health workers to prevent the spread of the disease.

“Last Mile Health has created a model that can be replicated. … The key: training and employing community health workers — individuals who learn to diagnose and perform medical interventions, and can serve as a bridge to the primary health system.”

At TED2017, Panjabi will reveal how he aims to transform access to care in remote areas elsewhere and protect against pandemic outbreaks.

More here. (Hat tip: Maria Popova on Twitter.)

Photo: Last Mile Health 
Born in Liberia, Raj Panjabi fled as a child because of civil war. He returned as a medical student — and went on to found Last Mile Health.

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Are you familiar with the “Lens” blog at the NY Times? It focuses on “photography, video and visual journalism.” Here David Gonzalez writes about the photos of Putu Sayoga.

[Hat tip: Asakiyume on twitter.]

“If you live in a far-off place, a library may be something you’d only read about in books. That is, if you had books to begin with.

“That became the mission of Ridwan Sururi, an Indonesian man with a plan — and a horse. Several days a week, he loads books onto makeshift shelves he drapes over his steed, taking them to eager schoolchildren in the remote village of Serang, in central Java. ..

“Mr. Sayoga, a co-founder of the collective Arka Project, had seen something about the equine library on a friend’s Facebook page. It reminded him of his own childhood, where his school had only out-of-date books. Intrigued, he reached out to Mr. Sururi, who offered to put Mr. Sayoga up in his home while he spent time photographing Mr. Sururi on his rounds. …

“Mr. Sururi made a living caring for horses, as well as giving scenic tours on horseback. One of his clients, Nirwan Arsuka, came up with the book idea as a way of doing something to benefit the community, specifically a mobile library. He gave Mr. Sururi 138 books for starters. Most were in Indonesian, and the books included a lot with drawings.

“Children at the schools he visits can borrow the books for three days, and demand has been so great that he now has thousands of books.” More here. Check out the slide show.

Photo: Putu Sayoga

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