August: Immunization Awareness Month

Medical Volunteer Opportunities Abroad

As we close out August and what feels like the millionth month of quarantine from a novel virus, we’re looking toward what this season typically brings for most people: back to school and sporting events that either put us all in packed stadiums or crowded bars watching a screen. For those of us in the northern hemisphere, it’s the last hurrah before colder weather pushes us all indoors and flu season takes hold.

Flu season… and the debates over whether to get the flu vaccine.  This year, we’re all also talking about the development of a vaccine for COVID-19.  When will it be ready?  Has it been tested enough?  Will we get the vaccine if it shows to be “only 30%” effective at preventing COVID?

At least perhaps our flu transmission will be down… if we keep following transmission prevention guidelines.

Well timed, August is also National Immunization Awareness Month in the United States.  While we could share statistics showing the efficacy of vaccinations and the low risk associated with it, we’d much rather share some of the life experiences that explain why we support vaccination (all data aside.)

About 30-ish years ago, vaccination coverage within the Ngäbe-Buglé Comarca really improved (they were available earlier, but harder to access.) We even have a couple of patients in their early 40’s who were crippled by polio in childhood [for comparison, there have been no cases of polio originating in the U.S. since 1979.]

Despite massive trust issues between the indigenous population and any outside agency, there is pretty much zero vaccine pushback from the communities we serve, even from those individuals who otherwise prefer botanic medicine to western medicine. This is because many have a fresh, living memory of life before vaccines… and they remember all too well.

In our clinics, we ask all female patients how many pregnancies they have had, and how many living children they have, and believe us- the child mortality rate was not good. Especially when you look at women who were childbearing 30 years ago or more, you start seeing a lot more women who have had 8 or 9 or more pregnancies, but only 5 or 6 living children (or less), many of those dying in the first 5 years of life.

Then vaccines started to get out into the population and the children started living to reach adulthood– and the resulting massive population boom has actually caused all kinds of challenges for subsistence families living with no power, clean water, sanitation, or roads in remote jungle settings. Many Ngäbe feel these challenges keenly (feeding a large family, growing enough, earning enough, cutting down more jungle to build more homes…in some communities there are so many kids that half go to school on one day and half go on another day). Very real issues, to be sure, but the Ngäbe prefer to deal with those rather than expecting half their children to die by age 5.

Many we’ve spoken to here are puzzled that there is a movement by parents in the United States and elsewhere to not vaccinate their children. Their experience is that without immunizations, their children will likely die of communicable- and preventable- disease.  The stories of those with first-hand knowledge of life pre-and post-immunization is extremely valuable to understanding important aspects of the relationship most of these communities have with the healthcare systems in their region. It encourages us- most of whom the population benefits of mass vaccination is removed by a generation or more- to pause and consider the question: Why would a population that has had such difficulty with the government in the past be so enthusiastic about receiving vaccines provided by this same government? The answer, to us, is clear- for them, it is literally a matter of life or death.