Friday, January 22, 2010

Vaccination Clinics

Why do we vaccinate?
 
In the countries the Songhai call home, overwhelming human needs are a part of life. The Songhai Team believes that the ministry Jesus modeled was holistic, the soul and the body together.

Over the years, we have sought the best way to meet health needs. We believe that one of the best ways is to help the government immunize. Each larger town has a clinic (CSI). The head nurse (major) is given the responsibility to care for an area of people, usually 10 - 15 villages, and about 20 – 25,000 people. While in a couple of the bigger outlying villages within this area, there are usually one or two first aid nurses, the major is charged to frequently visit the outlying villages. We can easily help with both transportation and man power for these visits to help them vaccinate this population. For us, we fit into an established, complicated system with minimal effort. Although it puts us in a helping role, dependent, and under their leading, it allows us to make relationships with local governmental and village leaders and medical personnel. We are given credibility to our presence in a post-colonial, project-oriented country.

Vaccination teams witness to Jesus’ compassion to needy people in a concrete way. Vaccinations provide immunity to diseases, both to individuals and communities and they lower the disease threat to communities, giving people more time to hear The Message. They provide inroads to new villages and continued open doors where otherwise Christians would be banned. They provide a wonderful opportunity to do pre-evangelism and direct, hands-on blessing and intercession. Vaccinations offer an opportunity to meet people and act as a conversation opener.
General flow
  • Registration – Tylenol – Vaccination - Gift

Giving “Tylenol”
  • Locally it is called “Paracetamol”
  • Doses are as follows:
    125 mg/ 1 tsp/ 5 cc of liquid for a small child
    250 mg/ ½ tab for a school age child
    500 mg/ 1 pill for an adult
  • It is best, but not crucial, if you can give the dose to the child before the vaccination is given. Give the cup to the mother, care giver, or the child to hold. Do not stand directly in front of the child as sometimes they will spew it out.
  • Bring an extra outfit or T-shirt per day.
  • Wear gloves.
Giving vaccinations
  • Some vaccines will need to be re-constituted. Have two people to check the dilution, no matter how busy you are.
  • Make sure you draw up ½ cc of vaccine, not air.
  • Keep all vaccines as cool as possible. Most are heat sensitive. BCG and Measles are also light sensitive.
  • Greetings are so important in this culture, first the parent and then the child.
  • Do not separate moms and children.Vaccinate them, if possible, while their mom or older sibling holds them or carries them on their backs. Sometimes the moms will just expect you to take the child yourself; try to encourage her to sit in the chair and hold her own child.
  • Use gentle but firm restraint. If a child is wildly thrashing about and screaming, an African will usually come to help hold the child. It is better to let the child go than to accidentally break a needle off in the child’s arm or have the child slapped and humiliated, injured from unnecessary restraint, or cause such a scene that the child will be abusively beaten afterwards.
  • If the child refuses, take their registration card and tell the person counting doses.
  • If a private place is not provided for the vaccinations, try to shield a child who you see is especially afraid with your body between them and the crowd.
  • If you shame the parent, you will only make it worse for the child when he/she gets home. If a Songhai parent is getting out of hand in his/her punishment towards a child, usually a friend or family member will come between the parent and child or will give the child sanctuary till the parent calms down.
  • Take every measure possible to insure you are not stuck with a used needle, bitten by a child, spit up on (especially in the face), urinated upon, or defecated upon. Most of this is minimized if the parent holds the child and gives the dose of Tylenol.
  • Also, it is advisable to take a change of clothing and a fresh lab coat with you each day, along with hand sanitizers, wet wipes, bleach wipes, a pen, and scissors.
  • Bless, pray, and speak Truth over the child. You have a special opportunity to pray for each child you lay hands on, what a privilege! Pray with your eyes open and continue through your normal movements so they will not think you are putting a spell on them. Eye contact with a child is fine. Bless them in Songhai.
  • Wear gloves.
  • Do NOT recap needles.
  • Dispose of used needles and syringes separately from paper trash.
  • Be accurate on your technique for each injection.
  • Pay meticulous attention to your sterile technique. Abscesses are common with all the filth.
  • Keep an accurate count of vaccinations given.
  • Put a check in the upper right hand corner of each card when you give the dose, so that the card cannot be used again by another person.
  • Vaccine must be kept cold. (Work out how you are going to do this with your Songhai Team Host)
  • All nurses will give the injection in the same arm. If this is not possible, note it in writing on the registration card.
  • It is best if the children can stay around the clinic for 15 – 30 minutes after the vaccination is given, to make sure there has not been an allergic reaction of any kind. If this is not possible to control, then we will try to stay in place 15 - 30 minutes after the last vaccination is given.

Songhai children’s fears
  • Some children have been taught that white people will eat them.
  • They are afraid of the latex gloves.
  • They associate your white coat with previous not-so-pleasant trips to the local clinic.
  • They are afraid of needles, pain, and the unknown, like we all are!
  • They are afraid of the shaming from peers and discipline (sometimes abusive) from their parents if they move or cry.
Volunteer health workers’ stresses
  • Language barrier
  • Very long, very busy days
  • Harsh climate (very hot or very windy and dusty)
  • The unknown, undefined working situations
  • Chaotic situations, noisy, crying in “surround sound”
  • Coming face to face with great human suffering and poverty
  • Being unable to address or meet all the needs

Needed supplies
Supplies depend on where you are working and the vaccine(s) to be given.
  • If you are coming to help a clinic to do the usual childhood vaccines, the major should be able to supply the syringes, vaccine, cooler, paperwork/ registration card, and used needle containers.
  • If you are coming to do a clinic independently of the major, you will need to bring all your own supplies. Generic medications are usually available for purchase here at good prices. If you are considering a medical-oriented ministry with us, we should begin to plan and purchase needed items as soon as possible to obtain what your team requires before you come. While they may not be of the same quality you are used to using in the States, this will cut down on your purchase expense and the amount of supplies you need to transport and clear through customs. Any medications or supplies you bring in must NOT be out of date.
  • Supply list to consider:
Vaccines and diluents
Syringes and needles, appropriate sizes for vaccines and reconstitution
Used needle containers
Alcohol and cotton
Regular - sized Band-Aids
Non - sterile gloves
Tables, table coverings, and chairs
Wet Wipes for faces and hands
Clorox wipes
Hand sanitizer
Acetaminophen (Tylenol) - liquid and tablet
Pill cutters
Medicine cups
BP cuff and stethoscope
Epi-Pens (or Epinephrine and syringes) and Benadryl
Trash cans and liners
Pre-evangelism tool

Pre-evangelism tool/ gift
While working in the government clinics and in some of the villages, Christian teaching is not welcomed. We can still give witness in indirect ways, take every opportunity to answer all their questions as to why we are there, and search out people to bless and pray for.
In the past, teams have used a coloring page of song lyrics (print a design and song text on white paper bring some coloring pencils to give out and teach the song while kids are standing in line). This has worked very well.

Other gifts could be: Dum-dum brand suckers, Happy Meal-type toys or Hot Wheels for children, costume jewelry for moms. Receiving blankets or stocking hats for newborns gives an opening to greet new mothers and pray for and bless new babies.
Get the job done
  • If you are working outside, you might use a string and the cars to establish boundaries and crowd control.
  • It is easier to keep “traffic” flowing if you arrange your stations in a row, which is not always easy when you are intent upon finding shade and avoiding donkey poop!
  • Whatever your hands find to do, focus on it, and do it with your might, because you are serving Christ.
  • Each person should have an assigned task. Stay put at your assigned job. It gets the whole team out of sync if one person goes missing. Each job is important, whether you are holding a child or counting doses or giving a sucker.
  • Vaccination clinics require of each individual flexibility, team work, stamina, resolve, and perseverance.
  • Bless, encourage, and build up individuals and parents. Model compassion with hugs and kisses, tender touches, and smiles.
  • Do not forget to encourage your team mates and pray for each other as the day goes by.
  • Do not forget in your busyness to drink your water and take a break for lunch.

Licensed medical professionals must bring with them
  • a notarized copy of your license(s) and diploma(s)
  • antiviral therapy in cases of needle sticks
  • white lab coat(s)

Other health needs
There will always be other health needs that require attention during a vaccination clinic. If the major is with us, he/she should see to these needs. If the team would like to address common kinds of things, such as pink eye, skin abscesses, ear infections, colds and respiratory infections, and malaria, this will require additional permission from the clinic and government. You should plan to bring out the necessary supplies, medicine, and personnel and have someone who is trained and licensed to diagnose and treat on the team.

Your prayer team
We will need some very faithful, serious prayer warriors to pray and fast for this ministry.
  • Start with praise and thanksgiving
Praise Our God who is a giver… a giver of good gifts, a giver of life
Thank God for making this ministry trip possible through those who have given generously -- those who have given supplies for the clinic and those who have helped others to make the trip possible, so that The Lost would have another opportunity to know Christ.
  • Intercede for travel
Safety in travel
Flight connections to be made
All baggage to arrive same day as the team
Ease through customs
  • Pray for the clinics
Peace surrounding the place we are giving the vaccines — it can get to be so wild sometimes we have to go home (noise, people pushing and shoving, kids crying and others running wild, etc)
Christ’s love to be shown in tangible ways
Openings for the Message to be shared
Receptivity of chief and elders in each village
Favor with the government nurses who we will be working with, good working relationship
  • Intercede for each child receiving the vaccination
For life and health
For the Picture Message “Jesus loves the little children” to be burned into their hearts and minds
For family to bring the children to get the vaccine
Against any false fear surrounding the receiving of the vaccine
Against any allergic reaction or anaphylactic shock or abscesses at the injection site
For each of the children receiving the vaccine, that this dose would preserve their lives so that they will have many opportunities to hear The Message and believe
  • Pray for team members
Pray for health and stamina, good nights’ rest
Daily, whopper measures of patience and joy
Understanding and compassion
Diligence, alertness, correctness in administering the vaccines
For team leadership -- well prepared but not paranoid pessimists, optimistic and organized but not oblivious to needs or overlook opportunities
  • Intercede for The Lost
May they know that the greatest gift that will be presented to them is not the vaccination, though valuable
“God’s greatest gift to us is, and always will be, Himself. His presence brings satisfaction. His absence brings thirst and longing.” (Randy Alcorn, "Heaven")
May they pant and thirst after the presence of God; may they seek His face in this dry and weary land where there is no water. (Psalm 42: 1,2 and Psalm 63:1)
  • Other prayer subjects
Details, like cars working, ferry running, remembering all in daily packing of supplies, food and water…
Pray against any closed doors not of God’s will

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