Efforts to reach every at-risk child

The effort to reach every single child in every household truly goes to the middle of nowhere and beyond. A Red Cross volunteer led a vaccinator for over an hour, on a motorcycle, on a tiny mud-rutted road with wild grass on each side growing higher than a large truck. As the vehicles traveled on the road, every now and then a child would pop up out of the grass, a face full of wonder about what was happening. Grass huts stood sparsely along the route, with mothers hanging clothes and fires burning that days' meals.

When the vaccinator reached the edge of a lake and what seemed the end of her trip, she was then met by three men and a dugout canoe to carry her, the vaccine, and other supplies for another hour-long ride across the lake to the island of Tisai. Lake Kyoga is the second largest lake in Uganda. Schoolchildren living on the island come across Monday morning for school, stay until Friday on the mainland, and then return by canoe for the weekend.

"It takes three hours for people to get from the island to a clinic in Kumi district for medical care. If they get sick, it's very bad," said Martin Etolu, a Red Cross branch field officer in Kumi with the Ugandan Red Cross. He uses a motorcycle and bicycles to do social mobilization on the island. These vehicles are also loaded in the canoes and rowed across to use on the island to mobilize. "We use people on the island to do social mobilization. If we brought others, people would say 'why are they bringing others to our island?'," said Albino Odomgo, a branch field officer in Pallisa with the Ugandan Red Cross.

"To assure that every child gets vaccinated, we must take the vaccine to them, unlike in the United States where parents can easily go to their doctor or to a clinic," said Dr. Grabowsky, Centers for Disease Control and Prevention.

Mr. Albino agrees "The water surrounds Kumi. The island of Tisai is difficult to reach to make sure children get routine immunizations. Our volunteers are right on that island. When it rains, nobody goes there, they can't get through on the muddy road."

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