Even though we had only spent one night in Accra, the capital city of Ghana, we could already hear the buzz in the streets about the week’s measles campaign. During a ride in the city, a cab driver named Hassan noticed the Red Cross hat that one in our group wore. Hassan had heard people talking about this week’s mass measles campaign taking place in his country. "I feel so bad that my family has access to healthcare but those further out in the country do not. My wife and I didn’t have time to take all our children to the clinic to be immunized this year – the one child we did not take to be vaccinated is now in the hospital with measles. I am going there now to see him." When Hassan asked what our group member’s name who was wearing the hat, he said his name was Michael. Hassan beamed and replied "That is my son’s name. Thanks man, for saving his life."

During the week-long campaign, workers and volunteers from the Ghana Red Cross Society will join the American Red Cross to vaccinate nearly 8 million children against measles, saving more than 11,000 lives.

As we depart in the early morning hours for our first day in the field, the streets of Accra are already filled with rush hour traffic and the typical sounds of the Monday morning hustle and bustle to get to work. We all wonder separately what we will see first, when we will see our first vaccination. We begin the day by meeting Larry Yeboah, the Volta Region secretary for the Ghana Red Cross Society. He will be our local guide and leader for the Volta Region part of the mass measles campaign.

As we cross the Volta River bridge almost an hour outside of the busy city, we are held up at the toll gate by an overcrowded commuter van and see two women standing on the street peeking inside. As we pull up beside them, we get the view we thought we would have to wait hours to see at a school or church. A swab of a child passenger’s arm and a quick plunge of a needle -- it is 8:00 a.m. and we have just seen our first measles ‘jab’ of this week-long campaign.

As we traveled on and talked with Mr. Yeboah, he explained that the goal for the early part of the week was for the trained vaccinators from the Ministry of Health to visit all of the schools in the 12 districts that make up the Volta Region. Because the goal of the campaign was to vaccinate all children between the ages of nine months and 15 years, most can be easily reached by vaccinating in the schools. The younger children would be reached by social mobilization, the act of Ghana Red Cross volunteers going door to door in communities to explain the vaccination process, invite the mothers to bring the children to a nearby vaccination post, and explain that the service is free and could save their child’s life.

The Evangelical Presbyterian Church School was our first school visit of the day. We arrived just as the vaccinators were preparing their syringes, vaccine, and safety disposal boxes in the small, dark, two-room classroom of about 50 children ages five to 10 years. In the first room were about 25 kindergartners with chalky faces from rubbing their noses during the morning’s lesson. They were barefoot and wide-eyed, looking scared to death. They each silently watched each other, looking for clues, and stared at the vaccinators suspiciously, quietly wondering what was about to happen. As a vaccinator approached the first child, she got a good look at the needle sneaking up to her arm and let out a howling scream followed by a waterfall of tears. A girl on the front row whose fears had apparently been confirmed dashed for cover under a nearby table. But another vaccinator was just as quick and followed her under the table, giving her a measles jab of her own.

As we entered the second room, we were greeted by a calmness not shared by the young students. The older students sat quietly, sleeves rolled up, staring straight ahead as they patiently awaited their fate. At an age where crying is not an option when surrounded by peers, this group was determined to be strong no matter what size needle headed their way. In a matter of just 10 minutes, the six vaccinators had successfully managed to give each child a shot, dispose of syringes in the bright yellow safety box and move to the next set of rolled up sleeves down the road. And as the vaccinators left, school was back in session, all tears and fears forgotten.

A quick stop at the local market led us to a young mother of two young children, ages two and five. She said that her children sometimes stay with her at the and would not receive their vaccination in school that day. She explained also that they had never been immunized against measles. We looked at Mr. Yeboah, all of us concerned that these two children may miss out on what we were all there to help make happen. "Don’t worry," he said. "Mobile and community teams will go all through this market giving a jab to each child they see in the right age group." Remembering this morning’s ad hoc vaccination in the commuter van on the Volta River bridge, I was confident he was right.

Our next stop was the Ho Poly Primary School where we were greeted by happy, smiling faces and waving hands hanging out of open school windows. Children who had already received their vaccinations huddled together on the front steps of one building, all holding their left arms with their right hands. Many of the students proudly held up their purple thumbs, marked by temporary dye so that they could be easily identified as already having received their vaccinations. More importantly, the lack of dye on children’s thumbs indicated those who still needed them.

As the day wound down, Mr. Yeboah explained that our next stop was truly important and the reason why the Red Cross volunteer force is so important during campaigns. We were going to visit Hlefi, a religious settlement where the families believe that God heals all, and therefore medicine is not used. Mr. Yeboah’s goal was to talk with the chief elders to try to convince them that a measles vaccination was not medicine to heal, but to keep the children from getting sick.

After polite and formal handshakes, introductions, and traditional greetings, the group sat down and waited for someone to start. The elder who was head of the church said simply, "Your mission, please." In the small, simple room with a ceiling fan swirling hot air, an exchange of thoughts and beliefs took place in a mix of English and Awe, the local language. Mr. Yeboah explained the importance of measles vaccinations and that Red Cross volunteers and health workers would be arriving to give their children jabs, but the elder was not easily convinced. They went back and forth for nearly 15 minutes.

"We don’t believe in medicines," the elder said.

"When one child gets measles, all children get it," Mr. Yeboah replied.

"My wife is 70 years old and has never tasted medicine," said the elder.

"This is protection for the body, it is not a healing medicine," Mr. Yeboah patiently answered.

"We believe in the healing power of Jesus Christ," the elder said.

"We are appealing to you," said Mr. Yeboah, "We know that you have traditional means for treating, but there are none for prevention."

"Our church welfare officer prays every day for the sick. The man next to me has been sitting here for 70 years." As we turn our attention to look at the church welfare officer, we see a round white bald spot worn into the normally red tile precisely where his feet rest.

Finally, after much nodding and a look of agreement among the three by his sides, the elder explained "We tell you we do not do medicine. You say this is a good thing. The Bible tells us not to reject these things. Since you say this is good, we humbly accept it." He laughed and said, "reluctantly." As we shook hands once again and prepared to leave, the elder added "We thank you for this. We admire you for sharing this information with us." The group will return to Hlefi tomorrow to greet the elders and support them as they begin a day of vaccinations.

On our way back from Hlefi we visit with Red Cross volunteers who are tallying the day’s successes. A volunteer with the Ghana Women’s Red Cross Group says proudly holding her sheet of hand-written tics, "We have 94." Our group looks at her blankly as we are sure we have seen many more children being vaccinated today just in our travels alone. Then she continues "…parents in one town bringing their children. "Ninety-four parents with 456 children in one town, 49 parents with 364 children in another town…."

At the end of the week, those numbers will have multiplied to include nearly eight million children with chalky faces, purple thumbs, religious beliefs, and lives free of measles.