Cholera control in Mozambique.

Thousands of people received the oral cholera vaccine today as part of a six-day emergency vaccination campaign led by the Mozambican Ministry of Health to help prevent the spread of cholera.

At the elementary school on April 7, in the village of Inhamayabwe, near the city of Dondo, enthusiastic schoolchildren gather in their classrooms and push each other in front of the room full of people where all the children receive their dose.

Amelia Mateos, preventive medicine technician, leads the campaign in this vaccination post, one of the 73 vaccination points in the district of Dondo. As each child advances, he takes a small glass bottle from the tray, inspects it, and shakes it vigorously before removing the lid. She gently tilts the girl's head back and, with a hand on her chin, encourages them to open their mouths. Shake the 1.5 ml bottle of liquid vaccine in the child's mouth and, with a light pat on the head, return it to daylight outside the classroom.

 It may not be very appetizing, but this vaccine will protect these children from something much worse: horrible and sometimes deadly cholera.

José, a volunteer, marks a cross on a piece of paper to keep track of the number of donated vaccines. More than 1,200 volunteers support the Ministry of Health and its partners in this rapid campaign. Each immunization team is headed by a health worker and three others who help prepare the vaccine bottles, count the vaccines administered and nail the nails of people who have already received the vaccine.

"We are carrying out this campaign because cholera is a major threat to public health," says Amelia. "Since we started at 7 am, we have already vaccinated 1,300 children in this school."

Since Hurricane Idai hit Mozambique on March 14, hundreds of thousands of people are living in temporary settlements without access to safe drinking water and sanitation. The Ministry of Health declared an outbreak of cholera on March 27 and, by April 5, reported more than 2,430 cases and 3 deaths.

On April 2, about 900,000 doses of oral vaccine against cholera arrived in Beira. They were donated from the world stock of cholera vaccines funded by Gavi. The campaign, also funded by Gavi, is led by the Ministry of Health of Mozambique with the support of WHO, UNICEF, Médecins Sans Frontières (MSF), the International Federation of Red Cross and Red Crescent Societies (IFRC). and Save the Children.

Less than 24 hours after arriving in Beira, the first patients started receiving the vaccines.

During his visit to Beira, Dr. Nazira Abdula, Minister of Health of Mozambique, met with WHO and other partners and acknowledged the tremendous support given to the oral vaccination campaign. "It's very difficult to launch a campaign of this magnitude in just three days," she says.

Dr. Djamila Cabral, head of the WHO office in Mozambique, said: "This campaign would not have been possible without the strong commitment of the local authorities and the communities themselves.The number of volunteers is impressive and, where that they go, the vaccine has been well accepted. "Everyone is very interested in the success of this initiative to curb cholera."

The vaccines are administered to the populations identified by the highest-risk government, those without access to drinking water and sanitation, in Beira, Dondo, Nhamatanda and Buzi. "The fight against cholera in these areas will reduce the risks for the rest of the population because fewer people will bring it to the community in general," says Kate Alberti, WHO expert on cholera immunization.

About a week after receiving the vaccine, the vaccinated person develops protection against cholera. A single dose will protect for approximately 6 months.

María Judith is a doctor of maternal and child health medicine at the Dondo Health Center. She is responsible for the vaccination post here, one of Dondo's 15 fixed points. In addition to these fixed stations, nearly 60 mobile vaccination units will move into the district and there are plans to go door-to-door at the end of the campaign to ensure full coverage. In total, local health authorities mobilized more than 340 teams for this campaign.

"Cholera is a disease that is spreading due to lack of sanitation," says Erica, an 8th grade student at Macharote Secondary School in Dondo. Erica is one of the thousands of high school students who have been vaccinated today. She has the black mark on her nail to indicate that she has received the vaccine.

"You should wash your hands, especially after going to the bathroom, do not leave litter and avoid dirty water."

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