Medicine: Lifesaving Stings

The village elders of Marsella, 6,300 feet up in Colombia's Cauca Valley, weighed the arguments and gave consent —yes, it would be a good idea to give the district's youngsters inoculations against whooping cough and diphtheria. Thereupon, the traveling "sanitary educator," Roberto Agudelo Valencia, 32, jumped into his jeep, switched on the public-address system and drove around announcing a movie in the village square.

"Of course," Agudelo says, "people were terrified, since it was the first time they had ever heard a loudspeaker." But they turned out, 1,500 strong, to see a Walt Disney health film projected on the cleanest whitewashed wall that Agudelo could find. The villagers heard more about the inoculations at Mass: el señor cura read a "spot" announcement written for him by Agudelo, saying the inoculations were a good thing. In school, the teachers said so too.

Long Knives. Last week hill farmers (growers of coffee, sugar and corn) and their wives crowded into Marsella, taking their preschool children for inoculations. All wore their Sunday best, the women in bright yellow, green or blue rayon dresses with black shawls, most of them in sneakers instead of sandals, and the men in white capes or ponchos and carrying long, narrow-bladed machetes.

Agudelo and Graduate Nurse Maritza Gonzalez, 23, had set up three inoculation stations around the village, each manned by a vaccinator—a girl who had taken six months of public-health training. Each vaccinator unpacked an alcohol burner from her black bag, sterilized a batch of needles and syringes, and went to work.

Many a hill family arrived with five or six children between the ages of six months and seven years. Most had been well washed. "But some were so grimy that we couldn't tell the color of the face," Maritza complained, "and others had had their faces washed but their arms were thick with dirt. Their parents had to listen to a little lecture on cleanliness."

As they stood around waiting their turn, some of the youngsters pleaded, "Mamita, don't let her sting me." But they all got stung, and after a few tears most of them affected an air of childish martyrdom.

Back for More. Agudelo's team, like six others in different parts of Colombia, had worked around the district, giving first inoculations in one place, returning a month and two months later to give the children their second and third shots. One index to the success of Colombia's campaign is that nearly all the children take the second shot, which is usually enough to confer immunity, and more than two-thirds get the third for extra insurance.

Another index is in the disease rates. Whooping cough has been reduced by 90% to 95% in cities where the program was started two years ago, and diphtheria has been cut by 65% to 70%. Nobody knows how many children's lives have been or can be saved, because Colombia's vital statistics are too sketchy. But where something like one-sixth of all children have been dying before the age of five, there is plenty of room for lifesaving.