Vaccination: three women in Nicaragua take a different journey towards a common goal

April 2018

Video: An act of Love in the land of lakes and volcanoes— Nicaragua

Karla Bethania Ortiz, 26, from Comarca Bosque de Xiloá, Nicaragua, never understood why she was not vaccinated as a child. Unlike her friends, she did not have a vaccination card.

A woman in her kitchen, in front of stove, in Comarca Bodque de Xiloa, Nicaragua
Karla Bethania Ortiz, 26, in her home in Comarca Bosque de Xiloá, Nicaragua
WHO/S. Mey-Schmidt

One day when a "brigadista" or community health volunteer was walking near her home, she decided to chase her down and asked to be vaccinated. It happened to be "Jornada de Vacunación" – the day vaccines are provided to all in the community free of change.

However, because Karla was a minor, she needed parental consent. Karla knew her mother, Silvia Elena Ortiz, did not believe in vaccines, but she decided to bring the health worker to her home to explain the benefits of vaccination. With more information, Silvia agreed to have Karla vaccinated.

"I was very proud to receive my first vaccine and my vaccination card," Karla says.

Now, with three children of her own, Karla never misses a "Jornada de Vacunación del Poder Ciudadano" organized by the Ministry of Health of Nicaragua and supported every year by WHO/PAHO, to vaccinate the community in hard-to-reach areas.


A group of people on a boat on Lagoon Xiloa, in Nicaragua
Karla and her family must take a boat on Lagoon Xiloá to reach the Xiloá Health Centre.
WHO/S Mey-Schmidt

Today, Karla will take her 2-month-old daughter, Franeichy, to receive her WHO-recommended vaccines at the Xiloá Health Centre. It’s 6 a.m. and Karla wakes up to prepare breakfast, bathe her children, and dress them for the special occasion. Karla and her entire family leaves the house at 8:30 a.m. and walk to Lagoon Xiloá, where a boat picks them up for a 10-minute ride to Xiloá.


A nurse buttoning her shirt in her apartment in Los Brasiles, Nicaragua
Maritza Elena Pallaviccini Cruz, 51, a registered nurse from Los Brasiles, Nicaragua
WHO/S. Mey-Schmidt

Hours before Karla’s family wakes up, nurse Maritza Elena Pallaviccini Cruz, 51, is at home preparing for the "Jornada de Vacunación" in Los Brasiles, Nicaragua—an hour’s journey from the health centre in Xiloá. After knowing two children who were paralyzed from polio when she was a child, Maritza decided she want to be a nurse. That was more than 30 years ago.

"My wish is that no child in my country dies from disease that can be prevented through immunization," she says.


A nurse walking by the Xolotlan Lake in Nicragua, while a horse with a cart, having two people are on it
Maritza Elena Pallaviccini Cruz walks by the Xolotlán Lake on her way to the health centre.
WHO/S. Mey-Schmidt

Nurse Maritza’s journey to work is not easy. She leaves her house at 7 a.m. and walks to the bus. After the bus, she takes a motorcycle taxi and walks some more. Sometimes if she is lucky, she gets a ride from a community member in a horse carriage, which saves her time. The last part of the journey includes a walk along the shore of Xolotlán Lake before she finally reaches the health centre at 8 a.m.


A group of health workers putting up a banner, in Nicaragua
Health workers are preparing for the Jornada de Vacunación.
WHO/S. Mey-Schmidt

Health workers and the "brigadistas" prepare for the the Jornada de Vacunación. A big banner and balloons are hung from the health centre’s fence, chairs and tents are set-up, and a DJ plays upbeat music to catch the community’s attention. A piñata is even hung from a tree so the children can have fun while they wait for their immunizations.


A nurse speaking to a mother with her baby in her lap, waiting to be vaccinated, in Nicaragua
It’s Franeichy’s turn to be vaccinated.
WHO/S. Mey-Schmidt

After arriving at the health centre around 9 a.m. Karla and her family wait under a tent with other community members. When it is their turn, they enter the health centre and meet Maritza, who has already set up her vaccination station.


A nurse drops vaccine into a baby girl's mouth as her mother is holding her
Franeichy receives four vaccines.
WHO/S. Mey-Schmidt

Maritza administers four vaccines—inactivated polio vaccine (IPV), rotavirus, pentavalent and pneumococcal (PCV13) – which protect against 8 different diseases.


A nurse hands a vaccination card to a mother, holding her young girl, in Nicaragua
Franeichy receives her vaccination card.
WHO/S. Mey-Schmidt

After vaccinating Franeichy, she reminds Karla to bring her back for the next round of vaccines, and gives her Franeichy’s first vaccination card.

"I always vaccinate my children since they were babies because I love them and because I know vaccines save lives," says Karla.


A nurse injects vaccine into an elderly woman's shoulder, in Nicaragua
Grandmother Silvia also receives her immunizations prior to heading home.
WHO/S. Mey-Schmidt

Before the family can head home, Maritza stops Silvia and asks her if she’s up-to-date on her vaccines. She quietly responds "no", but agrees to be vaccinated. She receives the tetanus and diphtheria vaccine. While Silvia did not originally believe in vaccines, "she changed her mind due to the love she has for her grandchildren," says Karla. "Today she knows the importance of vaccination to prevent several diseases."


A group of health care workers posing, in Nicaragua
Brigadistas at local health centres across Nicaragua are integral to the implementation of the large-scale immunization campaign in the country.
WHO/S. Mey-Schmidt

In Nicaragua, anyone can receive immunization services throughout the year for free at local health centres, but the Ministry of Health launches a large-scale campaign, the Jornada Nacional de Vacunación del Poder Ciudadano, in April of every year—as part of Vaccination Week in the Americas. This year, WHO’s Region of the Americas (PAHO) celebrates its 16th Vaccination Week in the Americas. To date, more than 720 million people have been vaccinated as part of the yearly campaign.

Whether you are young or old, immunization makes the world a healthier place for everyone, now and in the future.