Travellers shun vaccination

Genuine yellow card…obtained after vaccination

…as touts take over
TOBORE OVUORIE December 21,2011 National Mirror Newspaper.
Akuriene is not a first time traveller, she has been to several European, Asian, Mediterranean and African countries. Much as she has travelled, she has never taken the mandatory vaccination as required of all international travellers by the World Health Organization but she possesses a dully stamped Yellow Card, indicating that she has beern fully vaccinated against yellow fever, cholera and cerebro-spinalmeningitis (CSM), which clears her at every immigration post around the world.

Fake yellow card…obtained without vaccinationYou simply give your travel agent or middle man your international passport and you get it done. ” What has taking vaccination got to do with yellow card young woman?” she queries National Mirror.
Akuriene is not the only Nigerian leaving the shores of this country without vaccination. National Mirror discovered that many travellers could not even link the Yellow Card they carry with the vaccination which the card indicates they have received.
Fake vaccination stamp

A man in his mid-40s who identified himself simply as Okechukwu at the Murtala Muhammed International airport yesterday retorted when asked by this reporter if he had been vaccinated: “What is there with that insignificant little card that you must come here disturbing us? If that miserable looking card were not mandatory for me to exit Nigeria and enter other countries, I wouldn’t waste my time getting it”. Okechukwu revealed he had never taken any of the vaccinations ever since he has been going to Europe, yet he has had several cards.

Genuine vaccination stamp

According to him, the bureaucracy that goes with getting the card is worse than that of registering a business name at the Corporate Affairs Commission. “So why waste the time you don’t have passing through unnecessary pains when you could simply pay a middleman a token and get your card without pains”? he queried. National Mirror’s investigations however revealed so much as well Okechukwu’s claims to be true.
In the course of the investigation, several factors were discovered to be responsible for why Nigerian travellers shun the taking of the vaccines. Some of these include the fact that the vaccines are quite painful, so many travellers being ignorant about the vaccines, including how and where to go get them, the frustrating and windy process involved in taking the vaccines as well as processing the cards, racketeers or middlemen being more available than hospitals or vaccinating centres, travelers trying to cut cost, among others.
At the Lagos State University Teaching Hospital (LASUTH), this reporter, was at the mercy of the security men who turned out to be yellow card racketeers themselves as she sought to obtain the yellow card. The security guard who was approached for direction at Car Park A simply waved at his fellow colleague standing not too far away to get his attention. At this point, he told this reporter her problem will be solved by his colleague.
On approaching the other security man, he put a call to someone else simply saying “customer ti de o!” meaning a customer has arrived. After walking a few distance, this reporter was taken to the Sexually Transmitted Diseases (STDs) department where the security guards made spirited effort to discourage her from taking the vaccine. One of them informed her that the vaccine is a waste of time because it may take her forever to go through the process.
“Besides, why go through pains and pay for vaccines separately from the card when you could get the card and all the spaces indicating you have taken the vaccines stamped at a cheaper rate?” he demanded. Since the reporter was unwavering in getting vaccinated, the security man who is popularly known as Baba Easy directed her to go get vaccinated at the Ikeja Local Government but return to him for the card.
According to him, the local government’s system though bad as well, is not as terrible as what obtains at LASUTH. At the local government same day, National Mirror had to pay N500 each for the three vaccines to be taken.
They are: yellow fever, cholera and cerebrospinalmeningitis vaccines. The vaccines turned out to be extremely painful as some travelers had claimed. It took the reporter well over an hour to recover from the pains while still nursing the spots where she was injected.
The worst was not over as the local government official broke the news that the N1,500 paid did not cover the yellow card! In order to get the card, which she was told was original, this reporter had to cough out another N1,500 and an extra N500 to speed up the process in order to get the card same day because following due process could take forever! Though already in possession of a yellow card, National Mirror out of curiosity wanted to see the possibility of a person owning two yellow cards at a time.
It turned out to be very real because with N1,500 this reporter the next day got another yellow card through Baba Easy at LASUTH but without taking the vaccine. Beside the bureaucracy at the hospital, this reporter could not take another dose of the vaccines because intervals between vaccinations are normally 10years, thus the shots cannot be taken twice.
A traveller from Nigeria to other parts of the world can embark on his or her journey at least 10 days after taking the vaccination because it takes that number of days for the drugs to work. While anyone who has taken the vaccines, is advised to keep track of when the injection was taken and go for a booster 10 years after that. This however is in contradiction with the lifespan of a yellow card.
A yellow card lasts for six months, there after a fresh one is to be collected. Out of over 20 Nigerian travellers National Mirror spoke with at the international airport yesterday, only one of them knew about this fact and gave it as his reason for simply paying for the card without taking the vaccines.
The yellow card is World Health Organization’s recommended vaccination prove that the owner of such card has been vaccinated against the deadly yellow fever virus (cholera and CSM inclusive for Nigerian travelers). Without this card, travellers are not allowed into or out of endemic countries of South and sub-Saharan Africa because these diseases have a high fatality rate with no cure.
The conditions are even stricter in Europe and the Americas. Since Africa falls within the yellow fever endemic zone, most countries on the continent like South Africa, Ethiopia, Cote D’Ivoire and Chad religiously look out for the yellow fever vaccination cards of travelers before allowing them entry into their respective countries but, the Nigerian Immigration Service appears not to be doing much to forestall the spread of the virus especially from travelers who may be infected.
The agency just like the department of Public Health is yet to step up its implementation on the taking of vaccines – even in the wake of an outbreak in nearby Ghana. Ghana at the moment is battling the spread of the yellow fever virus. Over the years, it has witnessed periodic outbreak of the yellow fever virus. In the mid-1970s, Ghana recorded huge numbers of yellow fever cases and it is not surprising that it was declared the third yellow fever endemic country in the world.
An immigration officer who pleaded anonymity said the agency has not been formally instructed by the Ministry of Health to implement such checks though they (immigration officers) can tell the difference between a fake yellow card and a genuine one.
He explained to National Mirror that even if the Immigration Service proactively implements such on its own before granting any traveller entry or exit permits, there is no quarantine facility in place to actualize such. According to him, though there is a building to such tune, it is not being utilized.
The vaccine however is not recommended for children under 6 months and it is contra-indicative for babies under four months. It is given together with measles injection at nine months because when given earlier, the disease risk outweighs the benefits.
While one out of every two persons dies if infected with the disease. In an explosive outbreak, the fatality rate is over 60% whereas about 80% of cases are mild in sporadic situations.
Symptoms usually begin to manifest between 3 to 6 days after being bitten by the vector and includes simple ones as headache, muscle and joint aches, fever, nausea, loss of appetite, vomiting and jaundice with severe ones manifesting as hepatitis and hemorrhagic fever. A person with advanced yellow fever may show signs of liver failure, renal failure, and shock.
As the way forward, Dr. Felix Osia of the Federal Medical Centre Namoda, Zamfara state advised that any traveller should go to a medical centre which specialises in travel vaccinations because he has seen some people vaccinated for things they did not need and missing that which they needed.
He however called on the government to establish travel vaccination clinics preferably close to international airports in the country while these clinics must have weekly updates of all the latest disease outbreaks around the world because vaccines for each countries differ.
According to him, with such vaccination clinics in place, anyone who has decided on the location he or she is travelling to would be able to do the most important thing- check what he or she is to be vaccinated for.
“When travellers get vaccinated, everyone benefits from it as much as it is for their own safety because they can fall ill or even contract anything out there and bring such diseases back from overseas to us here in Nigeria.
We are so blessed here in Nigeria that we don’t have all manner of frightening ailments as obtains out there so let us stop cutting corners and do the right thing for our own good” Dr. Osia added.
For people who are not keen on needles, he proffered other options: “We have one antibiotic now that will cover all diseases overseas. All you have to do is take one tablet for three days though the tablets are not yet common in Nigeria” he stated.
But when National Mirror contacted Dr. Kabir, Acting Director, Federal Ministry of Health of the department of Public Health, Abuja, he condemned the claims that Nigerian travellers pay for yellow cards without taking the vaccinations. “It is not possible for such to be happening because no one can get our yellow cards without taking the vaccination” he out rightly stated.
When however presented with the experiences of this reporter and the fact that she is in possession of two yellow cards- one for which she was vaccinated and the other which she bought, he described such an action as illegal.
“But if it is really happening that travelers get the cards and even get them stamped without taking the vaccination as you say you have done and experienced, then it is illegal. You, such travelers and the fake cards are supposed to be confiscated at the airport” he declared.
Shocked at National Mirror’s revelation, Dr. Kabir went on to disclose that the department of Public Health have its men at the airport for this purpose so he still finds it difficult to believe that such is happening.
According to him, the cards being issued without vaccination of the collectors is not that by the Federal Government, rather it is that by the state government.
“I believe it is not our (the federal government’s) yellow cards that are being forged or stamped without the taking of vaccination, it is that of the various states. The different state governments have their own yellow cards as well and this is where the porosity is coming from” he disclosed.
Yellow cards are issued by both the federal and state governments respectively. At the state level, the vaccination and cards are issued at various local government secretariats, state primary health centres, and state hospitals.
The vaccines at both levelsfederal and state are free though anyone to be vaccinated is expected to pay N500 for each vaccine as logistics tokens.
He however disclosed that the federal government has been working on how it could have the sole franchise of the issuance of yellow cards in the country inorder to ensure strict monitoring of the issuance of the cards.
Consequently upon National Mirror’s revelation, he reiterated that the government would speed up the process so that no traveller would leave the shores of Nigeria without taking the vaccine.
“We are (the federal government) working hard and with these shocking revelations from you we will speed up the process to put an end to these cash and carry yellow cards craze without the taking of the necessary vaccines because the vaccines are available all over the country” he concluded.

International Airport, Lagos.