Perspectives in Health Magazine
The Magazine of the Pan American Health Organization
Volume 8, Number 2, 2003

Mothers and fathers line up with their children in tow, many dressed as if for a party. Enthusiasm fills the air, disturbed only momentarily by the shriek of a child who has just realized he’s going to be vaccinated.

Day breaks, and the work begins
June 2003

Guayaquil, June 1

After a quick breakfast of fresh-baked bread with butter and guava jam, black coffee and slices of fresh papaya, we leave our hotel in Guayaquil’s Simón Bolivar waterfront along the Guayas River. We head for our first destination, a small health center on the outskirts of town.

We go slowly. The street lights gradually turn off, and street vendors start to take up their positions. Some of them are children.

Before long the sun breaks out. By 7 o’clock the heat is already unbearable, as is the traffic. Our driver, Don Rafael, weaves expertly through a sea of cars, buses and pedestrians who cross the street whereverthey feel like it. This is a city of both old and new, changing from block to block. We pass the cathedral and Las Iguanas Park and begin to see small repair shops, kiosks and sidewalk stands selling fruit and vegetables.

After a sharp turn to the right, we leave pavement behind and enter a narrow dirt road full of potholes. From our jeep we peer out at rickety shacks, haphazard electrical wires and residents looking hesitantly out their windows into the scorching sun.

7:15 a.m.

We arrive at the Fertisa Health Center. A sign announcing Vaccination Week in the Americas hangs prominently over the entrance. Mothers and fathers are already lining up with their children in tow, many dressed as if for a party. Enthusiasm fills the air, disturbed only momentarily by the shriek of a childwho’s just realized he’s about to be vaccinated. The health workers are eager to show and explain everything to us. We ask about their colleagues who are going house to house to vaccinate, interviewing residents and reviewing vaccination records. We’re told they have already left but also where we might find them. We say a quick goodbye and promise to return.

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