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Keeping the cold chain

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Four-day-old-baby-Gaoma-receives-her-first-oral-polio-dropCLIVE HAWIGEN

An entry in the Crocodile Prize
PNG Government Award for Short Stories

RITA’s hands trembled as she opened the blue cooler box.

Heart pounding against her chest, negative thoughts flashed through her mind. She dreaded the worst and hoped for the best.

Did they make it in time?

At first the cooler refused to budge. It was sealed tight and required more than two hands so Rita used the blade of her pocket knife to force it open.

A sense of trepidation came over her. She dreaded looking inside.

Had the melting ice broken the cold chain? Were the vaccines ruined?

She opened the lid a bit further.

Mist from the melting ice rose briefly obscuring the contents.

Maybe there was still hope.

Rita put her left hand inside and pulled out the first ice pack from the top layer. It had completely melted. She felt gutted. The cooler had two layers of four ice packs meant to protect the vaccines. With the first ice pack gone, she had little hope for the remaining three.

She paused and looked around at the anxious faces then looked back at the cooler. She took a deep breath and pulled out the remaining three ice packs from the first layer. Over half the contents of each had melted away.

By now Rita was convinced. The cold chain had been broken and the vaccines ruined.

About ten metres away from her, a baby, no more than six months old, cried uncontrollably, screaming its lungs out. A crowd, mostly women and children, had gathered. They seemed in a good mood. Why wouldn’t they be? It had been a very long time since the last health patrol to their village and they were grateful.

Nearby a dog barked and the children chased it away. The men had congregated under a tree beyond the women and children, the smell of tobacco drifted in the air and someone asked for buai.

Further away, the noisy Watut snaked its way towards the mighty Markham River.

What would she tell them? How would she explain this adversity? She glanced up at the crowd. Some had walked for hours to get here.

It wasn’t the cost of losing the vaccines, it was a lost opportunity. Once a year they were able to visit and immunise the people of this remote village. Now it seemed like none of them would be immunised, and this crushed Rita most.

She had started the patrol with three coolers, two smaller ones and this big blue one. After almost four days without changing, the ice packs in the two small coolers had melted. The vaccines had come dangerously close to being destroyed so she made a decision to transfer the remaining vaccines into the larger blue cooler.

Rita knew that, once the blue cooler was opened, she had set in motion a process where the ice would start to melt faster. Now on the fifth day and two villages on, it was a race against time to maintain the cold chain and save the vaccines.

By now she had all but given up hope. She took out the first ice pack of the second layer. Its coldness numbed her fingers.

The ice was intact. It had not melted. There was still hope. She quickly removed the remaining ice packs and looked inside.

Rita was oblivious to the surrounding noise and her colleagues’ nagging to know if the vaccines were safe.

She went still. Her eyes welled up. Her shoulders shuddered. The tears flowed freely.

At 38 with two teenage sons, an abusive husband and a lifetime spent in some of the most uninhabitable places, Rita was a hard woman to break.

The realities of her personal life coupled with the harshness of the bush had trained her to be as strong as steel. To show any sign of weakness - a slight tremor of the hand; a quiver in the voice; a millisecond of hesitation - registered doubt amongst her patients and their carers, especially in places of male dominion

Rita fought disease and the power of masalai, sanguma, magic and a lifestyle which hadn’t changed much since first contact with white people.

A trained community health worker, she had spent half her life working in some of the remote parts of Morobe. Almost two decades later she had no regrets. She would gladly go out and do it all over again.

She had not encountered this situation before. The tears surprised her.

“Thank you Anutu,” she whispered, then glanced up at her colleagues. They looked defeated.

It was then they heard the sound of the helicopter. Between the canopies of green it came, the sound of its rotor deafening as it landed on a small clearing beside the Watut River. The ice packs had arrived.

The loadmaster handed the precious packs to one of Rita’s colleagues, who looked at Rita, asking with his eyes if they had made it in time.

“Thank you Anutu,” she repeated, this time loud enough for everyone to hear. Her colleagues knew the vaccines were safe.

More determined than ever, Rita announced to the gathering crowd that the clinic was open.


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