The Homestretch

It's been a quiet--if not unproductive--week here in Manila. I am feeling rested and re-energized (and imagine that a weekend at the beach which starts tomorrow will only add to that feeling of rejuvenation). Amazingly, I'm already 2/3 of the way through my time here in the Philippines. We're starting our last couple of weeks of field work on Monday. It's mind-boggling how quickly the time has gone (which is not to say that there haven't been days that seemed to stretch on interminably, or that I haven't been homesick). It's just amazing, packing my bags for the next couple of weeks in the field, to think that I'll be on my way home one month from today. We've already started putting together the preliminary results of our work so far, so that also feels like an accomplishment.

I'm headed out to yet another region on Monday. I'll be in Region 6, in the Visayas islands, about an hour's flight South of Manila. This region, and particularly one province, Negros Occidental, has been the epicenter of the country's ongoing measles transmission. They've done a lot already to try to stem transmission, including a national immunization campaign that went door-to-door in 2011, as well as a couple of local provincial immunization campaigns in the past few months. A large school-based campaign in September looks like it may have finally done the trick. It looks like there has finally been some success and that the number of cases is on the wane, but it will be interesting to be there and to see how the response is holding up, 2.5 years into the outbreak. I imagine that people are sick of thinking and talking about measles (which is precisely why we need to keep up the hard work now--so that it doesn't reignite into a larger problem!). Lest you think that measles is a faraway problem or one that only faces middle- and lower-income countries, note that an outbreak in Wales (http://www.bbc.co.uk/news/uk-wales-21950818) is making big news. More than 400 cases, and predicting 1000 by the end of April. Some of the problem in Wales is attributed to a reluctance to vaccinate with MMR because of the fraudulent study that purported to link MMR vaccine and autism more than a decade ago. It's astounding to me that the completely unsubstantiated single finding from that flawed (and ultimately retracted) study just won't go away.

It's tough to keep up the morale with immunization. New babies are born unimmunized every single day, and it's an ongoing struggle to motivate families to vaccinate their children. Vaccines require really high levels of population coverage (up to 95% with the measles vaccine, which also requires two doses!) to prevent disease outbreaks, and it can sometimes feel like an uphill battle. I'm really curious to see the morale of the folks in Negros Occidental in the face of this ongoing outbreak and all of the hard work they've been doing.

Before I head back out to the field, another of the STOPpers and I are headed to the Philippine's most famous beach, Boracay, for the weekend. It's likely to be a complete zoo--this is a national holiday, 4-day weekend, and the headlines in the paper talked about the "exodus" from Metro Manila to the beaches, but I'm still thrilled about some time on an incredibly beautiful (from the pictures!) white sand beach. I'm hoping to snorkel, go for a sunset sail, and drink up lots and lots of vitamin D. It should be a lovely little mini-vacation, and then it's a sprint to the finish with a couple of weeks of field work, a national immunization meeting, and presenting our final results to all of the local, national, and WHO folks who need to hear what we've been up to. It's going to be a busy month!