Les barrières à la demande de service de vaccination chez les populations nomades de Danamadji, Tchad

Some interesting themes emerged especially at the end of the individual interviews, focus group discussions as well as after observing the behavior of the nomads during this study. Firstly, among the themes identified is the mistrust towards the vaccinating agents by most simple rescuers or young people often from indigenous sedentary communities in conflict with nomads. But the mistrust of nomads goes further and even affects qualified health workers in turn affecting the relationship between the two groups. The nomads reproach the bad reception and discrimination by the health workers when rending care and services. Also, they fear the effects of drugs or their ineffectiveness. Other reasons exists that lead to the abstinence of the nomads from the immunization services. These are the cultural factors that require that the order to be vaccinated may come from the father of the family who is traveling a lot, in search of pasture or for other circumstances. Other important reasons were mentioned, which made the nomads turn away from vaccination. Among these reasons is the lack of information that keeps majority of the nomads in a state of ignorance. Namely, ignorance about immunization causes some nomads to reduce the notion of vaccination to the simple administration of polio drops, while others see vaccination as a business opportunity for health workers and their auxiliaries, rather than for the health of their children.This ignorance of vaccination creates some practices that hinder vaccination efforts. These include, for example, the conception of childhood illness in nomadic settings, and the understanding that divine or sacrificial origin of the diseases of children is inherent. For instance, for some parents, diseases are a divine test for children to train them in the various difficult circumstances of life. As such, it should not immediately be addressed by very quickly attempting medical care. And even if it is necessary to seek treatment, the trail of the marabouts (traditional healers) has been privileged as an important form of health care, due to the relatively low cost and the proximity of their services.Cost and distance are two main factors that cause some Danamadji nomads to divert from vaccination because they are not willing to waste time and money to visit immunization centers of which they do not know their usefulness. Often, the daily occupation or family duties of each member of the family is given as the reason that blocks them from seeking vaccination.