What better way to bring to a wide audience the challenges of vaccination in developing countries, than to give a celebrity an ice-box filled with Polio vaccine and tell them to go deliver? The two part documentary “Ewan McGregor: Cold Chain Mission” was broadcast by the BCC on the 22nd and 29th of April 2012. It followed Ewan McGregor and his team as they traced the route known as the cold chain, in order to deliver vaccine supplies to both urban and remote rural areas of India, Nepal and the Congo. The cold chain is so called because vaccine safety and efficacy depends on keeping supplies within a specific temperature range during its long and difficult journey. India’s success and the continued struggle of other countries in combating polio, demand a closer investigation of the cold chain problem and how it may be overcome.
The vast network of cold chains run by governments and non-profit groups are complicated by many factors. Vaccines are delivered many hundreds of kilometres via plane, road (often motorbikes), rail and boat over difficult terrain and in hot conditions. Overnight the vaccines are stored in fridges that are substandard and at risk of intermittent power failures. Delivery to a nomadic migrant community in Patna, Bihar (one of India’s poorest states), for example, challenges theusual vaccination protocols where it is impossible to recover patient records, record patient details, vaccinations or adverse events.
The documentary highlights the importance of simple technologies such as refrigeration, heat sensitive labels and reliable transport and road systems. Italso reveals the complexity of the disease problem, covering not only the delivery of the vaccine but the cause of disease itself (poor water and sanitation), and the poorly resourced and understaffed health system. As McGregor encounters the everyday complications of flooding, vehicles that fail and makeshift clinics that are stretched to their limits, the documentary familiarises the audience with the essential problems of the cold chain in developing countries.
There are yet more questions around the issue of the cold chain relevant to our work in DPP; how can technologies be further employed to make the cold chain more robust, why have countries such as India had such success in combating polio and not others and what happens to the cold chain and vaccination programs during times of prolonged instability for example during a civil war?
Celebrities and documentary film making around the issues of health and development are proving to be an effective way of raising awareness amongst policy makers and the public. It also makes complex problems accessible and understandable to a wider audience. In this age of multi-media, academia can both benefit from and contribute to knowledge captured and presented by documentary film making.