Report on Cold Chain Assessment of Jharkhand - 2005 - Nccvmtc.org

Cold Chain Assessment in Jharkhand! Some CSs take excellent initiatives to support and prioritize the cold chain programme.Rapid improvement in electrical installations (3-phase) at East Singhbhum is an example.7.3. Repair and maintenance! In most instances where the R-134a (CFC-free) units were repaired and failed, the failureseems to be largely due to the fact that the technician was ill-equipped to rectify theproblem.! The post of the refrigeration technician at Giridih district store, which has a WIC, hasbeen lying vacant for several years.! At Giridih, all the precautionary and safety measures for the WIC have been bypassed.! Many stabilizers that have been repaired locally have had the delay bypassed, defeatingthe very purpose of its use.! There is no stock of stabilizers and no replacement of stabilizers that have failed.! No instructions have been given with regard to the non-working/beyond repair machines.These occupy the already limited space at the PHCs.! No product manuals are available for the WICs and WIFs.! There is no itemised replacement plan.! No contingency or emergency plans exist.7.4. Personnel! There is negligence when it comes to the T series vaccines. The purpose of VVMs onOPV vaccine is well integrated, but there is considerable ignorance regarding the vulnerabilityof T series vaccines to freezing. Not one person questioned performs the shaketest for the T series.! Improper storage of vaccines in damp and water-logged condition in cold boxes andplastic carry bags leads to the loss of labels, which are important to identify the batchnumber, vaccine name, manufacturing date, expiry date as well as VVMs.! It was reported that UNICEF extenders provide unequal support. In some districts suchas East Singhbhum, the UNICEF extender does an excellent job and is well supported bythe Civil surgeon. However, this approach is not the same in every district.! The clerk, ‘computer’ or LHV usually handles the cold chain. Very few staff have undergoneany training. Of those who have undergone training, the last training programmethey attended was in the year May/June 2005 at Jamshedpur. Other global training oncold chain operation and management seems to date back to 5-6 years.! The staff lack awareness on how vaccine should be stored in ILRs with no allowancemade for air circulation or stacking the same vaccines together. The ‘T’ series vials areoften placed at the bottom of the ILR.! The general view is that only frozen ice-packs should be used. ‘T’ series vaccines areplaced in the centre in poly bags with no attempt made to isolate the ‘T’ series from theicepacks by newspaper or cardboard.! The cold chain staff is unaware of the hazards of leaving vials and used syringes undisposed.42