Cold Chain IQ Celebrity Special: Ewan McGregor Cold Chain Mission Interview

Actor Ewan McGregor has supported UNICEF since 2004. In his role of UNICEF UK Ambassador his most recent visit took him to India, Nepal and Congo, on a mission to immunise some of the world's hardest-to-reach children. The show Ewan McGregor: Cold Chain Mission was broadcast on BBC2 and BBC HD in April 2012. Ewan took time out of his busy schedule to speak to Cold Chain IQ www.coldchainiq.com and highlight the importance of the cold chain in vaccine and drug distribution to some of the hardest -to-reach places in the world.

Cold Chain IQ: You have been a UNICEF UK Ambassador for many years now, why was so important for you to highlight the importance of the cold chain in vaccine supply to remote areas?

Ewan McGregor: I have been a UNICEF UK Ambassador for eight years, during which time I have travelled a huge amount with the organisation to see the life-saving work they do for the world’s most vulnerable children. I had heard how challenging the cold chains routes can be so I was keen to explore them to really understand the crazy journeys health workers take on a daily basis to reach children living in the furthest flung corners of the world. Whenever people go for vaccines in the UK they just pop to their local doctors, so I thought it was important to tell the story of the incredible lengths that organisations like UNICEF have to go to make sure every child is protected against life-threatening diseases. Cold Chain IQ: What were some of the threats to safe distribution of vaccines to children you encountered on your cold chain mission?

Ewan McGregor: Keeping the vaccines cool along the routes was a real challenge. If the vaccine vial falls outside 3-7 degrees it is useless, so keeping them cool was always at the back of my mind. But the more remote we got on each journey, the scarcer and more precarious the fridges became, so getting them to the children in time felt like a real race against the clock. A couple of times through Bihar, India, I put the vaccines in the fridge at night, unsure as to whether they would still be cold by morning, but thankfully they always were. On each of our journeys we had a UNICEF health worker with us the whole way, who could advise as to how long the vaccines had until they would get warm, which provided welcome reassurance.

Cold Chain IQ: What surprised you most about the cold chain supply of vaccines to remote areas?

Ewan McGregor: I knew all the cold chain journeys would be challenging but I don’t think I realised just how difficult they would be, and how remote and isolated some of the communities would feel. In India we stopped at a river village that was a 4 hour boat ride away from the nearest town, which itself felt like the end of the earth. The village was like a film set, full of thatched houses and animals and children running around, but that couldn’t hide the extreme poverty and vulnerability of the children there. Most of the villagers were born into the lower caste of Dailats and as a result were not visible to the government immunisation programmes. It reminded me that isolation and remoteness don’t just refer to geographical distances.

In Nepal we had to do a two day trek up and over mountains to get to the hill top village where the children were waiting for their vaccines. The physical effort was a story in itself (health workers do the journey every month to reach the children there and on foot or mules is the only way to travel) but the fact that, despite the distance and lack of communication, all the mums knew we were coming and turned up with their babies on the morning of the session was nothing short of amazing. The dedication that is required by all the health workers involved to make this process run so smoothly is an incredible achievement

Cold Chain IQ: Which country did you find had the most challenging cold chain route?

Ewan McGregor: I think I probably found the Congo the most challenging. All the remoteness I had felt in India and Nepal was even more amplified on the Congo cold chain journey. Our destination was a tiny village on the edge of the Motaba river in the northern district of Likoula, which we reached by helicopter, then by boat for 6 hours. The village was through a clearing in thick dense forest, but again, it wasn’t just the geographical distance that made it feel so remote; the culture felt so different and alien that it was like entering a completely different world.

For the final leg of the journey, we decided to head further up the river to meet the children who live in the remote forest outposts and are off the normal cold chain path. UNICEF normally engages with local messengers to bring the children who live in the forest down to the nearest village to be immunised, but I wanted to experience for myself just how remote these final children were. To get there we had to take tiny dug-out canoes that could squeeze down the tiny tributaries that were surrounded by dense forest, before having to get out and wade through the actual swamp when the boats could go no further. When we reached the last outpost, it felt like we finally had reached the very ends of the earth. And again it reminded me, if UNICEF and partners can reach these children, there is no excuse for us not being able to reach every child in the world with these simple life-saving vaccines.

Cold Chain IQ: Did you see any interesting innovations?

Ewan McGregor: The best innovation I saw during my cold chain journey was the small vaccine carriers that are used to take the vaccines on the long journeys when there is no fridge in between the start and finish point of your journey. On our journey this could sometimes be for up to 10 hours, but these carriers and ice packs were still able to keep the vaccines at the right temperature, even in searing heat. It is the simplest innovation but it means the vaccines can be carried long distances, over really challenging terrain making it even easier for health workers to reach children in these remote locations.

Cold Chain IQ: Improving vaccine supply to remote areas, who needs to do more?

Ewan McGregor: The process of delivering vaccines is fraught with difficulties –challenging terrain, dealing with cultural sensitivities, lack of fridges to store the vaccines to name just a few –but I saw during my trip that despite this, some of the world’s most remote children are receiving the vaccines they need to keep them alive. The reality though is that 4,000 children a day are still dying from vaccine preventable diseases. It shouldn’t be like this. Collaboration is the key to the cold chain and thanks to organisations like UNICEF who work with local NGOs, communities, governments and other international organisations, the most unreachable children are being reached, but it takes time and dedication to make sure we reach every child, and additional funding is a crucial element to help make this possible.

Cold Chain IQ: Is there anything the private sector can be doing to improve supply in these areas?

Ewan McGregor: UNICEF, the world’s leading children’s organisation, is in the unique position of being involved at every stage of the immunization process, supplying vaccines to 56 per cent of the world’s children and working on the ground in over 150 countries with local partners and other international NGOs. But to do this work, UNICEF receives no funding from the UN budget and relies entirely on voluntary donations to support its life-saving work for children. For this reason, private sector funding is crucial to enable organisations like UNICEF continue its work. When you see the amazing the lengths these health workers go to in order to reach every child – many of whom are either UNICEF staff or trained by the organisation – it really puts into perspective how crucial every penny donated to the organisation can be.

As well as money, private sector engagement is also crucial to ensure new innovations, like the small vaccine carriers, are continually being worked on for the cold chain so that the vaccine journeys can become easier and less fraught, no matter where children are living in the world.

Cold Chain IQ: What else needs to be done to increase awareness of the importance of cold chain vaccines in remote regions?

Ewan McGregor: Communication for development is crucial to raise awareness of the importance of the cold chain in remote regions and forms a critical part of UNICEF's approach to immunisation. In Nepal, social mobilisers would always visit Luma, the final village on our cold chain journey to inform parents about when the immunisers were coming and why it was important they bought their children to be immunised on that day. Initially they said they were faced with opposition; the parents wanted to go straight to work in the fields as they were worried about losing money; there was also fears that the vaccines might harm their children and make them ill. Thanks to the work of the social mobilisers in this area however, attitudes are changing and mums are increasingly aware of why they need their children to be immunised.

Projects like the Cold Chain documentary are also crucial to raise awareness of the incredible journey these vaccines taken in an interesting, simple and engaging way. Two million people watched each episode of the Cold Chain documentary, an incredible reach for a programme, which is essentially about international development. I think the challenge with raising awareness about an issue like the cold chain is making it relevant to the lives of people in the UK, so that they want to engage it. We all go to the doctors to get vaccines and we all make sure our children are immunised against diseases, so showing the journey that vaccines have to take to reach children living in remote communities can bring a whole new dimension to our own lives and the way we look at them.