“He doesn’t sleep,” says Furiyay, a mother whose young son sits lethargically on her lap. The boy is thin and his legs are covered with sores. “He vomits the whole night and has diarrhoea,” his mother adds. Report by Eva Gilliam, MOGADISHU, Somalia.
VIDEO: UNICEF correspondent Chris Niles reports on a measles vaccination campaign in camps for people displaced by drought and conflict in Mogadishu, Somalia. Videographer: Eva Gilliam.
Furiyay’s son is suffering from measles. His is one of 9,000 cases of the disease reported in Somalia since January.
In the capital, Mogadishu, tens of thousands of families displaced by drought and conflict are living in camps around the city. Quarters are tight, making the conditions ripe for an infectious disease like measles.
“This is an airborne disease,” explains Dr. Yasin Mohamed Nur of the World Health Organization (WHO). “It is spread by coughing, sneezing – and imagine the risk when there are so many people living in such a congested area.”
Effects of malnutrition
Malnutrition makes the situation even worse. In south-central Somalia, a region where some 40 per cent of children under the age of five are acutely malnourished, the effects are disastrous.
“When the person becomes malnourished, his immunity drops, so he is prone to everything,” says WHO’s Mohamed Shire.
“When the child cannot get the basic necessities,” notes Mr. Shire, “his body will utilize all the nutrients that were stored in the body, and that will lead to a reduction in immunity. If the child is already malnourished, he can easily be infected by measles, and this can often lead to death.”
Conflict, drought and famine
The Horn of Africa is facing what has been described as the worst drought in over half a century, and the UN has declared a famine emergency in some regions.
In Somalia, where the drought is compounded by conflict, hundreds of thousands of people have fled to urban centres and neighbouring countries. National malnutrition rates are soaring. Combined with low immunization rates, they raise serious concerns about large-scale outbreaks of vaccine-preventable diseases.
Even before the current crisis, Somalia had low vaccine coverage compared to most other nations, with routine immunization rates stagnating between 30 and 40 per cent. The combined effects of poverty, civil unrest and poor health care have negatively impacted Somali communities even further.
Modest gains made in immunization over the last few years are now at risk, particularly with respect to measles elimination and polio eradication.
Emergency vaccination plan
Due to the crisis, a large number of children from Lower Shabelle, Middle Shabelle, Bay, the Jubas and other regions have settled in Mogadishu. Immunization activity in these regions stopped for nearly two years amidst conflict, leaving many of these children unprotected.
Over the last several weeks, UNICEF, WHO and other partners have been conducting emergency vaccination campaigns in parts of Mogadishu. A plan is also in place to vaccinate all children in south-central Somalia, where the famine is at its peak, over the next few months.
Humanitarian agencies provide basic health and immunization services in more than 150 maternal and child health centres in south-central Somalia. As networks of primary health care, the centres serve as the core of the vaccination campaign plan.
The campaign aims to provide supplemental immunization with measles vaccine, oral polio vaccine, vitamin A and de-worming tablets to children aged 6 months to 15 years – and to strengthen diseases surveillance for early detection of outbreaks.
Access amidst insecurity
Despite hopes for the mass campaign, which is targeting 750,000 children in all, many concerns remain.
“Insecurity remains one of our biggest obstacles,” says Dr. Nur. “It is important to get full access to everyone. Our concern now is for the [displaced persons] who will arrive in Mogadishu after we have completed the campaign here.”
Major donors to UNICEF’s immunization effort in Somalia include the UK Department for International Development and the Swedish International Development Cooperation Agency.