Feature - Preventing needless deaths

Under a sprawling acacia tree, nurse Ermias Beneberu draws up a lifesaving vaccine into his syringe. Several hundred children and their colourfully dressed mothers surround him, some crying, others nervously eyeing the dozens of needles laid out on a table. As Ethiopia's Somali Region struggles to keep a grip on a severe drought, it is the ever-growing risk from infectious diseases such as measles that is now threatening this already fragile community. In turn, each child apprehensively steps up, throws back its head and rolls up a sleeve. Two drop of Vitamin A and then the measles vaccination. It takes seconds, costs around US $0.25 per child and can be administered almost anywhere. SIMPLE, CHEAP LIFESAVER That simple, cheap lifesaver is vital in drought-stricken Ethiopia where one of the country’s largest ever measles immunization campaign was launched on Thursday. Measles is one Ethiopia’s top five childhood killers – there are around 1.45 million cases annually and 72,000 children needlessly die each year from it. With a full-scale drought in many parts of the country, the UN’s Children’s Fund (UNICEF) estimates that mortality rates among under fives could increase fivefold. Abdelmejid Tibouti, who is the deputy head of UNICEF in Addis Ababa, stresses the importance of tackling measles before an outbreak. “Measles can cause blindness, deafness and even brain damage,” he said. “Child mortality among malnourished children can rise as high as 20 percent because the immune system has been weakened.” Abdelmejid says that with the current emergency – some 11 million people in the country are in need of food aid – the vaccination programme is imperative. “The most important thing is doing this campaign in time and getting to the children who are most at risk," he stressed. PROBLEM WORSENED BY DROUGHT In Somali Region, the joint vaccination campaign is targeting more than 90 percent of the population. But attempts in the past to tackle measles have been poor because coverage has been low. Routine measles coverage in Somali Region has been around four percent using the scattered health centres – effectively making it worthless. “The coverage in this region traditionally has been very poor,” admitted Dr Hussein Shardi, the head of healthcare in the Somali Regional State. “At the moment we also have a drought in this area which makes the situation worse,” he added. He estimates that malnutrition rates in the region range from between 15 and 28 percent. A lack of accurate data is a widespread problem in Ethiopia. He warns that a measles outbreak is imminent and could be expected in this area, given the previous coverage and the scale of the drought. BREAKING THE CYCLE In pastoralist areas, immunising children between 9 months and 15 years is difficult as families roam hundreds of kilometres with their animals looking for pasture. But without a crucial level of more than 90 percent coverage, health officials believe they will never break the cycle. The campaign must also been completed within a tight timescale, as the incubation period is around seven days, and the faster the programme the greater the protection. Radios and loudspeakers have been used to inform local and rural populations about the campaign, which will cost about US $1 million. “The infrastructure is not here, nor are the trained people to carry out the programme and transportation to get to people who need to be vaccinated,” Dr Hussein pointed out. The ministry of health, UNICEF and the WHO are running the campaign - which is funded by international organisations - and all the drugs and needles are imported into the country ahead of the campaign.