By Alma Hassoun
At a school building in Homs city, sheltering 26 families who had to flee their homes due to fighting, children have gathered in the hallway waiting for their turn to be vaccinated. Those who are about to receive the vaccination hold tightly to the hands of their parents or siblings, some others are crying.
However, Rasha* (8) is not intimidated by the injection needle. “We shouldn’t be afraid of the injection. It is good to stay healthy.” she says proudly after receiving the injection in her upper arm.
Rasha was displaced one year ago with nine other family members: her parents, siblings, aunt and grandmother from one of the old neighbourhoods of Homs city. They now live in one of the classrooms in the upper floor of the collective shelter housed in the school building. It is only very recently that she started schooling for the first time, thanks to the classes conducted the shelter by a local NGO with UNICEF support.
Rasha’s father says: “We were informed about the vaccination campaign the day before from Syrian Arab Red Crescent (SARC) volunteers who supervise the shelter. We are familiar with the importance of immunizing children as I have elder children”.
The Ministry of Health, supported by UNICEF and WHO, has launched a nation-wide immunization campaign across Syria with the aim to vaccinate 2.5 million children against measles, mumps and rubella (MMR) as well as polio.
Children aged from 6 months old to 15 years who are living in collective shelters for displaced persons, children in schools from first to fourth grades, as well as children under-five who missed their vaccination in previous campaigns are currently being vaccinated.
In Homs, mobile health teams are travelling shelter to shelter, and school to school, to immunize all targeted children residing in in the city.
“With the summer fast-approaching, concern over disease outbreak, especially among vulnerable children, increases by the day amid deteriorating health conditions.” says Dr Iman Bahnasi, UNICEF Syria’s Health Specialist.
“Many displaced families and their children have had to move many times in search of safety and their health has been affected in the process. In overcrowded settings such as in shelters and schools in particular, the consequences of disease among children, especially highly contagious ones like measles, would be catastrophic”
UNICEF is supporting the campaign by providing the Ministry of Health with cold chain equipment, vaccination cards, syringes, safety boxes, and the MMR vaccines. 19 measles cases were reported by The World Health Organization between January and 9 March of this year.
At a school in Homs, children have formed a long queue outside the room where the mobile health team is busy attending to the children. The team is using a long list which shows the names of children between grades 1-4 in the school, and tick boxes to indicate those who have been vaccinated, absent, or sick.
Fighting often creates obstacles to the mobile health team’s movement and threatens their safety. But this does not deter the teams from trying to reach as many children. “It is true that sometimes it is very difficult to reach some areas due to insecurity, but what’s our option? Should we then just leave children unvaccinated?” said the supervisor of a mobile team during his mission to one of the shelters. He further added that it is sometimes even dangerous for members of his team to leave their neighbourhoods and go to work because of fighting.
A nurse from one of the vaccination teams recalled how fighting erupted while they were delivering the service and how they had to leave the area under shelling. “This is what I signed up for,” she said. “Those children are affected by the crisis and need our help. Although it is risky, life must go on and it is impossible that I stay at home doing nothing.”
The ongoing campaign will be completed by end of April. Shortage of funding remains a critical challenge in the face of reaching the targeted 2.5 million children, as UNICEF needs to purchase more vaccines to support the massive initiative. UNICEF is in need of $3 million urgently, in order to be able to pay for doses of the MMR vaccine necessary for the campaign.
*Name was changed
![Two-year-old Augustin Kunda, who is malnourished, eats a mixture of corn and peanuts, at the health centre in Kaniaka Village, Katanga Province [#2 IN SEQUENCE OF TWO] In February 2011 in the Democratic Republic of the Congo, women and children remain vulnerable to maternal and neonatal tetanus (MNT), an infection that has no cure but is preventable with routine immunization. MNT threatens the lives of 130 million women and babies in 38 countries around the world, including D. R. Congo, where the disease sickened at least 1,038 babies and killed 483 last year. Globally, the disease kills 59,000 infants within their first month of life, the equivalent of one death every nine minutes, every year. Limited access to basic health services and poor hygiene conditions during birth are the major contributors to MNT mortality: Many infections take place when women give birth at home, alone or in the presence of an untrained birth attendant. Delivery on unclean surfaces and handling with unclean hands or instruments increase the chance of MNT infection in both mother and baby. Yet three doses of the tetanus toxoid vaccine ? one of the world?s safest and least expensive vaccines ? protects almost 100 per cent of recipients from the disease. Additionally, children born to immunized women are protected from the disease for the first two months of life. Since UNICEF re-launched its MNT Elimination Initiative in 1999, at least 20 countries have achieved the goal of eliminating MNT, and since 2006, private-sector partner Pampers has donated funds for 300 million vaccines. In D. R. Congo, this initiative is promoting vaccination among girls and women of child-bearing age, particularly in southern provinces where health infrastructure is weak and vaccine shortages are common. The goal of the initiative is to eliminate cases of MNT from the world by 2015.](http://blog.unicef.org.nz/wp-content/uploads/2013/04/UNI106736.jpg)
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Practice makes perfect: Simulating an emergency response in Vanuatu
Imagine being woken up in the middle of the night to the sound of crashing plates and the power going out. A natural disaster – a reality some of us have already faced and a nightmare that others may experience one day. UNICEF helps countries all over the world prepare for emergency situations so people have the best chance of survival.
Hamish Lindsay, UNICEF NZ Programmes Manager, has just returned from Vanuata where his mission was to help the country prepare for a natural disaster by planning a grand scale disaster simulation. Here Hamish gives us a rundown on what’s involved.
What is a disaster simulation?
This disaster simulation is aimed at testing the response plans of the Vanuatu Government and three rural communities in an emergency situation.
Vanuatu is one of the most vulnerable countries in the world to natural disasters with regular cyclones, volcanic eruptions and fallout, earthquakes and tsunamis.
Community members work with UNICEF & partners to prepare for disasters
UNICEF New Zealand is part of a group of seven NZ-based agencies (with ADRA, Caritas, CWS, Oxfam, Rotary, Tearfund) who are facilitating a NZ Govt-funded disaster simulation exercise in Vanuatu.
At the moment we are focused on the planning of the disaster simulation which will replicate a natural disaster. We want to make our practice run as real as possible and to do this all emergency services will be activated, people will be evacuated from affected areas and temporary health clinics will be set up for those injured.
Essentially the emergency simulation will put us in the heart of an emergency scenario and, more specifically, will help us pin point where emergency response activities and co-ordination can be improved.
What are some of the challenges in effective disaster response?
Even though we only talked through a potential disaster and not the real event, I got a small glimpse of the complexity of responding to an emergency and the immense challenge of managing information in a crisis.
Preparing for disasters helps protect children’s futures
Some of you may be more familiar than others on how challenging communication can get in disasters – the Christchurch earthquake was a difficult time for many when the phones went down for example.
Effective communication systems are vital for effective disaster response – as both a warning system for impending disasters and for response co-ordination when disasters hit.
While in Vanuatu we spoke to an ambulance service member who highlighted the fact that communication is the biggest issue in a disaster as they currently rely on mobile phone networks, which will either be damaged by a natural disaster, or overloaded as people are trying to contact one another in the aftermath.
How else is Vanuatu preparing for any potential disasters?
At the moment many Vanuatu response agencies do not have the resources to buy satellite phones which are a key tool in disasters as they remain active in crisis situations when other forms of communication are down. But progress is being made and work is underway for a new radio network to be set up specifically for these disaster response situations.
Robrt Patton of ADRA NZ explains the exercise to community members
Satellite phones are fantastic as they allow key responders such as police, ambulance and aid agencies to communicate with each other when the mobile network is down – a vital tool to ensure a speedy and co-ordinated response.
Disaster simulations take a lot of effort to prepare and run, but it is our hope that the government’s and communities’ existing emergency response systems will be strengthened through this exercise.
Our planning trip was a success and I look forward to returning in June for Vanuatu’s real disaster simulation!
Photos: Mark Mitchell of Caritas NZ