In Central African Republic (CAR), Doctors Without Borders/Médecins Sans Frontières (MSF) emergency teams have vaccinated almost 10,000 children in the Gadzi area, about 186 miles west of the capital Bangui, after several cases of measles led local authorities to raise the alarm. The vaccination teams had to cope with major access problems due to the poor state of the roads and the dispersion of the population in the area, where more than 70,000 people live with virtually no basic health care.
A total of 9,717 children were vaccinated over two weeks, around 9,000 of them between six months and five years old. Of these, nearly a thousand—including about 700 babies under six months old—were also vaccinated against pneumococcal disease. The Pneumococcus bacterium is responsible for various infections, especially respiratory ones.
A Complicated Intervention
“The campaign began after the alert from a Gadzi local authority, who warned us in late September that there were cases of measles in the area. Initial laboratory tests were negative, but in spite of that a first distribution of drugs was still carried out,” says Montse Pubill, emergency team medical coordinator. “The intervention was complicated by the violence that erupted in the country in October, which caused dozens of deaths in the capital. But in November, the warnings continued from Gadzi and a second round of analyses confirmed the presence of measles, so an emergency vaccination was launched.”
The vaccination campaign began in late November in Djomo village, near Gadzi, and for more than two weeks covered a dozen health posts, some of them very remote due to the great dispersion of the population. “Access to some of the posts designated for vaccination was very difficult for us, and sometimes for the people as well, so we had to send teams on the fly to look for people with mobile posts,” explains Pubill. “The 13 initial points ended up being about 30.” In total, more than 300 people participated in the campaign, mostly members of the community and Ministry of Health staff.
To raise awareness about the dangers of the disease and the benefits of vaccinating children, health promotion teams visited areas ahead of the vaccination teams to explain the process. “In some places, like the town of Gadzi itself, some people were prejudiced against vaccines, so the work of the health promoters was very important, as usual,” says Pubill. “In many cases, they had to go door to door looking for children, and I remember one day that the promoter himself arrived holding two children in his hands with their parents following behind.”
The Gadzi region has been the scene of other MSF emergency interventions. “Despite its important mining activity, it is an area with huge health gaps where most health posts are just empty rooms with no ability to provide assistance to people,” says Pubill. “It is paradoxical that in the region there are areas of diamond mining, which generates income for some but doesn’t generate a minimum wellbeing for most of the population,” he says. “There are men who get some money in the mines, but they generally go to Carnot [a city in the west] to spend it.” Thus, many families don’t have even the minimum required to pay for basic treatments and, although MSF provides free service in the Carnot hospital, “the 62-mile journey to get there is a difficult barrier to overcome because hardly anyone has resources to pay for a motorcycle taxi in case of illness.”
MSF has worked in CAR since 1997 and currently has more than 300 international staff and over 2,000 Central African workers in the country. Since December 2013, MSF has doubled its level of medical care in response to current crises. MSF also assists Central African refugees in neighboring Chad, Cameroon, and Democratic Republic of Congo.