July 09, 2009

MSF is providing treatment to those infected, and has launched a vaccination campaign for approximately 400,000 children between six months and 15 years of age.

In response to a measles epidemic that has hit northern Mali, Doctors Without Borders/Médecins Sans Frontières (MSF) is providing treatment to those infected, and has launched a vaccination campaign for approximately 400,000 children between six months and 15 years of age.

More than 2,500 patients have so far been registered, half of them concentrated in the regions of Timbuktu and Gao. MSF has established three measles treatment centers in Timbuktu and two others in Gao. In addition, four mobile teams are doing outreach searches to locate more infected people, provide care for them, and refer complicated cases to treatment facilities.

Measles is a contagious disease that primarily affects children. The disease can be fatal or cause serious complications, including blindness and pneumonia. Measles can be prevented by vaccination, but in the affected areas in Mali, very little vaccination coverage is a major factor in the spread of the epidemic.

In order to prevent further spread of the disease, MSF started in May a vaccination campaign in the Timbuktu region, where the number of infected people surpassed the epidemic threshold. MSF and Ministry of Health teams have so far vaccinated 160,000 children in Timbuktu city and in the surrounding areas. The vaccination effort will continue in that region and in the neighboring Gao region.

Populations on the move

Among those being vaccinated, many are Tuareg or other nomadic populations who are heading south of Timbuktu in search of water. Teams have also vaccinated other ethnic groups who are currently heading to the Niger River to fish.

“People are constantly on the move and this is a big challenge,” explains Louis Kakudji Mutokhe, MSF medical coordinator. “It is extremely difficult to follow their migration. Two or three days before the vaccination we have to send a team of educators to let people know about the vaccination and to ask them not to move. But sometimes they move on to places where they can find better water points for the cattle.”

In such a vast and underpopulated area—about one inhabitant per square kilometer (half-mile)—MSF has had to mobilize resources to satisfy significant logistical needs. Adding to the difficulty, poor road conditions means that moving from one place to another takes a long time. In the Timbuktu region, 12 teams of MSF staff, Ministry of Health staff, and representatives of civil society, are working on the vaccination campaign. About 20 cars take the teams to the vaccination sites.

The temperature at this time of year in Mali is almost 50 degrees Celsius (122 Fahrenheit). However, to be effective, vaccines must be kept at a low temperature—between two and eight degrees Celsius (35 and 45 degrees Fahrenheit). “We have to keep the ‘cold chain’ right up to the most remote places,” explains Mutokhe. A cold chain is a system of transporting vaccines while keeping them cold since some vaccines must be kept at a low temperature or they will lose potency. “The cold chain is based in Timbuktu and at least two vehicles bring icepacks and vaccines to the field. You really need a lot of resources if you want to avoid giving ineffective vaccines to the kids.”

Overall, around 100 MSF staff, the majority from Mali, are working to address the measles outbreak.

MSF has worked in Mali since 1992. In Timbuktu, MSF operates on women suffering from obstetrical fistula, and in the southern Kangaba district, MSF runs a malaria project.