February 12, 2009

MSF has mobilized significant human and logistical resources to fight an ongoing measles epidemic in the district of Abéché, Chad.

Doctors Without Borders/Médecins Sans Frontières (MSF) has mobilized significant human and logistical resources to fight an ongoing measles epidemic in the district of Abéché, Chad.

Chadian authorities asked MSF in mid-January to vaccinate all children between six months and 15 years old against this highly contagious viral disease. Between February 7 and 12, MSF vaccinated more than 40,000 children at 12 vaccination sites in Abéché city and treated more than 100 children already infected with the disease in the city and the neighboring countryside.

MSF emergency teams took less than 10 days to set up the vaccination campaign, which included leasing vehicles, training Ministry of Health personnel, and establishing a system for keeping vaccines at a precise temperature from the point of departure to the field—called a cold chain. The team, specialized in vaccination campaigns, has had to adapt to a difficult environment. “In addition to the heat – it’s almost 104 degrees in the shade during the day – we have to respect fairly restrictive security measures,” said Dr. Nico Heijenberg, who is in charge of the vaccination campaign. “These measures had to be imposed following the frequent incidents that affect the organizations on site, including the theft of vehicles and nighttime burglaries.”

“Measles is a very contagious disease and in order to stop the epidemic, we absolutely must vaccinate almost all of the children,” said Dr. Eric Nilles, who is supervising the vaccination in the city. “But this is not easy since we only have an approximate estimate of the number of children up to 15 years old in each location. During the dry seasons, many of them leave their villages with their families to live in the city. Moreover, some parents refuse to vaccinate their children.”

Wadji, a young woman wrapped in a large multi-colored veil, brought her children to the Taiba vaccination site in the middle of Abéché. Her two sons, ages three and five, are dressed in their Sunday best. They glance at nurses, somewhat fearful. “I heard on the radio that there was a vaccination,” said the mother. “The children of two of my neighbors caught the measles in January. I want mine to be protected.”

As MSF teams were completing vaccinations in Abéché city on February 14, additional teams began work in the rest of the district. MSF nurse Florent Uzzeni is in charge of planning the vaccination days at each site. He visits the villages and nomadic camps to inform people of the situation and tells them when the team’s next visit will take place. He often makes long detours in his all-terrain vehicle to bypass the wadis, or dry river beds, and other obstacles. As soon as he arrives in a village, his first task is to find the leader of the community or an elder. “We must convince him to assemble all of the children on the day when the team will visit,” he explained. “Generally this goes very well. They clearly understand our message because there have been cases of measles in all of these zones.”

Now working outside the perimeter of Abéché city, the teams are reaching deeper into the country's remote areas. Logisticians bring the vaccinations, ice, water, and food the teams need by truck each day. And, teams need to sleep on site in the villages for several consecutive days, which can be challenging given the security situation in Chad.

MSF teams are currently undertaking a vaccination campaign along the Sudan border, in the neighboring district of Adré, under the same difficult conditions.

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