MSF-USA: MSF Starts Therapeutic Feeding and Fights Measles Epidemic in Chadian Capital

May 24, 2005
MSF Starts Therapeutic Feeding and Fights Measles Epidemic in Chadian Capital

Forchana Camp, Chad. Vaccinating a child against measles. Photo © Stephan Grosse Rueschkamp/MSF N'Djamena, Chad, May 13, 2005 - After having vaccinated more than 40,000 children in the Bousso district, 186 miles south of N'Djamena, MSF medical teams have now joined their colleagues in the capital of Chad. With more than 4,400 measles cases reported in the city in April, the emergency now calls for both preventive and curative medical action. N'Djamena, a city with an estimated population of one million, is facing the risk of a very long and very lethal epidemic. MSF has deployed a team of 30 specialists to help fight the threat.

A massive vaccination campaign has started two days ago and aims at immunizing an estimated 280,000 children. MSF has opened 29 mobile vaccination sites, in collaboration with the ministry of health.

The transport and storage of the 300,000 vaccine doses needed for the campaign make for a huge challenge. Measles vaccines are sensitive products, which lose their potency when exposed to heat, a real problem in N'Djamena where temperatures easily reach 104°F. The success of the immunization campaign depends to a large extent upon the quality of the "cold chain" - the combination of measures used to keep the vaccines between 35.6° and 46.4°F at all times.

Measles vaccination campaign in Kebkabiya, North Darfur, Sudan. Photo © Kris Torgeson/MSF

"You don't freeze a thousand ice packs in a few minutes," says Valentin Omari Sefu, MSF logistical coordinator for this intervention. "It usually takes a week to organize such a massive campaign, but we managed to do it in three days by bringing back frozen packs and two freezers from Bousso. It's a terrible ten-hour journey and we almost got stuck twice."

Maintaining the cold chain is only one of the challenges of an urgent and massive vaccination campaign like this one. Installed in temporary shelters, the medical staff must follow strict guidelines to reach the target of 1,000 immunizations per team per day. Timing is crucial to cut the spread of the epidemic.

Another concern is that measles exacerbates malnutrition in children. For that reason MSF has decided to, in parallel with the vaccination campaign, do a nutritional screening. The first results indicated high numbers of severely malnourished children. MSF has already sent nutritional kits with the equipment necessary to weigh, measure, register, and feed two hundred severely malnourished children, and opened three therapeutic feeding centers under the supervision of a nutritional medical nurse. Severely malnourished children are fed through a nasal gastric tube (because they are so weak that they are unable to swallow and chew food properly) and need very close medical and nutritional monitoring.

As the number of infections keeps growing, MSF is also providing medical support and drugs to 17 health centers for the less severe cases. The most severely infected patients are referred to the Union and Sultan Kasser Hospital, where MSF specialists assist the resident staff in treating the concomitant infections, such as pneumonia.

While MSF is trying to take control of the epidemic in the capital, new measles cases have been reported from two southern districts, Salamat and Moyen Chari, more then 400 miles away from N'Djamena. Assessment teams are on their way to evaluate the situation.