Engaging communities
In addition to these technical aspects, the most important thing is to engage communities. Vaccination campaigns cannot be effective if they don’t reach people. Indeed, mistrust of Ebola fosters rumours, which mean people only come for vaccination if they are convinced of the need to prevent serious illness in their children. Communities here are very familiar with measles and the danger it represents. However, communication is not enough to get them to come: they need to know that this vaccination activity is safe. Thus, vaccination sites are established at a distance from Ebola sites and health promoters inform families to help them understand the procedures and avoid rumours from spreading.
In July, we introduced the first measles vaccination in an Ebola context. Everything went smoothly and children in several health zones including Bunia and Ituri were vaccinated. We have therefore confirmed that it is possible to vaccinate against measles in an Ebola context, through ensuring specific measures are taken. This has reinforced the message that it is vital to vaccinate against measles even in these contexts, in order to prevent thousands of deaths from complications of the disease. Measles vaccination activities were carried out several months later throughout the country, taking into account the lessons learned from this first campaign. This was replicated in eight health zones in Ituri that were at high risk of Ebola transmission at that time.
Shifting priorities
In July, our collaboration with UNICEF and the Congolese Ministry of Public Health achieved the vaccination of 4,320 children in Ituri. Measles vaccination strategies in the Ebola context have been refined and validated by the health authorities at both local and national levels. With MSF’s expertise in measles vaccination activities, we were able to provide technical support through the training of health personnel, alongside the Ministry of Health, UNICEF, and the World Health Organization.
There was a general awareness that the number of measles deaths was much higher than those due to Ebola, that this year the measles epidemic has already affected more than 280,600 people in the 26 provinces of the DRC, and that it was therefore not possible to prioritize only the Ebola response.
The benefit of vaccinating against measles was therefore greater than the risk of spreading Ebola caused by people gathering in groups to be vaccinated. Above all, together, we have proven that measles vaccinations in this context of deadly double outbreaks can be carried out correctly, through appropriate communication and measures. This opens great opportunities for us to contain these viruses that are devastating communities in the DRC.
MSF has worked in the DRC since 1981. Our teams respond to the needs of communities during health and humanitarian emergencies, including epidemics, pandemics, displacement of people, and natural disasters, with the primary objective of reducing morbidity and mortality.