Faces from Yida: An MSF Vaccination Campaign in South Sudan

Sudanese refugees began streaming across the border into South Sudan in June 2011 when conflict erupted between the Khartoum government and the rebels of the Sudan People’s Liberation Movement-North (SPLM-N) in Sudan’s South Kordofan State. At the height of the crisis in Yida camp last summer, high mortality rates were reported among young children admitted to MSF’s hospital with respiratory tract infections, such as pneumonia, one of the leading causes of death. MSF determined that vaccinating with the pneumococcal conjugate vaccine (PCV) could result in a substantial mortality reduction in Yida. MSF has been working since September 2012 to procure PCV but faced significant delays due to lengthy negotiations and international legal procurement constraints. MSF was eventually able to obtain the vaccine from GSK at a reduced price, but delays have now pushed the planned vaccination into the logistically challenging rainy season. The objective is to immunize approximately 5,000 children under the age of 2 against several pathogens, including haemophilus influenza type B and pneumococcus. This is the first time that PCV is being used in South Sudan and one of the first vaccines to be implemented in compliance with the new WHO emergency vaccination recommendations.
Yann Libessart/MSF
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When epidemiologists with Doctors Without Borders/Médecins Sans Frontières (MSF) recorded a high child mortality rate at the Yida refugee camp in South Sudan, MSF took action. Vaccine-preventable diseases, including pneumonia, were killing the camp’s children. 

Medical and logistical teams responded with a vaccination campaign that included one of the first uses of PCV pneumococcal vaccine in a humanitarian emergency. To mark World Immunization Week, we are sharing the following images of some of the mothers and their children who MSF vaccinated during the campaign. 

MSF’s four key goals for improving access to vaccination in the year ahead are: greater temperature tolerance, lower prices, an end to age limits for receiving missed doses, and reduced roadblocks to vaccine use in humanitarian emergencies. 

Sudanese refugees began streaming across the border into South Sudan in June 2011 when conflict erupted between the Khartoum government and the rebels of the Sudan People’s Liberation Movement-North (SPLM-N) in Sudan’s South Kordofan State. At the height of the crisis in Yida camp last summer, high mortality rates were reported among young children admitted to MSF’s hospital with respiratory tract infections, such as pneumonia, one of the leading causes of death. MSF determined that vaccinating with the pneumococcal conjugate vaccine (PCV) could result in a substantial mortality reduction in Yida. MSF has been working since September 2012 to procure PCV but faced significant delays due to lengthy negotiations and international legal procurement constraints. MSF was eventually able to obtain the vaccine from GSK at a reduced price, but delays have now pushed the planned vaccination into the logistically challenging rainy season. The objective is to immunize approximately 5,000 children under the age of 2 against several pathogens, including haemophilus influenza type B and pneumococcus. This is the first time that PCV is being used in South Sudan and one of the first vaccines to be implemented in compliance with the new WHO emergency vaccination recommendations.
Yann Libessart/MSF
Sudanese refugees began streaming across the border into South Sudan in June 2011 when conflict erupted between the Khartoum government and the rebels of the Sudan People’s Liberation Movement-North (SPLM-N) in Sudan’s South Kordofan State. At the height of the crisis in Yida camp last summer, high mortality rates were reported among young children admitted to MSF’s hospital with respiratory tract infections, such as pneumonia, one of the leading causes of death. MSF determined that vaccinating with the pneumococcal conjugate vaccine (PCV) could result in a substantial mortality reduction in Yida. MSF has been working since September 2012 to procure PCV but faced significant delays due to lengthy negotiations and international legal procurement constraints. MSF was eventually able to obtain the vaccine from GSK at a reduced price, but delays have now pushed the planned vaccination into the logistically challenging rainy season. The objective is to immunize approximately 5,000 children under the age of 2 against several pathogens, including haemophilus influenza type B and pneumococcus. This is the first time that PCV is being used in South Sudan and one of the first vaccines to be implemented in compliance with the new WHO emergency vaccination recommendations.
Yann Libessart/MSF
Sudanese refugees began streaming across the border into South Sudan in June 2011 when conflict erupted between the Khartoum government and the rebels of the Sudan People’s Liberation Movement-North (SPLM-N) in Sudan’s South Kordofan State. At the height of the crisis in Yida camp last summer, high mortality rates were reported among young children admitted to MSF’s hospital with respiratory tract infections, such as pneumonia, one of the leading causes of death. MSF determined that vaccinating with the pneumococcal conjugate vaccine (PCV) could result in a substantial mortality reduction in Yida. MSF has been working since September 2012 to procure PCV but faced significant delays due to lengthy negotiations and international legal procurement constraints. MSF was eventually able to obtain the vaccine from GSK at a reduced price, but delays have now pushed the planned vaccination into the logistically challenging rainy season. The objective is to immunize approximately 5,000 children under the age of 2 against several pathogens, including haemophilus influenza type B and pneumococcus. This is the first time that PCV is being used in South Sudan and one of the first vaccines to be implemented in compliance with the new WHO emergency vaccination recommendations.
Yann Libessart/MSF
After long and difficult negotiations, MSF was able to procure a supply of expensive pneumococcal vaccine at a reduced price. In 2013, we organized a vaccination campaign to protect Yida’s children against pneumonia and other diseases caused by the pneumococcus bacteria such as meningitis, otitis, and others.
MSF also offered polio vaccination to Yida camp residents and the surrounding community. The women and children shown in these images were living in the camp. They came from the Nuba Mountains in South Kordofan, Sudan, where health care is limited. Refugees often move back and forth across the Sudanese border.
Time and again, we see mothers in developing countries show amazing determination in caring for their babies. This woman arrived at Yida after carrying her child for three days in temperatures over 105 ºF/40ºC. She may have originally come to the camp for a food distribution taking place on the same day as our campaign, but also stayed to have her child vaccinated.
In emergencies like this one, clusters of refugees are especially vulnerable to diseases that vaccines can prevent. MSF is asking pharmaceutical companies to guarantee that humanitarian groups like ours receive the lowest global price for the vaccines required to respond to emergency needs.
MSF advocates for lower vaccine prices that poor countries can afford. We also push for governments to allow children over age one to get vaccine doses they’ve missed, in keeping with the international standard. In addition, we encourage the GAVI Alliance – the biggest funder of vaccines in poor countries – to pay to vaccinate children over age one.
Most vaccines need to stay between 2°C and 8°C to remain effective. In developing countries, where electricity may not be reliable, keeping them cool is a huge logistical challenge. We’re forced to use cool boxes and ice packs to maintain a ‘cold chain’ of refrigeration. MSF advocates for vaccines that won’t spoil due to heat or cold.
We believe that nobody who needs immunization should be turned away, regardless of age. Anything from a vaccine stock shortage to a lack of electricity to keep supplies cool can mean that a mother’s journey to vaccinate her child ends in failure – whether it takes her across a refugee camp or many days’ walk from home.
W e’re relieved that we were able to protect the chil dren in Yida camp against the threat of pneumonia and other diseases. But there’s still muc h to be done: Every year, one in five of the world’s children under age 1 don’t get all the vaccinations they need. Learn more about our work to protect more young lives through vaccin ation at: http://www.msfaccess.org/our-work/vaccines