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Immunization

Immunization in emergencies

next Shamsul Farooq, Deputy Director, UNICEF Supply Division

Q: Under what circumstances does UNICEF conduct emergency immunizations?

Farooq: Over the last few years UNICEF has made a commitment to meeting the minimum emergency and critical needs for the survival and protection of children in the event of man-made disasters such as conflict and warfare or natural disasters such as earthquakes, hurricanes and floods. Fortunately emergencies often happen in situations where UNICEF has already been present, but the country office is usually overwhelmed and needs some extra support. We mobilize support from that region, from headquarters, or in some cases, through mobilization of non-governmental organizations and other UNICEF partners.

Q: What immunizations are done in these situations?

Farooq:  All efforts are made to maintain regular immunization programs, but often it is not feasible for these to be carried out in acute emergency situations. Therefore UNICEF focuses on polio and measles. We vaccinate against polio as part of the global effort to eradicate the disease. Each year we reach some 45 million children in emergency countries, most of which are in Africa or Asia. We also vaccinate against measles – a big killer – because children are very vulnerable to this disease in emergencies.

Q: How does UNICEF conduct immunizations in areas of conflict?

Farooq: We try to use polio and measles in a synergistic way to agree on what we call Days of Tranquility. This is when warring factions stop fighting for a couple of days or longer in order to give us access to the children so we can provide this very critical health service. We then use these days as a means to reach out to children across the lines of conflict and bring in other necessary assistance – not only ours, but those of other organizations as well. We have seen in several conflict situations – in the Democratic Republic of the Congo, in southern Sudan, in Angola and in Afghanistan – that these initial interventions allow us to piggyback other child-related work, such as reinforcing primary health care services and building the capacity of national staff.

Q: What are the short- and long-term goals of these immunizations?

Farooq: There are three components to such interventions. First, we are saving children from death with measles vaccination. Second, these immunizations can be a means to revise and revitalize the health structure – to kickstart regular immunization services following measles vaccinations. Third, these immunizations give health authorities a sense of confidence because they have been able to achieve something that is visible, concrete and impact-oriented.

Q: What is an example of a recent emergency campaign?

Farooq: In Afghanistan we have been supporting polio immunization through yearly rounds of National Immunization Days – even when the bombing and active fighting was going on in November 2002. In normal circumstances, we reach over five million children. In this case we still managed to reach 4.2 million children. Then, after the fighting stopped, the first initiative UNICEF supported was an emergency measles campaign.

Expert Opinion: Immunization in Afghanistan.