Iraq

National polio drive delivers drops of hope amid insecurity in Iraq

© UNICEF video

A boy in Iraq receives oral polio vaccine from one of 20,000 vaccinators currently working under difficult and dangerous conditions to reach up to 5 million children.

By Claire Hajaj

AMMAN, Jordan, 28 September 2007 – As Iraq’s first National Immunization Days of 2007 get under way, over 20,000 mobile polio vaccinators are uniting in a titanic effort to reach as many as 5 million Iraqi children under the age of five.

No matter where these children live – whether in cities or remote rural areas, in conflict zones or temporary camps – vaccinators bring the polio vaccine right to their doorsteps, with help from UNICEF and the World Health Organization.

The polio campaign has a simple objective: to administer two drops of oral vaccine to every eligible child. But its logistics are made overwhelmingly complex by insecurity and displacement.

Delivering polio vaccine in Iraq’s violent heartland has never been harder.

Impossible burdens

In Baghdad’s Karrada district, for example, experienced vaccinators are now struggling with impossible burdens.

“Huge numbers of displaced families have moved into this area because of violence in their neighbourhoods,” said Dr. Alyaa Ahmed Aziz, manager of the local primary health care centre. “You can imagine the load on the vaccinators who were already required to cover a large number of children living here Karrada even before the conflict.

“Displaced families are scattered over a wide area, and we have to work very hard to find every child,” added Dr. Aziz.

Teams go door to door

With more than 1 million Iraqis forced to flee their homes since early 2006, many vaccinators across the country are facing similar challenges. Close-knit communities are now filled with strangers – their names and faces unknown to the local health teams.

Vaccinators working in central Iraq, where violence and suspicion are at their most intense, risk their lives to knock on doors and ask to immunize children. Others have to make the long and difficult trek to temporary camps where displaced families eke out a precarious existence.

UNICEF has provided transport for many vaccination teams in an effort to improve their security, as well as carriers to protect the vaccine vials. The organization has also supported a massive communication and community mobilization effort to lobby support from local leaders and families.

Beating the odds

But vaccinators know that they carry the hopes and fears of Iraq’s polio eradication programme on their shoulders.

“Some families do not want to open their doors to us now, because in Iraq today it can be dangerous to answer your door,” said Dr. Aziz. “It is hard for us, but we persist because we believe it is important.”

“Iraq’s vaccinators are truly some of the world’s greatest champions for children, and among the least recognized,” said UNICEF Iraq’s Chief of Health, Dr. Alexander Malyavin. “Their courage alone has kept Iraq polio-free since 2000, despite the chaos brought by conflict and insecurity. To watch them work during a polio campaign is to understand what it means to challenge enormous odds – and beat them.”

Focus on the displaced

Succeeding against the odds has become a tradition for Iraq’s polio campaigns, which have continued for the past seven years, through sanctions and war, to maintain Iraq’s precious polio-free status. The last round in December 2006 reached over 90 per cent of its intended target, immunizing almost 4.4 million children.

But concerns are high that as insecurity traps children in ‘hot zones’ or forces them to flee, the most vulnerable will become harder and harder to reach. During this round, vaccinators will make special efforts to include recently displaced children, many of whom have not been counted on the tally sheets vaccinators usually rely on to keep track of their progress.

“These children are probably the most vulnerable in Iraq today, and we’re determined to ensure they don’t miss out,” said Dr. Malyavin. “The goal of the polio campaigns is every child, not just those that are easy to reach.”

And Iraq’s families continue to appreciate that determination. One father put his feelings into words as his son received the two drops needed to remain polio-free for life. “God bless the vaccinators,” he said. “They are doing their very best for the protection of our children.”