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Major immunization drive begins in East Timor

Tuesday, 19 October: The United Nations Children's Fund (UNICEF) and partner agencies today completed the first phase of a major immunization campaign aimed at preventing an outbreak of measles and other life-threatening diseases in East Timor.

The immunization campaign, being coordinated by UNICEF, Médécins Sans Frontières International (MSF) and the World Health Organization (WHO), reached about 4,000 children under the age of five in the capital of Dili today.

Measles spreads rapidly in transient populations and poses a serious threat to East Timor's children, many of whom have weakened immune systems due to weeks of displacement, prolonged exposure to the elements and inadequate nutrition. Children who were immunized were also given Vitamin A supplements to help boost their ability to fight off disease.

"This was an encouraging first step toward normalizing health care in East Timor," said UNICEF health chief David Alnwick. "Vaccination campaigns like this, in addition to our successful start at getting local health centres restocked and reopened, are going to save lives."

"Still, there's a lot more work to do to ensure a healthy environment for the people of East Timor," he added. "UNICEF and other agencies are working hard at it."

The campaign is a follow-up to an earlier immunization effort organized by UNICEF. In July, the agency hammered out an agreement with pro-independence groups, militias, and Indonesian military and police to guarantee "weeks of tranquility" so that children and their families could safely access vaccination services. The first two rounds of the immunization campaign proceeded peacefully, but the campaign was interrupted by the violence that followed the 30 August popular consultation.

For today's effort, UNICEF recruited 110 local nurses and other health staff to work as vaccination teams and trained them in operating vaccination centres. MSF (which provided the vaccine), Médecins Du Monde (France and Portugal), Assistencia Medicos Internacional (Portugal) and Caritas all took part in running the five vaccination centres established in the capital.

Tetum-language notices urging parents to bring their children in for immunization were distributed by UNICEF, while the Catholic Church mobilized support for the campaign at Sunday mass and through its networks. A mobile loud speaker system was also used to disseminate information about the campaign.

Based on the positive outcome of this campaign, UNICEF and its partners will design similar measles immunization efforts for other cities and towns around East Timor and work toward developing a national expanded programme of immunization for the other five childhood diseases: polio, diphtheria, pertussis, tetanus and tuberculosis.

In addition to the vaccination effort, UNICEF has carried out broader health assessments and helped coordinate the re-establishment of the city's health facilities in conjunction with international and local organizations. By early October, 10 of Dili's 11 health facilities - eight clinics and two hospitals - had reopened and were providing health care to thousands of internally displaced persons. UNICEF is supporting the start-up of a ninth health clinic in the compound of Dili's nursing school.

UNICEF has provided the clinics and hospitals with emergency drugs, medical equipment, first-aid kits and other health supplies.

The restart of immunization services and the reopening of Dili's health facilities are seen as a first step toward rehabilitating East Timor's shattered health care system.

"Once we have Dili covered we can concentrate on supporting the further expansion of immunization and health services to all other parts of the country," said Dr. Samhari Baswedan, UNICEF's Health Officer in Dili. "And once we have coverage over the entire country we will focus on improving the quality of health care delivery."

WHO, together with the Irish NGO Goal and UNICEF, is working on establishing a computerized Supply Management System (SUMA) to help track distribution of drugs, medical equipment and other aid cargo around the country and reduce duplication of efforts and other inefficiencies. The system will help improve the targeting and distribution of available drugs to communities most in need, as well as allow for the sharing of available resources among humanitarian organizations.

"We see SUMA as the embryo for a sort of central pharmacy for the entire country," Dr. Baswedan said.

UNICEF has been present in East Timor since the early 1980s. The agency evacuated on 5 September and its office was subsequently destroyed. UNICEF reestablished its presence in Dili on 20 September, and is now the lead UN agency for health in East Timor.

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