Say Yes, Autumn 2004: Up Hill, Down Dale … Routing Measles
Measles Immunisation Day in the remote hills of Muş -- a good opportunity to ‘top-up’ on routine vaccinations such as the oral polio vaccine.
Photograph Anadolu Ajansı © 2004
According to WHO, 3% of children in developing countries who contract measles will die. In Turkey, the campaign to eliminate this most deadly of vaccine-preventable childhood diseases is now in its second phase. Our main objective is to ensure that no child is left out of the measles vaccination programme
said Health Minister, Dr Recep Akdağ, at the launch of the UNICEF supported Ministry of Health (MOH) programme of Measles Immunisation Days in 10 provinces this Autumn. Our slogan is Let’s eliminate measles altogether
Dr Akdağ said.
The humorously grotesque little characters decorating this page were featured in promotional broadcast spots for the campaign by TRT, the national television channel. © Ministry of Health 2004
Every year, between 8,000-30,000 children in Turkey are infected by measles. The Measles Elimination campaign was launched last year with the target of immunising all school children -- 10 million -- against the disease. The MOH announced a success rate of 97% following this first phase.
During this second phase of Immunisation Days, 1,250,000 children between the ages of 9 months and 5 years of age and also children under the age of 15 years who are out-of-school were targeted over a fortnight between 1-15 October. A coverage rate of 90% was set for this group, taking the hard-to-reach
factor into account. A total of 6,000 health personnel were mobilised to ensure the fullest result.
This is an important day for Turkish children,
said Edmond McLoughney, the UNICEF Representative in Turkey at the campaign launch. Measles should be completely eliminated through this programme by the year 2010.
This campaign is a cornerstone of a healthier future for children
said Dr Akdağ. Turkey was very successful in the elimination of polio and we aim for the same result with measles.
The campaign focused on ten priority provinces of Ağrı, Batman, Bingöl, Bitlis, Diyarbakır, Hakkari, Muş, Şırnak, Tunceli and Van because these provinces have the lowest rates of routine vaccinations, including measles, in the country. As many as 250,000 children in this area were considered to be out-of-school although the exact figure remains under dispute.
A secondary objective of the campaign was to accelerate routine vaccinations for Diphtheria, Pertussis, Tetanus and Hepatitis B and also administration of the oral polio vaccine ensuring that Turkey’s polio-free status is maintained.
Health staff working in teams of two or three (one to record and write vaccination cards, the others to administer vaccinations), made house-calls in the villages and hamlets of some of Turkey’s most notoriously difficult areas to reach. In one case, staff travelled 60 kilometres by car and a further 20 on foot -- a journey of 6 hours -- in order to vaccinate 150 children in the village of İnardı in Muş.
This is the first time I’ve travelled to an area like this,
said Sultan Göktaş, some of these mountain slopes are so dangerous to get around -- but it was vitally important to get these children vaccinated.
To give some idea of the local scale of the immunisation drive, in the province of Muş alone, 350 personnel were allocated in 136 teams to cover 350 villages and 180 hamlets. In 2003, 71,255 primary school students were vaccinated. This year, 100,000 infants and children who are out-of-school were targeted.
Of course there were the universal problems with children offering strong resistance at the sight of a vaccination needle -- an unpredictable element in even the best laid plans. Health Staff, sorely pressed for time to meet their schedules, are nevertheless experienced in overcoming such tribulations. Photograph Anadolu Ajansı © 2004
An intensive advocacy campaign involving the press and television was launched in support of the drive.
The cast of ‘Bir İstanbul Masalı’ got together to make promotional television spots urging people to ensure that their children did not miss the opportunity of immunisation. The television series enjoys tremendous popularity in the Eastern target provinces and the actors’ contribution was undoubtedly a positive influence.
Özcan Deniz, star of ‘Asmalı Konak’ another incredibly popular series and talkshow host, Okan Bayülgen, also made similar broadcast spots.
Media support for this leg of the immunisation drive was given an initial boost with a conference in Diyarbakır attended by 33 local and national journalists.
An interesting contribution was added by Metin Akpınar and Zeki Alasya who revisited a series of comic scenarios they made for an earlier measles vaccination drive over nineteen years ago during Turkey’s first Expanded Programme on Immunisation (EPI). The actors updated the original ‘two-hander’ sketches for children with a fresh television appearance re-introducing the characters and pointing out that the original target audience are today’s parents.
Briefing kits on the issue were produced for the benefit of high-level decision-makers.
All provincial managers were given training on the importance of both routine vaccinations and measles immunisation. Together with the MOH, UNICEF supported training of the managers using the cascade model whereby they were able to reproduce their training with other health staff at the local level.
Read the Winter 2003 issue of Say Yes for more information about the campaign to eliminate measles in Turkey.
See the Programmes Section for more about Immunisation in Turkey.
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SAY YES, AUTUMN 2004
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