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Immunization campaign in Afghanistan aims to eradicate polio and empower women

© UNICEF Afghanistan/2010/Walther
At the launch of the campaign in Jalalabad, Catherine Mbengue, the UNICEF Representative in Afghanistan administers an oral polio vaccine to a child.

By Cornelia Walther

JALALABAD, Afghanistan,  18 February 2010 – A massive polio immunization campaign in Afghanistan recently reached 2.8 million children under five years old. Over the course of three days, about 20,000 health workers travelled from house to house in 14 provinces as part of an ongoing effort to eradicate polio in Afghanistan.

The campaign, which began in 2009, is the first in the world to use a new bivalent vaccine that immunizes against two types of polio with a single dose. Nearly four million doses were administered. UNICEF, the World Health Organization (WHO) and other partners including Rotary International and the Centers for Disease Control and Prevention (CDC) are supporting the campaign.

“We can do it, and it must be done” said Peter Graaff, WHO Representative in Afghanistan, at the launch of the country’s first campaign of 2010.

“The progress that has been achieved so far was possible only thanks to the strong partnership that we have built over the past years,” added Catherine Mbengue, UNICEF Representative in Afghanistan.
Stop the virus

Six rounds of National Immunization Days, reaching almost 7.5 million children, took place in Afghanistan in 2009. Sub-national campaigns  were conducted in areas where polio cases have been recorded in order to stop the virus and prevent the disease from spreading to other parts of the country and across the border to Pakistan. Further rounds of national and sub-national campaigns are planned this year.

© UNICEF Afghanistan/2010/Walther
After administrating the polio vaccine, a vaccination agent marks the finger of the immunized child to avoid duplication, in Afghanistan.

“To eradicate polio in Afghanistan is tantalizingly close, and yet we are still so far away,” said Mr. Graaff. “I hope that 2010 will be a major step towards a polio-free Afghanistan.”

A path toward empowerment

Female caregivers are a cornerstone in the realization of this goal. Since 2009, UNICEF and WHO have set up ‘Women Courtyards’ throughout Nangarhar Province in eastern Afghanistan.  Once a woman becomes a member of a courtyard, it is her responsibility to spread the word about polio prevention by discussing it with women in her neighbourhood.

This initiative aims to widely disseminate information about polio and other vaccine-preventable diseases. Today, an increasing number of the polio vaccination agents are female, allowing easier access to more households.

“So much has changed over the past months,” said Ms Mbengue. "Female vaccination teams have become a cornerstone of our fight against polio in the East. The involved women are amazingly dynamic and well organized.”

In rural Afghanistan, women are often hampered by traditions. They are neither allowed to move around freely nor to let foreign men enter their homes. The Women Courtyards have opened a path towards empowerment. As vaccination agents and community mobilizers, women are taking an active role in the fight against polio  and at the same time against traditions that have restricted them for decades.

Female community mobilizers go from door-to-door to homes, often in remote locations, to sensitize families on the importance of vaccination. Shortly after, vaccination teams visit the home. At the end of each day, the teams meet with male and female vaccinators in the same room and enjoy an equal right to speech.

A need for community awareness

Yet despite ongoing efforts, circulation of the polio virus continues. Thirty-eight cases were been reported in 2009, an increase from the year before. Lack of community awareness and inadequate health infrastructure are among the major challenges facing the campaign.

Population movement from polio-free areas to polio-endemic locations and vice versa is another reason for the spread of infection. This occurs most frequently along the border between Afghanistan and Pakistan – two of the four countries worldwide where polio remains endemic. With the support of Rotary International, vaccination checkpoints have been set-up at both sides of the border to make sure that children crossing into the respective countries are being vaccinated.

Nonetheless, access by vaccination teams to children living in conflict-affected areas remains limited. Tens of thousands of children still cannot be reached by either vaccination campaigns or routine immunization efforts due to security risks.



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