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Central African Republic

Despite conflict and displacement, half a million children vaccinated, and counting

© UNICEF Central African Republic/2013/Duvillier
An infant is immunized during the emergency vaccination campaign in the Central African Republic. Disrupted health systems and poor conditions in displacement sites have left the country’s children at greater risk of contracting deadly diseases.

By Laurent Duvillier

Delivering life-saving vaccines and medicines has become extremely difficult since the outbreak of conflict in Central African Republic, but UNICEF and its partners continue their efforts to reach as many children as possible. 

BOSSANGOA, Central African Republic, 4 November 2013 – The vaccination area was strategically set up at an entrance to one of the displacement camps in Bossangoa, in the northwest of the Central African Republic. After returning from the fields to pick pumpkins, eggplants and cassava, women would stop in and get their children vaccinated.

Joseline is one of them. Her village was attacked during the violent rebellion spreading across the country, and her husband was shot and killed. The 26-year-old widow escaped with her four children. She is seven months pregnant.

“I hope my child will be born in a country with peace,” Joseline said when she came to the vaccination site run by the NGO Médecins Sans Frontières (MSF) and UNICEF.

“I came to vaccinate two of my children. It will make them stronger and bring them good health. They need it, especially here in the displacement site,” she said. “We eat little; we sleep on the ground; we don’t always have enough water – all this is not good for our health.”

It took only few minutes, and after a few tears, Nicaïl, age 5, and Merlin, 2, received the drops and shots that will protect them against deadly diseases.

The importance of getting vaccinated

Over the past six months, UNICEF and its partners, including the national Ministry of Health and the World Health Organization (WHO), have provided vaccinations and other life-saving treatments to more than 500,000 children.

During the vaccination campaign in Bossangoa, carried out with support from UNICEF and logistics assistance from MSF, nearly 9,400 displaced children between 6 months and 14 years were vaccinated against measles and polio, and received vitamin A supplements and Albendazol tablets for deworming.

© UNICEF Central African Republic/2013/Duvillier
Joseline brought her children Nicaïl, 5, and Merlin, 2, to be vaccinated. “It will make them stronger and bring them good health,” she said. She and her children escaped an attack on their village; her husband did not survive.

“[Families] know the importance of getting vaccinated,” said René, a coordinator working at the vaccination site. The 57-year-old volunteer monitors the number of vaccines used and fills in vaccination cards. “The ground is humid. It’s bad because families are likely to fall sick, just like us. I am myself suffering from flu.”

“Women know us,” said Kevin Onassis, 31, a volunteer field vaccinator who previously worked in a health clinic that closed down due to violence. “It’s not the first time we are carrying out a vaccination campaign. We are displaced people as well. We tell them not to be afraid. Caring for children is very nice work.” 

Supply routes disrupted

Since the onset of the crisis almost a year ago, health activities have been disrupted across the Central African Republic, with the supply chain completely halted outside the capital, Bangui. As of September, about 600 cases of measles had been identified throughout the country.

“Many health facilities have been looted and fridges stolen,” said UNICEF Health Specialist Dr. Deogracias Manirakiza. “Under these circumstances, how can we safely transport vaccines from the warehouse to the area where children are getting vaccinated? This is the main challenge our teams on the ground have to face every day. Without careful planning, the cold chain can be broken at any point and vaccines will be spoiled.”

Outside Bangui, most petrol stations have been looted or damaged in the conflict. “Fuel is absolutely essential to ensure the cold chain functions properly,” Dr. Manirakiza said. “UNICEF has no other option but to supply the fuel by road, over a distance of up to 1,500 kilometres from the capital city. If we don’t, we wouldn’t be able to reach the most vulnerable children living in remote rural areas.”

Despite the serious logistical challenges and an extremely volatile environment, Nearly 300,000 children – close to 93 per cent of the target – were vaccinated in October during the first phase of an integrated campaign in four health regions, including Bangui.

The second phase of the campaign, scheduled for November, will target the remaining three health regions and reach about 200,000 children.

Continuing needs

UNICEF requires some US$2.6 million to respond to emergency health needs this year in the Central African Republic, but so far, less than two-thirds of the funds have been received.  

Since the beginning of the crisis, more than 1,646,500 doses of vaccines have been supplied by UNICEF to partner humanitarian organizations and the Ministry of Health. Continued support is critical if children like Nicaïl and Merlin are to get the treatment they need to protect them against deadly diseases.

In spite of the tear-stained faces of her children, Joseline is happy that today she has two very valuable pieces of paper – their vaccination cards.



UNICEF Photography: Former child soldiers

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