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Immunization campaigns reaching across conflict lines

© UNICEF/2004/Agbo
Dr. Agbo immunizes one of more than 700 children against polio, during the recent assessment mission in North Darfur. The mission travelled through areas that hadn’t been reached by aid workers or government services for years.

DARFUR, 10 August 2004 – Last Friday, UNICEF and UN staff flew to the Eritrean capital of Asmara to negotiate for access to rebel controlled areas of Darfur for two large immunization sweeps – one against measles, and the other against polio, the latter in late August. At the same time, a small assessment team moved into parts of North Darfur that hadn’t been reached by aid workers or government services for years – with the full consent of the Sudanese government.

The purpose was twofold: In Asmara, the idea was to win the agreement of the Sudan Liberation Movement/Army’s (SLM/A) and the Justice and Equality Movement’s (JEM) political leaders for the campaigns. In Darfur, the goal was to demonstrate to field-level commanders what an immunization operation would look like in practice. The SLA provided guides and maintained radio contact with the assessment team, in order to keep them oriented during their journey, in which they covered more than 1000 km.

The UNICEF team was led by the programme officer responsible for UNICEF’s immunization activities in Sudan, Dr. Samson Agbo, a Nigerian. He says it was some of the toughest terrain he has seen during his five years in Sudan, and that he had never seen people in worse condition. Many people live more than a week away from the nearest market. Large numbers of people have been reduced to eating the wild fruit that grows throughout the region.

© UNICEF/2004/Agbo
Villagers come to meet the assessment team in North Darfur.

"We travelled by car and by foot when necessary, and it’s such a tough region,” said Agbo. “We were lost a number of times during our five-day mission. Mostly there are no tracks, just scrub. The tracks have not been traversed by vehicles for at least two years, and many tracks simply petered out into the bush. It was like climbing Mount Everest without the right equipment. At night we slept under the stars in dry wadis [ravines].”

Malnutrition raises the risk of contracting life-threatening diseases

Apart from being naturally arduous, the area is also a dangerous war zone, littered with craters and unexploded bombs. “There was one town called Musbat which has basically been depopulated by hundreds of air raids. These are ghost towns, where people gave up living and took to the hills,” said Agbo. “These people have developed amazing coping mechanisms.”

While in the field, Dr. Agbo carried out simple tests for malnutrition (the MUAC, a measurement with a strip of plastic of the circumference of the upper arm). On this basis, he estimates that children living in the SLM/JEM-controlled areas are critically malnourished, and at great risk of death through disease and lack of food.

“Many of those children we assessed for malnutrition fell into the ‘red’ category – on the threshold of dying. And that potential for dying is increasing all the time. The whole population is hungry for assistance. They need food, but before even food they need security so that they can travel in safety to areas where they can obtain food, medical care, and other help they may need.”

© UNICEF/2004/Agbo
A woman, having learned how to administer the polio drops, tries her hand.

Half a million children still remain to be immunized

Carrying cooling boxes with him, Dr. Agbo took the opportunity to vaccinate more than 700 children against polio. “It’s a drop in the ocean, of course. Both polio and measles [immunization] have to achieve almost saturation coverage to be truly effective – but we took the opportunity anyway. I mean, almost all the children we came across had never been vaccinated.”

A huge measles campaign in Darfur last month reached more than two million children, but planners realized that, in order to be effective, measles and polio campaigns would have to reach across conflict lines into cut-off areas to reach nomadic people. UNICEF estimates that around half a million children still remain to be immunized in these areas.

The UNICEF team was accompanied by staff from other agencies, including the World Food Programme (WFP), Office for the Coordination of Humanitarian Affairs (OCHA), the UN High Commissioner for Refugees (UNHCR), and the World Health Organization (WHO).



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A major immunization campaign reaches vulnerable children in Darfur

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