Protecting children against diseases

Health Ministry, Gavi, UNICEF and WHO reach millions of children during a measles and rubella campaign

By Proscovia Nakibuuka Mbonye
measles, rubella, vaccination, immunization, UNICEF, WHO, Ministry of Health, conflict, displaced children, war
UNICEF/UNI514481/Ahmed Elfatih Mohamdeen
18 February 2024

When the community mobilizers arrived at Al Adad gathering point for displaced families in Kassala, Fatima, a mother of eight listened attentively. The mobilizers spoke about measles, a perilous disease that can be fatal for children if not protected through vaccinations.

This visit was a crucial part of the pre-activities leading up to the recently concluded Measles and Rubella campaign. The activities are critical in building trust among the communities, creating demand and acceptance for the planned vaccination drives as well as addressing any rumors and misconceptions around the vaccines.

Fatima, intrigued and concerned, delved deeper into understanding measles. She now acknowledges that

“Measles is a serious disease that causes fever, eye pain, and convulsions in children, and can lead to death.”

Additionally, she learned about the risks associated with rubella, recognized as the most common infectious cause of birth defects. Both diseases are life-threatening.

Health services in Sudan have been severely impacted and disrupted by the ongoing war. Outbreaks of diseases like cholera, dengue fever, and measles are putting the lives of children at risk. Despite the challenges, children cannot be left unprotected from preventable and life-threatening diseases like polio, measles.

Amidst these very challenging circumstances, the Federal Ministry of Health, with support from UNICEF, WHO, and Gavi, the vaccine alliance, successfully planned and executed the first phase of the Measles and Rubella (MR) campaign in 62 localities across the seven states of River Nile, Blue Nile, White Nile, Kassala, Gadaref, Red Sea and Northern.

The tagline for the campaign – ‘No matter what, vaccination programmes continue’ speaks to the resilience and determination of all actors towards protecting children in Sudan from diseases, regardless of the obstacles.

Over 5.4 million children between 9 months and 15 years old were targeted for the campaign that run over 6 days. Preliminary data indicates 5.3 million children (94 per cent coverage) received vaccinations. This success is a ray of hope amidst a troubled Sudan.

Fatima, a displaced mother, anxiously awaited the arrival of the campaign days so her children could be protected. Having learned about the dangers of the diseases and that it could be prevented through vaccination, she looked forward to the arrival of the health workers.

The mobile health team arrives

In Kassala state, mobile teams such ‘Al-Nazheen for the Displaced’ – locally translated ‘displaced for displaced’, were assigned to traverse faraway locations to ensure every eligible child was reached during the campaign. Wijdan, a vaccinator and volunteer displaced from Gezira state is part of one of the teams. Their catchment area includes gathering shelters hosting displaced families, refugees, and host communities within the three localities on the outskirts of rural Kassala. This also includes Al adad gathering shelter where Fatima and her family reside.

measles, rubella, vaccination, immunization, UNICEF, WHO, Ministry of Health, conflict, displaced children, war
UNICEF/UNI514490/Ahmed Elfatih Mohamdeen
measles, rubella, vaccination, immunization, UNICEF, WHO, Ministry of Health, conflict, displaced children, war
UNICEF/UNI514494/Ahmed Elfatih Mohamdeen

The mobile team’s commitment to reaching every eligible child is evident in their clear strategy and detailed knowledge of the target population. Undeterred by the vast distances between communities, the team traverses on foot and occasionally jumps on donkey carts for longer distances. From sunset to sunrise, with vaccine carriers, essential supplies, and megaphones, they move from one location to another, calling families and making stops to vaccinate.

“We have all the information about families in the shelters and we found acceptance from the families, since most of them are displaced people like us,” says Wijdan.

Their persistence is evident in their ability to turn refusals into vaccinations by convincing hesitant parents and caregivers.

measles, rubella, vaccination, immunization, UNICEF, WHO, Ministry of Health, conflict, displaced children, war
UNICEF/UNI514469/Ahmed Elfatih Mohamdeen

At Al Adad gathering shelter, Mashkaat, a volunteer, uses her megaphone to mobilize mothers and caregivers. She even enters shelters, emerging with groups of children at the vaccination site. The mobile team spends time at the shelter, vaccinating one child after another. Fatima, with all her children in tow, expresses the significance of the health of her children, eagerly awaiting the vaccination team.

One by one, the children are safeguarded against measles and rubella. Four-year-old Abdul Qader, the youngest, also receives other vaccines that he missed while the family was on the move. Fatima expresses her relief, saying, “After my children received the vaccination, I am at peace”. In their catchment area alone, the mobile team successfully vaccinated over 900 children by the end of the campaign.

measles, rubella, vaccination, immunization, UNICEF, WHO, Ministry of Health, conflict, displaced children, war
UNICEF/UNI514499/Ahmed Elfatih Mohamdeen

UNICEF is present from planning to execution of the campaign

For a successful campaign, UNICEF worked closely with partners at different levels. From microplanning to implementation, monitoring and supervision of the campaign and post campaign to ensure the planned coverage was obtained.  With support from Gavi, UNICEF was able to bring into the country 21.5 million doses of the MR vaccine to support the campaign as well as an additional 1.1 million doses to support the introduction of the MR vaccine into routine immunization programmes going forward.

During the launch of the campaign in Port Sudan, Mandeep O’Brien UNICEF Representative, reiterated UNICEF’s commitment to supporting routine child immunizations and campaigns until Sudan has zero no dose children. “A healthy life is every child’s right,” she emphasized.

Anne Cronin the Gavi Coordinator noted “Through the launch of the MR vaccine, we declare our unwavering dedication to ensuring no child is left vulnerable to these preventable diseases.”

measles, rubella, vaccination, immunization, UNICEF, WHO, Ministry of Health, conflict, displaced children, war
UNICEF/UNI514479/Ahmed Elfatih Mohamdeen
measles, rubella, vaccination, immunization, UNICEF, WHO, Ministry of Health, conflict, displaced children, war
UNICEF/UNI514453/Ahmed Elfatih Mohamdeen

In Kassala state, an 87.6 per cent coverage of all eligible children was achieved.

“The campaign was successfully concluded in all the 11 localities of Kassala albeit the difficulties posed by the conflict including mass displacements and disease outbreaks,” Zuhair Suliman, UNICEF Health Officer noted.

The campaign marked the official introduction of the rubella vaccine into the national immunization schedule for Sudan.