Mogadishu - In Somalia, one in seven children dies before their fifth birthday and, in many cases, these deaths are preventable by use of vaccines.

It was for this reason that Nadifo Sirad Ali was waiting with her three children in a long line at the Maternal and Child Health Centre in the Hamar-Jajab district of the capital, Mogadishu, under a hot morning sun in early September.

“All my children are now healthy, so I have no fear even if there is an outbreak because I know they are vaccinated,” the 30-year-old mother said afterwards, as she and her children stepped out of the health centre.

The first part of polio campaign, aiming to curb the spread of the ongoing polio outbreak, took place last month in the Banadir region – which includes and surrounds the capital city of Mogadishu, is home to the largest number of displaced people in Somalia, and a hub for Somalis travelling internationally. The strain of polio that is in circulation is different from the wild poliovirus, recently declared as eradicated from Africa, but it can also put communities where not enough children have been vaccinated at risk and leave children paralyzed for life. The strain of polio has paralyzed 19 children since late 2017.

Almost 500,000 children targeted

Ms. Ali’s children were among the hundreds of thousands of children in Banadir targeted by a mass immunization campaign against measles and polio.

“This campaign took place in all the 17 districts of Mogadishu with the aim of reaching out to 492,000 children, which was achieved. We also gave out Vitamin A and deworming tablets to boost their immunity and kill parasites,” says Mahamud Shire Mohamed, a Polio Eradication Officer with the World Health Organization (WHO).

The campaign was organized by the Federal Ministry of Health with support from WHO, the UN Children’s Fund (UNICEF), the Global Polio Eradication Initiative (GPEI), and Gavi (the Vaccine Alliance).

According to local health authorities, the immunization exercise was prompted by a recent measles outbreak in Mogadishu. From the beginning of the year, measles affected 744 children in the Banadir region, representing nearly half of Somalia’s reported cases. The highly contagious infectious disease can cause a fever and rash among other symptoms in unvaccinated children, and the most serious complications of the illness include blindness, encephalitis, severe diarrhoea and related dehydration, and severe respiratory infections, such as pneumonia.

“We carried out the vaccination campaign after new cases of measles were confirmed in the city. Since measles is a deadly disease, we had to contain it to save our children, sensitise the public against the dangers of polio and measles, and make sure the children are vaccinated,” said the Director of Health at the Banadir Regional Administration, Mohamed Mahamud Adow.

COVID-19 complications

Organizing such a mass immunization campaign is complex in the best of times. The impact of the country’s response to the COVID-19 pandemic meant even more challenges, in particular due to movement restrictions instituted in Mogadishu, which made it difficult for parents to take their children to health centres for routine immunization.

Faced with a sharp increase in number of cases, the local health authorities, with support from UN agencies, started a public sensitization campaign which encouraged parents, guardians, and caregivers to have children vaccinated at any of the 83 immunization centres organized in Mogadishu and its surrounds.

Anticipating that some parents would not be able to bring their children to the health centres involved in the mass immunization campaign, 1,200 outreach teams have been set up to sensitize families. About 3,300 community mobilizers went from door to door to encourage parents to bring their eligible children to nearby sites for vaccination, thus covering all the neighbourhoods in the Benadir region, which consist of around 2.7 million residents.

According to WHO, the campaign was also an opportunity for health workers to remind parents of the simple measures required to prevent the spread of the coronavirus. It will be followed later in October by a second, house-to-house round of the response campaign that will cover more than 1.6 million children in the southern and central regions of Somalia.  Another immunization campaign is currently ongoing in the capital of Jubaland, Kismayo, in response to a measles outbreak there, targeting 60,000 children under the age of five.