Det er især Nigeria og Mali, der volder problemer på grund af islamistisk terror, oprør og militærkup – og kampagnen er kun effektiv, hvis man når ud til alle børn i den enorme region.
DAKAR, 23 March 2012 (IRIN): Health volunteers, aid agency and health authority staff are trying to immunize 111,1 million children under five across 20 countries in West and Central Africa against polio. The four-day campaign started Friday, but instability in some of the target countries could hamper the effort.
Parts of Nigeria are highly unstable due to ongoing attacks by islamistic Boko Haram; a tuareg-rebellion is currently under way in northern Mali, while security in the capital Bamako is also precarious with a military junta having ousted the president.
Over half of the children targeted – some 57,7 million, are in Nigeria, which is West Africa’s only polio-endemic country.
Meanwhile parts of Niger (for instance Tillabéri in the northwest) are difficult to access, as are parts of eastern Chad, with some aid agencies working only with armed escorts.
“Access to children in some of these places can be a serious problem,” said UN Children’s Fund (UNICEF) regional health specialist Halima Dao.
“Vaccinators’ safety can be compromised, or insecurity means the whole population of a village may flee at a moment’s notice, or there may be far more people than we expected in an area, due to displacement,” she told IRIN.
Thousands of displaced people
The conflict in northern Mali has, for instance, led to about 195.000 people being displaced either within the country or when they fled to Algeria, Mauritania, Niger, Burkina Faso and Senegal, according to the UN Refugee Agency (UNHCR).
But these numbers are constantly changing as people return or move from camps to host villages, meaning reaching them could be complicated.
Halima Dao admits some children in the Tombouctou and Kidal regions of northern Mali may not be reached, though they are discussing with NGOs working there, including Médecins Sans Frontières and the Malian Red Cross, to see how to reach as many as they can.
“We have to work with authorities and NGOs who are used to accessing these insecure areas,” she said.
For a polio immunization campaign to be effective, 100 percent of the children must be reached, says the World Health Organization (WHO), while the long-term fight against polio will only work if routine immunizations are consistently kept up, for at least 90 percent of children under five, for several years running.
Last year, election-related in violence in Ivory Coast hampered efforts to quash a polio outbreak affecting 36 children, according to aid agencies.
Thus far, only Ghana, Cape Verde, Burkina Faso, Gambia and Togo have achieved the required 90 percent coverage, according to UNICEF.
Children in the hardest-to-reach areas are often the most vulnerable, said Dao, as they do not have access to regular health services. Agencies will try to give Vitamin A and de-worming medicine to these children where possible.
Weak health systems
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