February 18, 2014
In October of last year, the World Health Organization (WHO) documented 15 cases of the polio virus in Syria’s eastern Deir e-Zor province — the first documented cases in Syria since 1999. The highly contagious virus shows symptoms in just one of 200 children infected and can paralyze a child in a matter of hours.
Two additional cases were found after the initial discovery, one in Outer Aleppo and one in Outer Damascus. A Reuters investigation uncovered evidence that the Syrian government had excluded Deir e-Zor from a 2012 vaccination drive.
The discoveries prompted a large-scale immunization campaign by the WHO and UNICEF, who undertook to vaccinate over 20 million children in Syria and neighboring countries. In November, the UN airlifted 538,000 polio vaccinations from its Damascus headquarters to the northeastern city of al-Hasakah, which were then distributed throughout eastern Syria.
Yet some areas were excluded from the campaign, either because government forces had blockaded them or because ongoing violence prevented humanitarian personnel from entering.
Juliette Touma, the spokesperson for UNICEF Syria, tells Syria Direct’s Elizabeth Parker-Magyar that as long as teams cannot access all corners of Syria to administer the vaccine, the risk remains of further outbreak.
Q: What can you tell me about how UNICEF’s campaign to combat polio has been going?
For us at UNICEF, we have made the response to polio and vaccinating the kids a top priority for us as an organization.
For that, we have to work to respond not just quickly but also in a very wide way. We’ve launched the biggest campaign to combat polio in the history of the Middle East.
Around the region, in the neighboring countries, it has been quite a success, because obviously there’s no armed conflict on the ground. It’s a matter of providing the doses and coordinating with the partners on the ground to help inside Syria.
However, we have managed to reach about two million children [inside the country]. In the context of a civil war, [the vaccination campaign] becomes increasingly challenging because of the nature of the conflict, because of access problems, because of the need to negotiate with different parties, because of the ongoing violence, because of the siege on a number of areas inside Syria that we could not access.
So far we have done two rounds of polio vaccinations in Syria, we need to do another four from now until April.
Q: Can you clarify the specific process involved in vaccinating children?
We need to vaccinate each child six times. We might reach, for example, a child in Deir e-Zor in round one, but in round two there is violence in Deir e-Zor, and we cannot reach a child the second time.
Q: There have been reports of the Syrian government blocking access to Deir e-Zor. Has there been any improvement in access to these hard-to-reach areas?
We have a number of windows to deliver to areas that we have not reached in the past, but that doesn’t mean that the job is complete. There are a number of areas in Syria that are under siege. Areas like, for example, the Old City of Homs, some parts of rural Damascus, some parts of Aleppo, Yarmouk camp as an example. These are all areas we need to access that we haven’t been able to access.
A virus like polio travels fast, doesn’t need permission, it will not stop at a checkpoint, it will not stop at a border. So the risk of a virus spreading in Syria still exists.
A child receives a polio vaccine in Syria. Photo courtesy of @SYRedCrescent.
Q: What about access to a-Raqqa province?
In a-Raqqa, we’ve reached some but was have not been able to reach all of a-Raqqa. The access problem is dual-layered. The areas we are not able to reach are either those areas that have been sealed off, or areas where the violence is ongoing, like a-Raqqa, but also in Aleppo and some areas of Homs, where heavy fighting is taking place.
Vaccination is not an easy task like delivering other supplies, because of the nature of the vaccine—of the need to protect what is called the “cold-train,” the vaccine needs to be maintained under a certain temperature. There are also electricity issues to maintain the vaccine. Then of course you need capable, hands-on teams who have been trained, who know how to protect not just the vaccinated children, but the cold-train itself.
In addition to that you have the awareness, and this is something UNICEF is also responsible for. How to raise awareness within the communities to vaccinate children, so in a context where there is no electricity, some awareness tools that might otherwise work – radio, TV – might not work.
Q: Before the war began, immunization rates for polio in Syria were near 90 percent—since then, they’ve fallen to 70. Are you able to tell how whether this rate has been brought back up?
No, we haven’t been able to – there is a challenge in verifying the exact number. We’ve received reports that we’ve reach two million, but [we cannot always undertake] the verification reports we would normally do, where you have teams that go and verify children have actually been vaccinated. In some areas we have been able to do that, in other areas it has been more of a challenge.
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