South Sudan overcomes great obstacles to protect children

Despite conflict, the South Sudanese government brings in five-in-one pentavalent vaccine with Gavi support.

  • Elizabeth Nyalen, 30, walks through a camp temporarily housing people forced from their homes because of civil conflict in South Sudan. Her husband died in the fighting, and she fled with their five children to seek refuge here at the United Nations base in Juba, the capital.
  • Despite the fighting, Vaccine Alliance partners are continuing routine vaccinations here at the Tomping Camp. Mrs Nyalen carries her 11-month-old son Gisma Stephen to a nearby makeshift health clinic for his measles immunisation.
  • James Tariak is among the staff at the clinic, run by Magna Children At Risk. Here he is preparing to administer a vaccine provided by Gavi. Without the work of partners in the field, thousands of children who can no longer reach their local health centres would miss out on crucial vaccinations and be left at risk of childhood illnesses.
  • Magna and Unicef staff tour the camp, which houses in excess of 18,000 people, using loud-hailers to alert mothers that vaccinations are available. Each day, dozens of people come to the clinic to have their children immunised. Some would not be able to reach clinics if they were still in their villages, which are often remote from major towns.
  • Conditions in the Tomping camp are poor for internally displaced people, and made worse by the current daily rainy season downpours. Drainage channels for run-off rainfall become clogged, and fill with human effluent, but children still need to navigate their way around them. Disease can strike quickly.
  • Eight months after conflict broke out in December 2013, few here believe they will be able to go home soon. The camp has begun to resemble a more permanent settlement. ‘Main streets’ have stalls selling household goods, small tea shops, and television kiosks showing re-runs of World Cup football games from Brazil.
  • Families living in the Tomping camp rely on handouts from international aid organisations and the United Nations. Children’s nutritional conditions are above emergency levels, but the situation is still precarious.
  • Despite facing enormous challenges, the Government of South Sudan successfully launched the new five-in-one pentavalent vaccine in Juba on July 16. Just two days later, supplies arrived at this clinic in Walag’lang in Central Equatoria province. Here, six-week-old Keji Francis receives a shot that will protect her against diphtheria-tetanus-pertussis (DTP), hepatitis B and Haemophilius influenzae type b.
  • Midwives told Keji’s mother, Jackline Juan, 20, about the importance of vaccinations when she gave birth at a nearby hospital. She says the fact that her daughter can be immunised with just three injections with pentavalent, instead of nine before, saves her time and causes less pain to her baby. “All of us here are coming for this new medicine now we have heard about it,” she says.
  • Poor infrastructure is among the most serious and difficult-to-fix challenges faced by South Sudan, which became an independent country only three years ago. Many roads are impassable during the long rainy season, meaning health staff struggle to reach rural clinics with essential supplies including vaccines. Some villages are cut off for months at a time.
  • It’s hard to reach medical care in case of emergencies, and people have to walk to remote health centres to get even basic services such as vaccinations or ante-natal information. The same rainy season that leaves roads impassable also brings increased levels of disease, especially malaria.
  • Clinics in rural areas far from towns are rarely connected to electricity, and staff struggle to keep vaccines cold with kerosene-powered refrigerators. Increasingly, however, solar power is reaching at least one clinic in each district. From there, mobile teams can take vaccines in cool boxes deep into the hinterland on daily outreach missions.
  • Back at the Tomping displacement camp in Juba, Mrs Nyalen has returned to her temporary home, a shelter covered in plastic sheeting that leaks when it rains. She struggles to keep the children healthy in this environment, she says. That’s why she took Gisma for his measles shot. “In these conditions I know the importance of protecting the children as much as we can,” she says.
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Last updated: 27 Sep 2019