Curbing measles in Kenya’s conflict-troubled Mandera County
Vaccine vials, clued-in parents, dedicated health workers... and armed police: VaccinesWork finds out what it takes to rein in a measles outbreak in Kenya’s north.
- 31 January 2023
- 4 min read
- by Cyrus Michino
Late in 2022, measles began to spread in Mandera county, northern Kenya. By mid-December, 140 cases had been confirmed. For Issack Adan, the county's public health director, the rate of spread was a clear and urgent warning. "We have over a hundred confirmed measles cases, and our kids' lives are at stake. We have to take action," he said.
Bordering Ethiopia and Somalia, the county's recent history has been punctuated with internal and border conflicts. Health infrastructure is, generally speaking, thinner on the ground in Kenya's north, and many medical practitioners here fear traversing the area because of security concerns. It's no coincidence that Mandera's routine immunisation rates rank among Kenya's lowest.
“I’m in pain for losing my two kids. I will not allow another mother to lose her children when we have vaccines.”
– Deka Dacar
For some residents, the cost of this latest outbreak of a vaccine-preventable illness has been unspeakable. Deka Dacar from Derkhale Ward, Banissa Constituency in Mandera, lost two of her children to measles. Both children developed a rash, cough and fever that escalated with time, said Dacar, but, living in a remote area often attacked by bandits, she could not get them to the hospital on time. The kids succumbed to the disease upon arrival at the health facility.
When clinicians Sudani Abdi Awad and Sahra Ali heard what had happened, they volunteered to take the vaccination exercise to Banissa Constituency.
"We will not lose more children to measles. Sahra Ali and I have liaised with the county health department to help take vaccines across Banissa Constituency. We have a population of about 150,000 people, and a good number are children below five years old, most of whom have not received even a single dose of the MMR vaccine," said Awad.
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Adan declared a ten-day sensitisation period to inform parents about the importance of giving their children vaccines: that vaccines would protect them from measles and other illnesses. Having lost two children, Deka Dacar was at the forefront of the awareness campaign.
"I'm in pain for losing my two kids," said Dacar. "I will not allow another mother to lose her children when we have vaccines."
Parents, especially mothers, turned up with babies in arms. County authorities announced the vaccines would be administered to children aged between nine months and five years. Across Mandera County, that meant about 155,000 children were eligible.
"We are here to sensitise parents on the importance of dispensing vaccine jabs to children. I'm delighted because mothers have come in large numbers. Even grandparents are coming to learn more about measles and vaccines," said Ali.
Two major challenges loomed: transportation and security. Luckily, the county public health director assured residents of maximum protection from the police.
"I'm here to assure everyone's security. In addition, the county government will provide a fully fuelled four-wheel drive to the clinicians," said county public health chief Issack Adan.
Equipped with vials of vaccine, health workers Awad and Ali administered jabs to the eligible children while police officers armed with guns assured everyone involved of their safety. A hundred kids were vaccinated on the first day alone.
“Vaccines remain the safest way to keep our children healthy and safeguard their future. A healthy child is a beaming tomorrow”
– Sudani Abdi Awad, Mandera County health worker.
"My son is a little over a year old. He has received his first injection of the measles vaccine," said one mother, Astur Ayaan.
"My young daughter hardly knows how to walk. She was developing a fever, but the clinicians have said it is nothing dreadful. She has gotten her measles vaccine shot. She is ready to conquer the future with a healthy body," Barkhado Amina, a mother of three, told VaccinesWork.
Awad and Ali professed their willingness to make sure all the children of Banissa Constituency were protected against measles, no matter how long the vaccination campaign would take.
"Vaccines remain the safest way to keep our children healthy and safeguard their future. A healthy child is a beaming tomorrow," said Awad.
County health authorities said they would keep an electronic record of all children for future vaccinations.
"Routine immunisation will prevent future recurrence of measles and other diseases preventable by vaccines. We have about 150,000 eligible children across Mandera County. We will ensure all eligible children in Banissa Constituency and the whole of Mandera County will receive their jabs," said Adan.