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South Sudan: “We vaccinated children in sandstorms.” How our emergency team saves lives

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Source: Save the Children
Country: South Sudan

Dr Nicholas Alusa, member of our Emergency Health Unit

Measles is a highly contagious, horrific disease. If left untreated, in a worst case scenario, it can lead to death.

There’s no specific treatment for measles: all that medics can do is isolate the sufferer, give them vitamin A, and hope for the best.

In high-income countries most people infected with the disease recover in a couple of weeks, very few die. But in developing countries it kills up to one in five.

A safe and cost-effective vaccine does exist. But families in remote areas, in countries with weak health systems, struggle to access it.

An emergency unfolds

Mayom County, in rural northern South Sudan, is one such place. A remote population in a country whose infrastructure has been crippled by civil war, no children have received routine vaccinations here for over two years. In January a few suspected cases of measles appeared, dotted around the main town. By the end of February, the county was in the grip of a fully-blown outbreak.

Nearly three quarters of the cases were children. If someone didn’t act fast, a tragedy of enormous scale was on the horizon: tens of thousands of children were at risk.

Previously in situations like this, we would have to spend time pulling together teams of specialists and supplies – a delay that costs lives. But last year we revolutionised the way we get medical care to children in emergencies, when we launched the Emergency Health Unit.

The unit is made up of fully-formed, world-class teams of medics on standby all over the world, ready to deploy within hours – complete with equipment, supplies, and logistics experts like me with the skills to get everything where it’s needed quickly.

When you have pre-positioned supplies you don’t have to spend time initiating the supply chain process, raising a procurement form, searching for funds, finding suppliers who can take months…while children in emergencies wait. That’s why these kits are so important.

Transforming emergency care

As soon as we heard about the measles outbreak in South Sudan, my team was mobilised. Within two weeks of the outbreak being announced, we were on the ground vaccinating children in 18 clinics and 24 mobile outreach centres.

Tracking the population in South Sudan is difficult, especially since the outbreak of conflict and the huge movement of people it has caused. A rough estimate told us we could expect to vaccinate around 26,000 children. Three weeks later, we had vaccinated 44,447.

We linked up with local staff and infrastructure and worked with the community to raise awareness on our behalf and tell people we were here. Word spread quickly, and after receiving 60 children on the first day, numbers rapidly swelled to up to 400 daily. Reaching out to the community in this way is so important to our work in emergencies – we would never have reached as many children as we did without their help.

A medal of honour

The infrastructure in Mayom is poor – it’s difficult to reach this part of South Sudan, and many NGOs are reluctant to attempt healthcare here. We relied on an array of transport, including motorbikes and canoes, to reach the most remote communities. We travelled across rough, rugged terrain and collapsed bridges, and vaccinated children in the middle of sandstorms.

We hurried, carrying life-saving vaccines that melted at three times the normal speed in Mayom’s 40-degree heat in precious cool-boxes . All while wearing what my colleague Nathalie calls the ‘Mayom suit’: head-to-toe dust.

In one rural cattle ranch our team leader, Koki, was heavily spat on by an elderly man on our arrival. “Hey, what’s this?” Koki said at the time, wiping the slimy liquid from his forehead. It turned out this was a sign of appreciation from the old man, who in his lifetime had never seen any NGO reach his remote community. ‘’Being spat on by an old man signifies immense blessings bestowed upon Save the Children!’’ a local health official told us.

And this salivary medal of honour feels truly earned. It was an incredible achievement: in this most inhospitable of environments, we did whatever it took to protect the vulnerable children in this isolated part of the world. Our new system works: in just three weeks, 44,447 children were permanently saved from a potentially deadly fate. A catastrophe was averted.

Now – what’s next?

Nicholas Alusa Dr Nicholas Alusa is an experienced pharmacist and medical logistics expert working as part of our new Emergency Health Unit, a major change in our work. The Unit consists of immediately deployable teams containing the ideal combination of medical and operational specialists, strategically positioned in emergency hotspots around the world and fully equipped with the best tools for the job. We can deploy these teams in a matter of hours, putting them at a child’s side, giving them the treatment they need in those critical early stages of an emergency.


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