It is hard to know the pain and discomfort three month-old Peter*(real name not given to respect privacy) is going through. But just looking at the rash all over his body gives you an idea.
Peter is among many children infected with measles and admitted at the National Referral Hospital in Honiara, Solomon Islands. A special measles ward has been set up to deal with a terrible outbreak. But it is not big enough and dozens of children have to be placed somewhere else along the emergency unit, either on a bed in the corridor or on the floor. Others have to be taken back home since there is simply no space for them.
As I entered the Ward, Peter’s mother carefully and gently laid him down to sleep and with a sigh of relief turned around to look for something to drink and eat. For the past few hours,she was struggling to stop his crying and get her baby to sleep and it was obvious that she was exhausted.
Peter’s parents noticed something was wrong with him over the weekend when he got a high fever:
“We were worried because he refused to eat and was very grumpy. We could also see what looked like small red patches along his neck and chest and that’s when we brought him here to the hospital,”his mother told me.
When I met Peter and his parents on September 1st, the measles had spread to his legs. “Just yesterday when we brought him in the red rash could only be seen on his neck and chest but now it has spread down to his feet,” his concerned father explained.
As I made my way out from the hospital through the emergency ward, I saw a mother sitting on the corridor floor of the emergency ward with her small son on her lap. “We have been here for more than an hour waiting to see the nurse and because the seats are all occupied I have to sit with my son here, I do hope a nurse can look at my baby soon,” the mother explained with a worried look..
Since the outbreak began in July, two children under 3 months old have died due to measles related complications. Almost 800 cases of measles have been reported to the Ministry of Health and Medical Services Surveillance Unit and with measles being a very infectious disease,and not all cases being reported, the Ministry reckons the real number could be in the thousands.
Measles cases have been reported in Malaita, Guadalcanal, Isabel, Western, Temotu and Renbel Province. The Ministry of Health and Medical Services (MHMS) is conducting a special mass vaccination campaign, to include everyone from 6 months to 30 years of age across the country.
In addition to the hardworking nurses, doctors and other health care workers who are doing their best to both prevent and treat cases, others are working behind the scenes. UNICEF is working with the MHMS and WHO, and has sent vaccines from its regional emergency stock in Fiji, and is procuring hundreds of thousands more doses on an urgent basis. The Government of Fiji is also loaning vaccines and a two international vaccine funding donors have committed funds.
The vaccination campaign is a massive effort and requires everyone’s cooperation – every Solomon Islander needs to get the word out and encourage or help everyone 6 months to 30 years old to get vaccinated! Together we can stop this terrible outbreak.
· If you or your child is aged 6 months to 30 years of age, go to one of the eight satellite clinics in Honiara or if you live elsewhere, to your health clinic for a measles vaccine.
· The Honiara satellite clinics are located at: Art Gallery, Burns Creek Community Field, Kobito Community Hall, Kukum Field, Lawson Tama Field, Panatina FOPA village, Rove Police Club, and White River School.
· If your child received their first dose of the measles vaccine more than one month ago, take them to a clinic for a second dose.
· The vaccine is free, safe and effective; the best protection against measles.
· If you have symptoms of measles (high fever, rash on face and body, runny nose, red eyes) visit your health clinic and keep away from others.
· Solomon Islands: Over 800 cases were reported to the National Surveillance Unit at the beginning of September, with majority of cases from Honiara. Incidence is higher in the age bracket 15 to 19 years of age. So far two measles-related deaths in children under three months. GAVI and MR Initiative have agreed to the government’s proposals and have advanced the funds to conduct SIAs up to 30 years. Already SIAs are underway covering up to 30 years in HCC and 2 GP zones (and up to 5 yrs in the rest). 65,000 additional doses of MR are available in the country. Additional 470,000 MR doses have been requested by the government. Also the government has requested for additional TAs in communications and operations.
– UNICEF Country Office response: Deployed 1 EPI consultant and 1 Communication Specialist. Recruiting additional consultant to support the SIAs in mid-September. Contributed to drafting the funding proposal and SIA action plans. Liaise with WHO HQ, WPRO, EAPRO, CDC and MR Initiative. Distributed/donated 65,000 MR doses from the regional stock and plan to send additional 200,000 doses by the second week of September. These vaccines were ordered in advance (prior to government request) as a precautionary measure. Additional 270,000 MR doses will be procured and shopped directly by UNICEF Supply Division.
– UNICEF field response: Serving as part of the activated MoH Emergency Operations Center (MEOC) to manage and coordinate on a daily basis the measles outbreak response in Honiara and other provinces. Serving as a member of the EPI technical committee. Contributed to drafting the funding proposal and SIA action plans. Supporting the SIAs implementation by training staff, microplanning and developing communication/social mobilization plans. Vaccination tents supplied across Honiara City Council for the mass campaign.
– UNICEF field response: EPI consultants have participated in planning and implementation of SIAs. Advising the government on technical matters.
– Funding: MFAT is supporting the travel cost for the Samoa-based EPI consultant and the 3-month EPI consultant. DFAT supported the procurement of the SUV. Both MFAT and DFAT have contributed to the Vaccine Independence Initiative (VII) which was the mechanism for ordering the MR vaccines.
· Rest of the region: UNICEF Country Office has developed the attached draft risk assessment tool with input from WHO to assess the current situation in the region. According to the tool, 5 countries are deemed as “high” risk in term of measles transmission. They include Vanuatu, Samoa, RMI, Tuvalu and Kiribati. Vanuatu and RMI are already taking steps to mitigate an outbreak. UNICEF is holding discussions with WHO to determine action points with Samoa, Tuvalu and Kiribati. Also attached is a roster of technical staff/consultants deployed to various countries.
· Forecasting for 2015 has started. All vaccines for 2014 except HPV for Cook Islands have been distributed. We are now trying to restock the regional warehouse to assure adequate buffer.
· HQ-SD-RO mission: Final ToRs were circulated. HQ and RO have confirmed their attendance and will pay for their travels. SD has yet to confirm. Oz Mansour is being recruited to support this effort. There are also talks of changing the venue which should be discussed further.
– Action point: It would be good if you kindly communicate with everyone about the change of venue (if final decision is already made) and with SD about its attendance.
· SD supported position in Suva has been decided. We are awaiting a response. Discussing with Devraj about where this person should be based (Operations or Program).
By Atenia Tahu,
UNICEF Solomon Islands Field Office