By Katy Migiro
Wednesday, May 04, 2011
Kenya has experienced repeated measles outbreaks despite regular national immunisation campaigns because of an influx of unvaccinated refugees and illegal migrants from neighbouring war-torn countries where health systems have broken down.
The latest outbreak started in November. Health officials say doctors in Kenya's northern Kakuma refugee camp treating a child infected with measles, traced the origin of the disease to Eastleigh, an area in Nairobi dominated by ethnic Somalis.
In response to the problem, the Kenyan government launched a measles prevention campaign in Eastleigh on Tuesday, working with trusted community leaders to raise awareness of the disease among Somali refugees -- many of whom are unregistered in Kenya.
The campaign is also using leaflets that explain in Somali the symptoms of measles and the importance of vaccination, with pictures for those who are illiterate.
Conflict and lawlessness in Somalia since the 1991 ouster of dictator Mohamed Siad Barre has caused hundreds of thousands of Somalis to flee the Horn of Africa country, which has become mired in an Islamist insurgency against the weak government.
Fear, ignorance and poverty often prevent refugees from seeking health care, aid workers say.
“If I am here illegally in the country, the last thing I am going to do is go all the way across town to a government clinic because I am going to get accosted (by the police) on my way there,” said Greg Irving, a health officer with the International Organisation for Migration (IOM), which is co-hosting a conference on migrant health in Nairobi this week.
“You are going to hide and the services aren’t going to reach you," he added.
Vaccination programmes are also hampered by misinformation, Wilbert Shihaji, IOM’s national migration health officer, said.
"People have all sorts of wrong beliefs (about immunisation). People say that their children are being sterilised. People say their children are being injected with HIV," he told AlertNet.
FALLING THROUGH THE CRACKS
Kenya hosts around 450,000 legal refugees, 10 percent of whom are registered in Nairobi, according to the U.N. refugee agency UNHCR. Most of them are Somalis, followed by Ethiopians. But the number of illegal refugees and migrants in the capital city is unknown.
The Kenyan government’s policy is that all refugees should live in two camps on its parched northern border.
Those living in Nairobi without the proper documentation risk arrest and harassment by the police, rights activists say.
Shihaji estimates that 500 new migrants flock to Eastleigh suburb every day.
“There is a huge population of migrants who are here illegally, undocumented; people who fall through the cracks; people who fall through the porous borders in the northern part of the country,” he said.
“We get to know of these people when there is an outbreak like there is now.”
IOM operates a clinic in Eastleigh where translators are provided for patients and staff are trained not to discriminate against illegal migrants.
“My people went to a city council health clinic where they were told they cannot be treated,” Halima Abdi, a Somali woman living in Eastleigh, told IOM. Two of her children were receiving treatment at the clinic for tuberculosis.
Besides measles, tuberculosis is another major health problem among urban migrants. TB transmission is common because penniless families live in crowded conditions, often with up to 10 people in a single room.
Sick people do not get diagnosed early enough, sometimes taking over-the-counter cough medication for years beforehand.
Once diagnosed, they often do not receive the full treatment, which takes six to nine months, leading to drug resistance.
“By the time it gets to the correct healthcare it is too late. Either they have developed resistance or complications,” said Shihaji.
Maternal health is another area where access to services needs to improve.
“People are showing up nine months pregnant, ready to give birth, having never been to the doctor, with the baby in backwards and bleeding everywhere and