From the sky, the Dadaab Refugee Camp in Garissa County
looks like a tuft of green hair in the balding savannah that is the
northern part of Kenya.
Sporadic clouds throw black
splotches that look like burn scars on the pale peach-hued earth. To the
sympathetic eye, the camp looks like an oasis in the middle of the
parched land that stretches to the Kenya-Somalia border where terrorism
has interrupted the rhythm of life.
That Dadaab looks
like an oasis is no accident of history or geography. Humanitarian
organisations have teamed up to sink boreholes that can produce over a
million cubic litres of water at short notice. An intricate arterial
network of invisible pipes distributes this water to various blocks in
the refugee camp.
This is the lifeline of the 209,606 refugees, mostly Somalis, who call the camp home.
Every
few metres, a nod in this system forms a water collection point from
which a cluster of households collects water in yellow jerricans, which
the boys take home in improvised wheelbarrows or which the women roll on
the ground by pushing the jerricans with their feet.
Two-year-old Maida Abdulhakim lives in one such household
in Block L4. On the second day of the polio vaccination campaign that
ends today, Maida had accompanied her mother, Ms Warsan Muhamud, to the
L6 health post where she and other refugee women run a demonstration
kitchen garden where they learn how to grow various food crops like
sukuma wiki and spinach to supplement their diets.
Those
who are good at it also grow a surplus, which they sell to other
families in the camp. Although the group is called the Mother-to-mother
Nutrition Support Group, it has men and girls among its members. They
all learn from one another on how to improve the health of their
children, such as Maida.
"Has
this child been vaccinated?" someone in the group asks as others water
the vegetables in the demo garden. It turns out that she has not. At
once, Mr Jamal Abdi, the community health promotion officer with the
International Rescue Committee gets on the phone and calls the nearest
team of vaccinators.
As the man in charge of
co-ordinating the polio vaccination campaign in the camp, he knows where
each of the 29 mobile teams of vaccinators work from.
In a short while, the team — comprising the team leader, community volunteer and vaccinator — arrives.
After explaining to Ms Muhamud what the vaccine is about, she consents to have Maida vaccinated.
It
only takes two drops of the Bivalent Oral Vaccine, which Mr Mohamed
Ahmed, the Unicef education specialist at Dadaab, administers for
demonstration purposes.
Maida
proudly shows off her little finger after the vaccinator paints her
nail with the black indelible ink, the sign that her immunity from the
debilitating disease has been boosted. Maida, like the other 35,000
refugee children targeted in the latest campaign, can expect to be free
of the incurable disease that is caused by poor sanitation or contact
with infected faecal matter.
The vaccination campaign,
which was launched after the polio virus was found in Eastleigh,
Nairobi, in April, is just one aspect of a holistic approach to ensure
that children in the camp live a healthy life.
However,
ensuring that only refugee children are vaccinated from polio would be
ineffective if the same is not done with children from the host
community, who have constant contact with refugees since movement into
and out of the camp is not restricted.
Garissa
has seven sub-counties and Dadaab is one of them. This is where the Ifo
and Dagahale camps, which form the larger Dadaab refugee camp, are to be
found. As the sub-county health promotion officer, Mr Abdulrahman
Bashir, a lanky man with a deep voice, has the responsibility of
ensuring that all the children under five in the host community are
immunised.
His job is more difficult than that of Mr
Jamal Abdi. In the camp, it is easy to find the children since the
refugees are sedentary. However, the host community is not. This means
that Mr Bashir has to work harder to find the families and vaccinate
their children to ensure that they are not exposed to the highly
contagious polio virus.
Last Saturday, a day after the
vaccination campaign for the 12 high-risk counties was launched in
Garissa town by Health Cabinet Secretary Cecily Kariuki, Mr Bashir
summoned his team to the Dadaab Hospital to start the onerous task of
finding and vaccinating the 18,666 children under the age of five in the
sub-county. As luck would have it, a baby born at the hospital that
very morning was the first to be vaccinated.
HUMANITARIAN ORGANISATIONS
Unlike
the refugee community, where the vaccination campaign is supported by
humanitarian organisations, the local community depends entirely on
funding from the ministry of Health.
"The budget for
fuel was not enough to cover the entire sub-county," he said. Although
he was allocated one vehicle, he felt that an additional one would have
made the campaign more successful. He also had money to hire six people
to work as mobilisers although he needed more considering that some
parts of the sub-county are unreachable by vehicles.
"We have had to be innovative," he told the Nation.
To
his credit, on the first day of the campaign, his team vaccinated 5,994
children, translating to 95 per cent of the target for that day.
Thankfully,
Mr Bashir and his team have two things going for them. The first is
that since the refugee community has been sensitised about the
importance of the vaccine, this high level of awareness has rubbed off
on the host community. Secondly, the team does not need to vaccinate
practically every child there is.
"When majority of the children get the vaccine, the rest get what is called 'herd immunity'," says Mr Bashir.
The
last case of polio reported in Kenya was that of Awil Awad Abdoule, who
got the disease in 2013 when he was 19. He had fled from the violence
in Somalia at the age of 10. But because he had never been immunised, he
woke up one day and found that he could not stand on his own.
He also manifested other signs associated with polio, such as fever and weakness of the muscles.
Like many Somalis fleeing to safety in Kenya, Abdoule was not screened when he crossed into the country through Liboi.
Such unregulated free movement of people across the border has major implications for public health and safety.
And
although the International Organisation for Immigration has built a
border check point at Liboi, Kenya is yet to send immigration staff
there though having a strong health team at Liboi has the potential to
reduce risks and strengthen the national health system.