Reaching every child: polio immunisation in Ethiopia

Amina holds her daughter in the Somali region of Ethiopia. © UNICEF Australia / Tim O'Connor
Amina holds her daughter in the Somali region of Ethiopia. © UNICEF Australia / Tim O'Connor
Amina holds her daughter in the Somali region of Ethiopia. © UNICEF Australia / Tim O’Connor

With the Australian Government and the Australian community, UNICEF Australia began supporting mobile health teams in the Somali region of Ethiopia during the food crisis of 2011. We recently travelled to Jijiga and beyond, to meet some of the children and families these vital health services are still assisting.
“I would like my little daughter to become a doctor,” says Amina Amine Hassan, as she shelters from the heat in the shadow of the Kora Health post in the Somali Region of Ethiopia.
We met Amina as she waits for her daughter to receive the two drops of polio vaccine to ensure she, like every other child in the Somali region, will be safe from the debilitating impacts of polio, which re-emerged in a handful of cases here in 2014.
Over 900,000 children under the age of five across the Somali Region are expected to be vaccinated against polio in the next few days as the national immunisation drive, targeting over 14 million children, strives to reach every single child.

Coordination, collaboration and commitment
The prior evening, we met with the Somali Region Polio Command Post, which coordinates the campaign. Presided over by the State Minister for Health, Dr Kebede, and Somali Regional Health Bureau Head, Dr Omer, we were impressed with the commitment of their team to the health of the children under their care. Representatives from UNICEF, WHO and the Somali Regional Health Bureau listened carefully to reports of daily progress in each woreda (district) and plans for collaboration to ensure the army of health workers and volunteers going door to door reach every single child under five.
The debriefing covered issues like more children presenting than was planned for in one woreda and a new supply of vaccines being required to meet the shortage. A misunderstanding meant that a group of refugees recently arrived from Somalia had not yet received access to the vaccines and accessibility issues in another woreda impeded the vaccinators from achieving their goal.
Dr Kebede took advice on each matter throughout the evening and no one was leaving until a plan was developed that would ensure every single child would be vaccinated, regardless of where they were living, illustrating the clear commitment to children. Such meetings are happening in every district and region across Ethiopia as the national immunisation drive continues.

UNICEF is working with the local health services to protect children from polio. © UNICEF Australia / Tim O'Connor.
UNICEF is working with the local health services to protect children from polio. © UNICEF Australia / Tim O’Connor.

Reaching every child

Camels careened across our path as we made our way to Kora on the main road from Babile. The narrow winding dirt track is edged by thorn bushes that keep the camels and cows from eating the crops that grow in the fields beyond. “A black camel!” exclaims Yusuf, UNICEF’s passionate health officer in Somali region, “I have never seen one before,” his ever present excitement this time bubbling over.
Simple mud huts in the typical style of this region dot the fields and mango trees are beginning to flower as the dry ground awaits the imminent rains. At the end of the road, Kora health post sits at the foot of a large hill that overlooks the vast valley below. The nearest health centre is just visible there in Babile, more than five hours walk away.
“I can’t describe how important vaccination is,” says Amina. “Immunisation protects children from dangerous diseases like measles. We are very grateful for this health post that keeps our children alive and healthy”.
It is a sentiment echoed by all the mothers we speak to as they, like all mums, want the best start for their children. “I am impressed with how the health workers here are treating people, this is why I want my daughter to grow up to be a doctor,” she emphasises. Amina has two older sons, five and four years old respectively, and has now ensured that her children are fully immunised.

Building the local capacity

“Before this health post was built here two years ago, when our children, or we, got sick we would have to go to Babile – at least five hours walk away. There is a great change now: I do not worry all the time about my children getting sick.”
UNICEF-supported integrated health teams are critical to the running of the clinic, providing vital supplies like plumpy-nut, a vaccine storage unit, antibiotics and other crucial medicines to treat potentially fatal diseases like diarrhoea and malaria. The life-saving services provided by the Mobile Health and Nutrition Team (MHNT) include: managing and treating uncomplicated medical conditions, both common illnesses and malnutrition; and referring critical medical and malnutrition cases, including complicated pregnancies and deliveries, to the nearest appropriate health facility. All MHNT members receive special training in the provision of these services.
Importantly, the Mobile Health and Nutrition Team also trains the local health workers who run the health post. With just six months training, health workers need to constantly update their skills and have regular reminders about appropriate treatment, as well as having someone to back them up when the community comes to them with more complicated cases.
In this distant part of Ethiopia, UNICEF is reaching the hardest to reach. Working with the local health bureau and the many committed health workers, children and their mums are finally getting access to the health care that is their fundamental right. Not only will this important health programme give the children that are vaccinated today the best start in life, but UNICEF is helping to build the foundations for a sustainable and effective health system for many years to come.