|
 Public health researchers say missing out the Syrian province
contributed to the reemergence there of polio, a highly infectious,
incurable disease that can paralyze a child within hours but has
been wiped out in many parts of the world.
In November, the World Health Organisation (WHO) said 13 cases had
been found in the province. Two more have since been recorded there
and the virus has surfaced in Aleppo city and near Damascus, the
first outbreak since 1999 in Syria, where civil war has raged since
a crackdown on protests in 2011.
A Dec 6, 2012, WHO statement said it, in conjunction with the Syrian
Ministry of Health and the United Nations Children's Fund, had
launched a campaign to vaccinate "all children below the age of five
against polio".
It said the campaign, involving 4,000 health workers and volunteers,
would cover roughly 2.5 million children in 13 of Syria's 14
governorates except for Deir al-Zor as "the majority of its
residents have relocated to other areas in the country".
It was not possible to contact the Syrian government for comment on
its reported decision to leave out Deir al-Zor, a region of roughly
1.2 million people, where more than 600,000 under 15s were living in
2012, according to WHO data.
By December of that year, rebels had taken territory in other
provinces as well.
While international agencies support such vaccination campaigns,
designed to fill gaps left when emergencies prevent routine
vaccinations, it is a country's government which decides when and
where they will take place.
Asked to comment on researchers' allegations aid groups should have
raised the alarm earlier and prepared better, Chris Maher, who is
coordinating the regional polio response for the WHO, said it had
warned vaccination rates were falling.
The Dec 2012 and the Oct-Nov 2013 campaigns were planned and
organized in response to that, he said. "In a complex emergency
setting, it is not that easy to continue routine campaigns."
PARTIAL VACCINATION LATER
Maher said it was reported that 67,000 children under the age of
five were subsequently vaccinated in Deir al-Zor in January 2013.
Public health researchers say that is a coverage rate of around 50
percent, insufficient to prevent polio from spreading, based on
census data. The actual population is hard to establish; some
residents fled while other people fled into Deir al-Zor from
elsewhere.
Repeated vaccinations and high coverage levels are needed to
interrupt transmission of the virus and prevent outbreaks.
"There was a lack of a proper campaign to vaccinate children across
the country over the past two years," said Dr Adam Coutts, a
Lebanon-based public health researcher who has been studying the
humanitarian response in Syria.
"With the breakdown of the health system, sanitation and nutrition,
the exclusion of Deir al-Zour from the vaccination campaign provided
the ideal conditions for an outbreak to occur."
It was not clear why the remote province near Syria's border with
Iraq was singled out. The city of Deir al-Zor is partially
controlled by Syrian government forces while the countryside around
it is in the hands of rebels fighting to remove President Bashar
al-Assad.
[to top of second column] |
Maher did not say whether there were other vaccination campaigns in
Deir al-Zor during 2012 but confirmed that there was one in October
this year, around the same time that polio cases were found in Deir
al-Zor.
Asked if he thought leaving a gap in the 2012 campaign allowed polio
to take hold in Deir al Zor, Maher said: "There are unimmunized kids
all over Syria."
"I have no information that that particular area was higher risk
than anywhere else given the general deterioration of immunization
rates during the conflict."
He said polio vaccination coverage had dropped across Syria from
more than 90 percent in 2010 to below 70 percent in 2012.
United Nations humanitarian agencies work in Syria with the
permission of the Syrian government, which has blocked aid convoys
to some areas of the country. Opposition fighters and clashes have
also hampered access for aid work.
Despite dramatic progress many parts of the world thanks to a
25-year-old campaign to eradicate the disease, Polio is still
endemic in Pakistan, Afghanistan and Nigeria.
There is no cure and it can only be prevented through immunization,
usually three doses. The WHO's long-standing and repeated warning on
the disease is that as long as any child remains infected, children
everywhere are at risk.
"Questions remain as to why WHO did not better prepare for this,
given their own recognition about the risk of outbreaks," said
Coutts, whose colleague Dr Fouad Fouad shares his concern.
The WHO says the largest-ever immunization response in the Middle
East is under way, aiming to vaccinate more than 23 million children
against polio in Syria and neighboring countries.
"Inside Syria, the campaign aims to reach 2.2 million children,
including those who live in contested areas and those who were
missed in an earlier campaign. Many children in Syria remain
inaccessible, particularly those trapped in sealed off areas or
living in areas where conflict is ongoing," it said.
The WHO says almost 2 million children in Syria have already been
vaccinated, including 600,000 in contested areas of the country, in
the first of several rounds.
Coutts says public health professionals in the region are concerned
that this response is "too little too late and is exposing a deeper
failure of regional health agencies and systems to respond to a very
predictable health crisis".
(Editing by Kate Kelland and Philippa Fletcher)
[© 2013 Thomson Reuters. All rights
reserved.] Copyright 2013 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed. |
