Nationwide measles campaign launched in Yemen
SANA’A, March 10 (Saba) – The Government of Yemen in collaboration with UNICEF, WHO, USAID, ICRC and other partners Saturday launched a nationwide measles campaign in Sana’a, targeting all children under the age of ten – an estimated eight million.
This campaign comes in the wake of an outbreak of the disease in the past few months, with over 3600 reported cases and 126 children under the age of five confirmed dead.
This situation is unacceptable,” says UNICEF Representative Geert Cappelaere. “Measles is a preventable disease and Yemen was close to being declared measles free in 2010 with zero deaths.”
The disease is spreading fast, reaching highly populated areas as well as areas with high levels of acute malnutrition. There is deep concern that many more deaths might occur, particularly among children, which makes today’s campaign even more urgent.
“Measles is a big killer of children” says WHO Representative Dr. Ghulam Popal. “Measles can be easily prevented by vaccination. The high rate of malnutrition and diarrhea among children would increase the fatality of measles. Therefore, it’s very important to implement the national campaign to prevent thousands of deaths among children.”
As a direct result of the 2011 conflict, immunization rates dropped dramatically, by up to 60% in some areas. This decrease in coverage risks exposing children to easily preventable diseases such as poliomyelitis (infantile paralysis) and measles.
The US$9 million campaign (costing an estimatedUS$1.10 per child) will be conducted in phases with phase I planned for 10-15 March, targeting 1.5 million children in regions with the highest reported incidence. These are the conflict affected governorates of Abyan, Al-Baidha, Aden, Dhamar, Lahj, Shabwa and Saada. Phase 2, which will cover the rest of the country, will be launched at the end of March.
The following article I wrote in 2006 about a chickenpox outbreak in a rural village shows the devastating impact of that preventable diseases have in Yemen and some of the challenges that will be faced in the vaccination campaign:
A Village in Yemen: A Day in the Life of a Failing State
Jane Novak, Worldpress.org contributing editor, June 9, 2006
An outbreak of chickenpox in Yemen goes a long way in demonstrating the challenges of daily life for Yemeni citizens. The incident is also a snapshot of the factors that may lead Yemen toward state failure.
Barhan is a typical village in Yemen where most villages have no electricity, no sewage system, and no clean water. Nationally, one in 10 kids dies by age five; contaminated water contributes to half their deaths. Of the millions of kids not in school, the highest percentage is among rural girls.
Barhan has reported over 90 cases of chickenpox, including a number of severe cases. Generally, infants, adolescents, and adults are at higher risk to develop complications from chicken pox including pneumonia and encephalitis. If a pregnant woman contracts chickenpox, the fetus is at risk for birth defects. The highly contagious disease has spread to all households in Barhan, which has no doctor, and the village of 1,200 people is at risk of developing 85 percent infection. The village’s only road is under blockade by a neighboring village.
The Yemen Times, which recently won an International Press Institute Award for courageous reporting in an extremely hostile press environment, interviewed a member of the Health Ministry. The source did not want to be identified:
“We sent a message to the Epidemic Monitoring Department’s director general, which told us it’s a disease not subject to Health Ministry monitoring and that it’s not dangerous. We were told to contact Director General Dr. Abdulhakim Al-Kuhlani, who refused to talk to us, giving certain excuses.”
Barhan village has no doctor, no nurse, no midwife, and no hospital. Medical practitioners are scarce in the Yemeni countryside where 70 percent of the population resides. There is one doctor for every 600 people in the capital Sana’a, one doctor for every 12,000 people in Dhamar governorate, and one doctor for 90,000 people in Otma province. Yemen allocates just 1.3 percent of GDP to healthcare and over 7 percent to military spending. (The military and security forces are largely headed by President Ali Abdullah Saleh’s relatives and tribesmen.)
In addition to low funding levels, medical care is hampered by bureaucratic corruption and inefficiency. By failing to distribute medicines in 2005, the Medicine Fund allowed 60 million Yemeni rials in medicine to expire on its shelves. Smuggling accounts for about 40 percent of medicines in circulation. Even when legitimate medicine is available, it is hard to afford for most Yemenis when nearly half the country lives on less than two dollars a day and many more live close to this level.
In response to the outbreak in Barhan, the Ministry of Health sent a doctor to the village for one day and released a statement that the outbreak was contained. The villagers were promised medicine and doctors. They are still waiting as the virus spreads.
The only road from Barhan is under blockade by a hostile neighboring village. Tribalism is growing in Yemen and the blockade arose as revenge. The freedom to travel is restricted for a fair portion of rural citizens due to tribal hostilities that often erupt in shootouts and deaths. One Barhan resident said, “We are living two tragedies: one involves the blockade and the other involves the epidemic.” Living in fear of an attack by the neighboring village, residents are unable to transport their sick relatives to a hospital. Barhan is only 40 kilometers west of the nation’s capital city of Sana’a.
Barhan has received no help in securing the road from the military or security forces, recipients of about 40 percent of Yemen’s budget. Tribal disputes, arising in the absence of an impartial judiciary, are normally left to fester by the regime. The Yemeni government sometimes gets involved by taking hostages in order to pressure one of the parties involved. A 2004 parliamentary report noted scores of persons listed on prison documents as “hostages.” This regime policy can backfire: several times last year tribesmen kidnapped foreigners to pressure the regime to release or bring to trial detained relatives, including one 12 year old.
One distraught parent in Barhan told The Yemen Times, “We’ve sought the help of the Health Ministry, the capital secretariat, the local council and all concerned parties, but they’ve done nothing to protect our children from this horrific disease.”
Local councils set up in 2001 were supposed to enhance democratic participation in Yemen, but somebody forgot to tell the councils and the regime, because the local councils do not work — literally. The local councils have little training, structure, authority or coordination with central authorities. Executive council meetings are poorly attended. A Barhan resident explained:
“They’ve done nothing ever since we elected them to be our representatives, to adopt our concerns and issues and solve them in coordination with Sana’a authorities. They’ve disappointed us.”
Other “democratic” institutions in Yemen are equally disappointing. Parliament is dominated by the General People’s Congress Party (G.P.C.), which is headed by President Saleh. Parliament does little beyond shuffle oil revenue in mysterious ways. M.P.’s who try to advance the interests of the public are called traitors. The minority opposition parties hotly criticize the authoritarianism of the regime but are undemocratic in structure and practice themselves. There is an election coming in September for both the presidency and the local councils. With voter registration processes in the hands of G.P.C. loyalists, so far there is about a million questionable voter registrations, according to one opposition tally about 11 percent of the rolls. Yemen is on the road to becoming a one party state, and an ineffectual one at that.
In a region filled with dictatorships, the one in Yemen is particularly incompetent and distinctly corrupt with a good portion of public funds stolen, borrowed, embezzled, paid as bribes, or otherwise misappropriated. The chicken pox vaccine is 95 percent effective in preventing a moderate or severe case of chicken pox. Other remedies are available for people who have already been exposed, including infants, to reduce the risk of a severe case. Yet at the top of Yemen’s shopping list are helicopters, Mig-29 fighter planes, and armored personnel carriers.
In the run up to the election, President Saleh has taken a road trip around the nation, laying cornerstones and making promises. In the little village of Barhan, 1,200 people remain blockaded with no doctor and a rampant infectious disease. They have no government. There are 129,229 villages and districts in the Yemeni countryside. The lack of basic services, security, and democratic institutions affects them all.
Jane Novak is an American journalist and political analyst.