UNHCR, 06 Aug 2011
UNHCR fears the outbreak could lead to high mortality and serious illness in an already vulnerable refugee population whose overall health was already fragile. An outbreak could also reverse the progress which had been made over the last several weeks to stabilise Somali refugees, many of whom arrived in Ethiopia in extremely poor health.
Officially, there have so far been 47 cases and three deaths from suspected measles in the Kobe camp of 25,000 people over the last week. But on 04 August alone, community health workers reported 25 deaths in the camp, half of which were suspected to be from measles. Refugee children are the most affected. Other suspected cases have been reported in the other two refugee camps in the area, as well as in the transit centre where there are just over 15,000 refugees awaiting relocation to the newly-opened Hilaweyn camp.
According to medical experts, measles in healthy populations does not kill but measles complications do. In the context of the refugee camps in Dollo Ado, the mix of measles and high levels of malnutrition can be fatal.
This situation is alarming and we cannot afford to wait. We must act now, urgently and decisively, to arrest and turn around this situation, Moses Okello, UNHCRs Representative in Ethiopia, said after returning from Dollo Ado for a first-hand assessment of the situation.
Okello who said he was shaken by the situation in the Dollo Ado camps, held an urgent meeting Saturday with Ethiopian Government officials and UNHCR health partners to agree a plan of action. He said the number one priority is a mass vaccination campaign noting that the emergency required seamless teamwork for an effective response. He called on all UNHCR health partners to scale up their capacity to meet the extremely serious public health challenges. UNICEF and WHO, through Ethiopia's Ministry of Health, are providing the needed vaccines.
Vaccination of all children between the ages of six months and 15 years of age was started Friday for all refugee children being transferred from the transit centre to the newly-opened Hilaweyn camps. Some 300 children were vaccinated before relocation and seven cases of suspected measles isolated for in-patient care at the transit centre. The relocation is expected to be completed within a fortnight with daily convoys of 1,000 people.
Following Saturdays meeting, UNHCR and the government will lead a UN/NGO team of health experts to Dollo Ado on Sunday, 07 August to support the roll-out of a plan of action which includes the preparation of a mass vaccination campaign to begin August 09 for all children aged six months to 15 years in Kobe camp -- the most affected camp. The vaccination campaign which will include vaccination against polio will be extended to the other camps as well as to the hosting communities where deemed necessary by the health authorities.
Health workers emphasised the importance of proper management of identified suspected measles particularly as vaccines provide protection only 14 days after administration. They also agreed to strengthen surveillance and case finding using community health workers, set up satellite and mobile health clinics to improve access to health services and intensify a mass information campaign which started Friday. An isolation ward in Kobe camp is also being set up and additional health personnel are being dispatched to help manage this ward as well as additional clinics in the camps.
Health experts said high rates of acute malnutrition, low vaccination coverage in Somalia and overcrowding in the camps are some of the aggravating factors associated with this outbreak. They also cited poor hygiene habits and poor health-seeking behaviour as challenges.
Before the outbreak, UNHCR and health partners, including the government, had significantly increased their health response capacity in the camps to address high malnutrition rates among the newly arriving refugees and the overall poor condition of the population. There are now malnutrition programmes in all camps as well as in the transit and border reception centres. All refugees in the transit centre are provided two meals a day to boost their nutritional status. Round-the-clock health services are being provided and access to the facilities improved through ambulance services. These have been complemented by public health campaigns and door-to-door identification of the sick and malnourished.
As of 05 August, the number of Somali refugees in the Dollo Ado camps had reached 118,400. Nearly 78,000 of them arrived this year. This is in addition to more than 41,600 Somali refugees in the Jijiga area of the Somali region. Ethiopia hosts a total of 237,500 refugees mainly from Somalia, Eritrea and Sudan.