Ethiopian street children vaccinated against measles

Report
from American Red Cross
Published on 04 Nov 2003
Andrei Neacsu , Special to RedCross.org
"Today is measles vaccination day!" With his voice booming through a megaphone, Lufthansa's message travels far and wide over the city of Woliso in Ethiopia. "All children between six months and 14 years of age must come to the Red Cross post for immunization!"

Lufthansa is a Red Cross volunteer, known and respected by all in the community. At every corner he stops to chat with a young boy or girl, making sure that they will come for their measles vaccination.

In front of the mosque, he approaches a group of street children. Squatting down to their height, he explains that "it will take less than a bee sting" for them to be healthy.

The boisterous group then leaves together for the vaccination center. But a few hundred feet up the road, next to the church this time, another group of street children is more reluctant to get the "bee sting."

Chewing the grains of roasted wheat offered by the priests at the church, Shoanes, Haile and Zena are three boys who were "chased by poverty" from their home village of Galie Rogda. They walked for three hours then took the bus - a five birr (the Ethiopian currency) fare - to make it to Woliso where there is more opportunity.

"We're healthy, thank you," says 11 year-old Haile, visibly frightened by the prospect of receiving an injection. As a larger group of curious children gathers by the church, the Red Cross volunteer asks them, "Anyone here got his kufin (measles) vaccination?"

"Ishi, ishi! - yes, yes!" reply several of them, hands raised in pride. Reassured that "it didn't hurt at all," the three street children agree that they will soon be vaccinated as well.

The Ethiopian Red Cross (ERCS) believes that boys like Shoanes, Haile and Zena represent up to 50 percent of those missing the routine immunization campaigns.

"We have put a particular focus on reaching this high risk group [of children living on the streets]," explains Cecilia Brunnström, a Swedish Red Cross delegate and International Federation's representative in Ethiopia. Her national society was a key supporter and donor to the ERCS in this campaign.

In turn, the ERCS and the International Federation are part of a wider partnership involving a number of global public health organizations, including the World Health Organisation, UNICEF, the Centers for Disease Control and Prevention, the UN Foundation and the American Red Cross, which are aiming to drastically reduce measles mortality. Some 30 million children contract measles every year. Of those, 745,000 die, making it the deadliest vaccine-preventable disease.

"It costs less than a dollar to vaccinate a child against measles," says Brunnström. In Ethiopia, one dollar represents the equivalent of a loaf of bread. That dollar covers the costs of all necessary resources, including the vaccine, syringes, cotton balls, the safe disposal of syringes, training for volunteers and the resources for spreading the word about measles in local communities.

"The cost of the treatment for a child suffering from measles, however, is almost 100 dollars," says Dawit Legesse, measles campaign coordinator in Woliso. "That represents a serious burden for the health authorities and a sum impossible to put together by most Ethiopian families."

In Debre Birhan, a region where the Red Cross is targeting an additional 100,000 children at risk, everyone remembers the impact of last year's measles epidemic -- particularly the more than 1,600 children and their teachers at the Kait primary school.

During the epidemic which hit the community in November and December 2002, as many as 50 percent of the children missed school, as they suffered the fever, rash and insomnia associated with measles.

It took two months for 10-year-old Gebre Mikael to be cured and meet his school mates again. His eyes fill with tears as he recalls "the pain in breathing and the very bad stomach" he suffered. These are most probably signs of pneumonia and diarrhoea, two of the most common - and sometimes fatal - complications of measles.

In Gebre's class alone, 13 out of 30 pupils raise their hands when asked if they had measles last year. It is a similar reaction in many other classrooms visited by the Red Cross team, who is determined to get all children vaccinated. Even if they cannot walk there, like 10-year-old Elias, the Red Cross will make sure all children have access to the vaccination.

Seven years ago, Elias fell on a patch of blood from a freshly-slaughtered ox. Afterward, he got a high fever and could no longer walk, according to his mother. Judging by the boy's limbs, the cause looks more likely to have been polio, but because he couldn't walk he was transported in a Red Cross ambulance to the vaccination post and won't have to suffer measles in addition to his disability.

By the end of 2003 a total of 20 million Ethiopian children should have received their measles vaccine, in addition to Vitamin A supplements. The drive will not only have saved many families from the anguish of losing loved ones, but will also have represented a saving of 8 billion birr (US$ one million), which otherwise would have been spent on the cost of transporting and caring for measles cases.

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