Despite dangers, measles vaccinators fan out across Iraq

By Claire Hajaj and Blue Chevigny

MISSAN PROVINCE, Iraq, 26 April 2007 - In one of the biggest humanitarian operations in Iraq in the last two years, 8,000 vaccinators are working to prevent a possible outbreak of measles among children, many of whom have not received routine immunization due to violence and conflict.

Iraq's Ministry of Health is heading up the measles, mumps and rubella campaign with support from UNICEF, the World Health Organization and the European Commission. According to UNICEF Special Representative for Iraq Roger Wright, the timing of the two-week vaccination drive, which began on Sunday, is critical.

"One million Iraqi children now have no protection against measles, as a result of insecurity and falling immunization rates," he noted. "This vaccine will certainly save many young lives, and we are calling on everyone in Iraq to ensure vaccinators reach children safely."

Protection for all

While special attention is being paid to Baghdad's most violence-ravaged areas, Diyala and Anbar, the vaccinators are setting out to reach children in all parts of the country. Some trained medical staff stay in health centres to immunize children brought in by their mothers, but the majority of vaccinators move door to door in teams.

"I have been a vaccinator for 15 years but never in times as difficult as this," said Fatima, one of a team of heading out each day to reach children near the Iran-Iraq border.

"We have to protect all children who have not been immunized, because measles is dangerous and deadly," she added. "We are all hoping that it goes well, because last time we tried a vaccination campaign here last December, the police said it was too dangerous for us to go out and do our work."

100 children per day

Fatima (not her real name) and others who go on foot to reach these vulnerable children take great risks by being seen out in the open, helping children.

"I am the only female vaccinator in a team with six men," she remarked. "Because I am a woman they wanted to keep me back at the Primary Health Centre for my safety. It is true that if I stayed behind I would be much more comfortable and secure. But I insist on going with them."

On the first day of the campaign, Fatima arrived at the health centre at 7:30 a.m. and put enough vials in her vaccine carrier to immunize about 100 children. "Each of us is supposed to immunize this many every day," she said.

Vaccinators targeted

Many people from other parts of Iraq have come to the area around the border with Iran to escape the worst of the violence in their country. This situation sometimes creates tensions between the vaccinators and those they are approaching, simply because they are not known to one another.

"We don't know if they will welcome us or make trouble for us," explained Fatima. "We have heard that vaccinators have been kidnapped or even shot in other provinces.

"You never know what you will face when you knock on a door these days," she continued. "We hope it will be a mother, so we can ask her if she has any children between one and five years old. If so, we immunize the children then and there, at their doorstep."

The vaccinators travel with a hand-drawn map to mark down which houses they have reached and which ones they must come back to another day. They also mark the doors of the families whose children have been successfully inoculated.

'Crucial for Iraq's future'

Unfortunately, due to constant insecurity, many Iraqi children have fallen through the cracks of seemingly routine immunizations. Living in a state of fear, many people have become isolated even from basic services.

"Some of the mothers - particularly the newly arrived ones - are afraid of vaccination. They won't open the door," observed Fatima. "In these situations, you have to be persistent and unafraid. I believe that what I am doing is crucial for Iraq's future."

The importance of this work cannot be overstated; nor can its potential dangers be denied. It will go on each day of the campaign, however, because courageous vaccinators like Fatima are committed to providing a simple chance for survival to children in Iraq under the age of five - children who have never known a life without conflict.