Keeping Syrian children free from polio at home and across the border

April 2015

The four-year-long armed conflict in the Syrian Arab Republic has disrupted health services across the country. More than 11 million Syrians have been forced from their homes, with inevitable disruptions to their children’s health care, including immunization.

Children point to a circle around the ‘x’ on the outside of their caravan. The ‘x’, drawn by a vaccination team, indicates that children were missed during a door-to-door campaign visit. The circle is drawn after a ‘mop-up’, when all children under five living in the household have been vaccinated.
Children point to a circle around the ‘x’ on the outside of their caravan. The ‘x’, drawn by a vaccination team, indicates that children were missed during a door-to-door campaign visit. The circle is drawn after a ‘mop-up’, when all children under five living in the household have been vaccinated.
WHO

Tens of thousands of people have crossed the border into Jordan, seeking a safe haven in camps for displaced persons. Among them are Morti and Shikha and their children, who range in age from 2 to 16 years. “It was our last solution,” Morti says. “Our home was no longer safe – what could we do?” The family has been living in a caravan in the Za’atari camp, on Jordan’s northern border with Syria, for more than a year.

Morti and his family rely on services provided by United Nations agencies, mainly UNHCR and partner organizations working in the camp, which provides a home for some 80 000 people. Primary health care services, including immunization, are included. Polio vaccination is a strong focus.

“Our youngest children, Khaled and Malak, were vaccinated against polio last year,” Shikha says. “Most of my neighbours, relatives and friends are supportive of vaccination efforts to protect their children against this debilitating disease. We all know it is good for the children.”

Active campaigns in Jordan

Jordan stopped polio transmission more than 20 years ago, and the Jordanian Ministry of Health aims to maintain that status. Since November 2013 the Ministry, together with the WHO, UNICEF, UNHCR and other partners, has embarked on a series of campaigns to ensure all children under 5 years of age living in high-risk areas of Jordan, including in the camps, are vaccinated against polio.

Before polio campaigns start, people in the camp are educated about polio vaccination through public announcements and flyers. Then teams of health workers travel throughout the 12 districts of the camp conducting door-to-door visits. Caravans are marked with a coloured cross or tick to indicate which families’ children have been immunized. A second team of health workers conducts a follow-up, to ensure that no child is missed. During World Immunization Week 2015, the Ministry plans to vaccinate 200 000 children, including those at the Za’atari camp.

WHO supports polio vaccination in Jordan by providing technical assistance and training to Ministry of Health staff and other key health partners involved in the campaigns. The Organization has also supported the introduction of innovations such as using mobile devices to map immunization data and enhance early detection of communicable diseases, including acute flaccid paralysis – the most reliable marker for polio.

Fighting polio within the Syrian Arab Republic

The civil war, in addition to causing widespread devastation and 220 000 deaths, resulted in a setback to Syria’s immunization coverage. In 2013, the country reported an outbreak for the first time since 1999. Subsequently 35 children were paralysed by polio. After a series of vaccination campaigns, transmission was stopped, and the last case was reported in January 2014. The fact that the virus originated in Pakistan demonstrates that poliovirus will remain a threat to children who are unimmunized no matter where they live, until it is eradicated.

Volunteers like bag-maker Riad Teriaqi, form the backbone of Syria’s efforts to prevent another outbreak. In April 2015 he was preparing to embark for the 8th time on a house-to-house polio immunization campaign. “I know recurrence of polio was caused by the current crisis, and I consider it worthwhile to make some sacrifices in support of my fellow Syrians in these hard times,” Teriaqi says.

WHO has provided technical and financial support to halt transmission of polio in Syria. During the most recent campaign, in March 2015, close to 3 million children under 5 years of age were vaccinated.