Polio vaccination teams under threat in Syria

Published online 15 December 2013

Health workers are trying to contain a polio epidemic in Syria, but a mass immunization programme is being undermined by the danger of the conflict.

Andrew Bossone

© UNICEF/NYHQ2013-0987/Lyon

Health organizations are responding to a resurgence of polio in war-torn Syria which broke out in October after many years of a polio-free status.

The immunization programme – coordinated between UNICEF, the World Health Organization (WHO), the Syrian Arab Red Crescent and others – is the largest ever to be attempted in the Middle East and aims to immunize 23 million children across seven countries by April 2014 at a cost of US$39 million.

UNICEF's head of health and nutrition in Lebanon, Zeroual Azzeddine, says immunization rounds have been successful in Lebanon, reaching more than 580,000 children, about 98% of those targeted. UNICEF worked with the UN refugee agency, UNHCR, to immunize children at refugee registration centres at four border entry points and through mobile teams going door-to-door.

While this may be repeated in neighboring countries, health workers in Syria face grave threats from warring government forces and armed rebel groups.

"Patients have difficulty accessing health centres and hospitals because the roads aren't safe. There are snipers on the roofs," said Elizabeth Hoff, WHO representative in Syria. Cars being used to transport vaccination teams of the Syrian Arab Red Crescent have reportedly been shot at.

Azzeddine says health organizations need to change their strategies. The WHO has shelved rebuilding hospitals and health centres in Syria, Hoff says, and is focusing on mobile units and training local health workers.

Targets may only be achieved, however, by exerting more pressure on both sides. Azzeddine says the WHO recently sent a high-level delegation to Syria to discuss the situation with government officials. And according to Hoff, the WHO has lobbied the Syrian ministry of foreign affairs as well as UN director general Ban Ki Moon.

Health workers also face danger from rebel groups. Gunmen kidnapped seven people from the International Committee of the Red Cross in October. Four of them were released the following day, but three are still missing.

Azzeddine, who has previously worked in Darfur, attributed a successful vaccination campaign there to negotiating with people from all sides of the conflict.

"The only way to respond to the outbreak of measles and polio was to train people from the area to do the work because they did not accept anyone from the government side," he says. "We had people trained from both sides, and it worked."