A measles epidemic has hit northern Mali this year. MSF is providing treatment to sick people and has launched a vaccination campaign for approximately 400,000 children between six months and 15 years of age.
More than 2,500 patients registered so far in the regions of Timbuktu and Gao have had measles. MSF has set up three measles treatment centres in Timbuktu and another two in Gao. In addition, four mobile teams are doing outreach searches to locate sick people, care for them, and refer complicated cases to treatment facilities.
MSF staff conduct a measles vaccination campaign in Timbuktu region, northern Mali. Mali, 2009.
Photo by Jean-Michel van Laere/MSF
Measles is a contagious disease that mostly affects children. The disease can cause blindness and pneumonia, and can be fatal. Measles can be prevented by vaccination, but in the affected areas in Mali very weak vaccination coverage is a major factor in the spread of the epidemic.
In order to prevent this, in May 2009 MSF started a vaccination campaign in the Timbuktu region, an area where measles has reached an epidemic. MSF and Ministry of Health teams have so far vaccinated 160,000 children in Timbuktu city and in the surrounding ‘circles’ (areas). Vaccination will continue in the Timbuktu region and another campaign will soon start in the neighbouring Gao region.
Populations on the move
A major challenge in tackling measles in Mali is internal population movement. The ‘Tuareg’ and other nomadic populations, for instance, are heading south of Timbuktu in search of water. Teams have vaccinated certain ethnic groups who are currently heading to the shore of the Niger River in search of fish.
“People are constantly on the move and this is a big challenge,” explains Louis Kakudji Mutokhe, an MSF medical coordinator. “It is extremely difficult to follow their migration. Two or three days before the vaccination we have to send a team of educators to let people know about the vaccination and to ask them not to move! But if it starts raining somewhere, then they move on to these places where they can find better water points for the cattle.”
In such a vast and underpopulated area (about one inhabitant per square km), MSF faces significant logistical needs. On top of that, the poor condition of the roads means that moving from one place to another takes a long time. In Timbuktu region alone, therefore, there are 12 teams of MSF staff, Ministry of Health staff and representatives of civil society working on the vaccination campaign. About 20 cars take the teams to the vaccination sites.
The temperature at this time of year in Mali is almost 50 degrees celsius. However, to be effective, vaccines must be kept at a low temperature – between two and eight degrees celsius. “We have to keep the ‘cold chain’ right up to the most remote places,” explains Louis Kakudji Mutokhe. “The cold chain is based in Timbuktu and at least two vehicles bring icepacks and vaccines to the field. You really need a lot of resources if you want to avoid giving ineffective vaccines to the kids.”
Overall, around 100 MSF staff, the majority from Mali, are working to address the measles outbreak in the country.
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MSF has worked in Mali since 1992. In Timbuktu, MSF operates on women suffering from obstetrical fistula and in the southern Kangaba district, MSF runs a malaria project.