In Cameroon, struggling to address a polio outbreak

By Vikas Verma

While an outbreak of polio in eastern Cameroon has brought urgent efforts to immunize refugees from the Central African Republic, the threat remains that it may spread further.

KETTE, Cameroon, 11 September 2014 – Since violence erupted in the Central African Republic in December 2013, more than 125,000 refugees have fled to neighbouring Cameroon. One of them is 38-year-old Awoua. Her husband was killed in the Central African Republic, and now she must support her six children on her own – including her 18-month-old son, Amadou, who was recently diagnosed with polio.

© UNICEF Cameroon/2014/Verma Five-year-old Habiba, one of the polio cases confirmed in Cameroon among refugees from the Central African Republic

An epidemic of wild poliovirus centered in Cameroon and Equatorial Guinea is spreading internationally and threatening the whole region. Since the onset of the outbreak in October 2013, nine cases have been confirmed in Cameroon.

A UNICEF mission travelled to the eastern region of Cameroon, near the border with the Central African Republic, to document new cases of polio among the refugee population. A local health worker, Mr. Gomina Daniel, took us 2 km outside Kette district, to a temporary dwelling called Bettanie quarter. Around 1,550 refugees from the Central African Republic settled here in April after violence forced them to flee.

A group of elders sits at the entrance of the settlement, where refugees have built their huts. Further along, we meet Ms. Awoua. She says she has never been aware of polio or how to prevent it. None of her children received vaccination drops before they arrived in Cameroon, but now community volunteers have told her the importance of vaccination and managing clean water.

Just 20 metres away in another hut, there is another polio case, a 5-year-old girl named Habiba. She is an orphan, having lost her parents in the violence in the Central African Republic, and is now being cared for by two cousins and aunt. She too had never received any polio vaccination.

There is real concern that conditions in the settlement will lead to a bigger outbreak. For community mobilizers, the lack of previous vaccinations and low awareness among the public pose a major challenge. The French Red Cross is working to reach every dwelling, but the continuing arrival of new refugees a task makes it a difficult task.

© UNICEF Cameroon/2014/Verma Awoua with her 18-month-old son, Amadou, who received polio vaccination drops but still contracted the disease because of his low immunity

“We have undertaken seven NIDs [National Immunization Days] since January, and in every round, the number of children to be covered increases, making it difficult for us to plan activities and vaccine availability,” explains Mr. Apakohokel Badjel Clement, Chief of the Kette Health Centre. “In June, we covered 23,716 children in the polio round, and in July we had to cover 37,761 children.”

Both Amadou and Habiba received polio drops in May and June, but since their immunity was still very low, they contracted the virus.

Dr. Clement says that better vaccination coverage requires putting vaccination posts at the border crossings, increasing human resources and providing additional cold chain equipment, especially vaccine carriers. “Then the hope of better coverage can be guaranteed,” he says.

With the Cameroonian health system under pressure to manage multiple emergencies at once, the UN system and its partners are doing their best to meet the challenge posed by the outbreak. UNICEF supports the provision of vaccines, as well as community awareness and social mobilization activities such as radio broadcast messages, community appeals and announcements in schools and places of worship, megaphone announcements through community mobilizers, and motorcycle taxi rallies through the streets.