After eradicating polio in 1997, Somalia has reported new cases since 2005 with a surge in outbreaks in 2018. The gradually increasing number of cases shows that the disease is far from gone and caused the World Health Organization (WHO) to call for immediate action in eliminating polio in Somalia in 2018.

Background

Somalia reported 228 cases of polio between 2005 and 2007. The country responded with an immunization campaign of four rounds of national immunization days conducted in 2008. Somalia maintained a polio-free status for six years following the campaign. And the country continues to require two national days of immunization per year following the end of the 2007 outbreak. Its National Child Health Day initiative has added a polio vaccination attempting to broaden the number reached. However, due to a number of challenges, National Child Health Day reaches less than one-half of eligible children.

Resurfacing of Disease

In 2013, polio in Somalia resurfaced with 194 cases. Polio outbreaks around the region were frequent in 2013, due to the influx of refugees fleeing Syria, a country which has had severe outbreaks since the start of the Syrian Civil War. Fourteen months after the first confirmed case, the outbreak was officially over. WHO commended the country for quickly containing the epidemic highlighting the importance of cooperation and commitment between government health officials and parents.

Polio rates in Somalia are highest in southern Somalia, which the WHO considers an inaccessible area. Only 3 percent of children in south Somalia have all three of their polio vaccinations, compared to the 17 percent of children that have all three doses in the northern region. The differing rates correlate with the national borders of Somalia and Somaliland. Northern Somalia declared independence in 1991 as the state of Somaliland, although no other nation recognizes it as independent. Somaliland has since flourished in comparison with democratic elections, working government institutions, a police force and its own currency. Many consider Somalia, by contrast, a failed state. It remains under the control of an Islamist armed group and fights instability and insecurity, causing it to remain in a constant humanitarian crisis. Due to the forces that govern, vaccination campaigns rarely occur, and many NGOs lack access to the region’s vaccination eligible children.

Fighting Back Against Outbreak

Following the 2013 outbreak, UNICEF funded the creation of Dhibcaha Nolosha or Drops for Life. Dhibcaha Nolosha is a weekly 15-minute radio segment attempting to combat the misinformation about polio and polio vaccinations. Of children vaccinated in 2019, less than half of their caretakers understood that children had to have multiple doses of vaccinations. The radio show has medical experts explain how polio transmits and how the vaccination works, including personal stories and space for listeners to ask questions about polio.

Somalia launched a nationwide three-day campaign in March 2019 to vaccinate 3.1 million children under the age of 5. The campaign, launched by the government and supported by the WHO and UNICEF, went door to door with 15,000 frontline polio health workers. The campaign sought to vaccinate all children under the age of 5 with at least the first round of the oral polio vaccine. The WHO plans to continue supporting the efforts with annual campaigns in Somalia along with monitoring any future outbreaks.

Polio in Somalia continues to be a problem with the most recent report in June 2019. Somalia currently has 15 confirmed and open cases but continues to promote vaccination campaigns, trying to regain polio-free status. However, with little cooperation with governing figures in the southern region, the WHO continues to monitor the situation closely.

– Carly Campbell
Photo: Wikimedia Commons