Six months after the measles outbreak that killed 83 people, most of whom were children, UNICEF Pacific Representative Sheldon Yett talks about the long-term impact of the vaccination campaign and how Samoa is now better prepared for Covid-19.
I spoke to countless families in Samoa during the measles outbreak. Early on, there was some resistance to the idea of vaccination. But soon there was a wave of public pressure, nobody wanted to be the last person in the neighbourhood to get their child vaccinated.
I remember talking to a mother in the queue at a health centre. I asked her if she was worried. Maybe she had heard some of the misinformation out there about vaccines. Fake news about measles was rife at the time. “Yes, I have heard the stories,” she said. “But they are just stories. I know I need to get my baby vaccinated.”
She told me she had seen what could happen if she didn’t; children were dying. There was no doubt in her mind. She couldn’t have been more eager to wait in line and ensure her baby was protected as soon as possible. Now, more than six months later, the impact of the outbreak on families and the public health system cannot be overstated.
In every corner of the country, people saw children die. That will have a lifelong impact. The immediate effect was increased public pressure to ensure that immunisation programmes run well and that those responsible for conducting routine immunisation are well-trained, well-compensated and well-supported.
The UNICEF vaccination campaign achieved 95 per cent coverage. Over 265,000 doses of the vaccine were procured. We know that some 85,000 children were vaccinated, 22,250 of whom were under the age of five.
It is important to have a campaign like this to stop an outbreak when immunisation rates are too low. But that’s no substitute for having high rates of routine immunisation, and having that nailed to the foundation of the public health system.
On that count, we’re still analysing the 2020 figures for measles vaccination coverage. However, increased coverage towards the end of 2019 is a very positive sign. There are other reasons to be hopeful. Large speciality refrigerators required to store vaccines were purchased and placed all around the country.
Three-year-old Josh awaits a measles vaccination in Leauvaa Village, as part of a UNICEF-supported National Vaccination Campaign.
Some 150 vaccine carriers used to carry the vaccine in communities were purchased, and used by the vaccinators themselves to go household to household. We also purchased things like ventilators, syringe pumps, nebulizers, a huge quantity of supplies and equipment. We provided training and deployed teams to go into communities. Every component necessary to ensure children are vaccinated was covered by UNICEF.
We’re really grateful to our donors. Stuff readers alone raised $27,000 for the campaign. Your ability to respond and help us get supplies where they need to go as quickly as possible was critical to stopping this outbreak. We couldn’t have done it without you.
Of course, measles isn’t the only childhood killer, children are vulnerable to other diseases as well: waterborne diseases, airborne diseases, all the other diseases of childhood. The equipment used to fight this outbreak will be used for other outbreaks, possibly even to fight Covid-19 should Samoa be affected by the virus.
It goes beyond even equipment and supplies. We spent a lot of time making sure that nurses were well-trained, contact tracing was observed stringently, and that accurate messages were distributed in communities. Those processes will serve the public health system well should there be a coronavirus outbreak.
A boy receives a measles vaccination at a temporary clinic in Lalomanu, a village on the eastern coast of Upolu, Samoa.
During the response to measles, it was important that community members understood the impact of so-called fake news. At the time, there was a lot of false information circulating about measles: rumours about a possible cure, misinformation about how the disease was being spread, and who was responsible.
The same kind of issues are true for Covid-19. Ministries need to know what to do; communities need to know what to do. Whether that be government officials or church leaders, not just public health authorities. Anyone in a position of influence in the community can help spread the right messages.
Wanda holds her six-month-old son Azamat, as he receives a measles vaccination in Leauvaa Village.
This experience gave people the impetus to step back and say “wait a minute, this doesn’t make sense”. It taught people the importance of looking at the best sources of public health news such as public health officials, the World Health Organisation, UNICEF and our partners.
This is a lesson that will be carried forward in the event that there was a Covid-19 outbreak. The basics really do make all the difference. It’s pretty simple: we need to ensure that vaccines are in place, and that people are trained to administer them. When it comes to public health, borders are meaningless.
We need greater public understanding. All of us have a role to play here. It doesn’t just require epidemiologists and people with PhDs and public health degrees. It requires concerned citizens to ensure the lives and wellbeing of children are protected. Surely that is in everyone’s interest.