South sudan msf vaccinates 132,500 against cholera

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South Sudan: MSF vaccinates 132,500 against cholera

Date Published: 22/02/2013 04:07

Médecins Sans Frontières/Doctors Without Borders (MSF) teams have just completed apreventive cholera vaccination campaign in and around the refugee camps in Maban County,South Sudan.

One hundred and five thousand refugees in four camps and 27,500 residents of the area werevaccinated, with the aim of preventing possible cholera cases.

South Sudan: Mass cholera vaccination http://www.msf.org.uk/articledetail.aspx?fId=Cholera_vaccinations_M...

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With the cooperation of the South Sudan Ministry of Health, MSF launched the vaccination campaign aspart of a cholera preparedness and prevention plan. The teams had already set up and pre-stockedcholera treatment facilities in the camps, in case of an outbreak.

Potentially severe cholera outbreak

Children from the host community are vaccinatedagainst cholera in a village outside Bunj town.© Corinne Baker/MSF

But the remoteness of the area and supply difficulties mean that a cholera outbreak would have thepotential to be severe.

So prevention is crucial alongside preparedness, and a vaccination campaign provides an extra layer ofprevention.

“The key for preventing cholera is to ensure sufficient access to clean drinking water, and to haveappropriate sanitation and hygiene facilities,” says Paul Critchley, MSF emergency coordinator inMaban County.

“We are currently tackling an escalating hepatitis E outbreak in the camps, so we know that sanitationconditions here are not yet adequate. Hepatitis E is spread in similar ways to cholera, and thisreinforces the need to do all we can to prevent cholera breaking out too.”

Logistical challengesGathered in four refugee camps located in an extremely harsh environment, around 110,000 refugees,who have fled the ongoing conflict in neighbouring Sudan’s Blue Nile State, are entirely dependent onhumanitarian organisations.

With no easy access routes, it was a challenge for MSF to bring in 19 200-litre fridges, the generatorsto keep them running and the 290,000 vials of vaccine.

Despite the logistical challenges, the innovative approach to cholera-prevention is justified in a situationwhere a population is exceptionally vulnerable and where the consequences of an outbreak would beparticularly devastating.

An MSF team set up the cholera vaccination site.© Corinne Baker/MSF

Oral vaccine


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by Chameleon

The vaccine comes in the form of oral drops and was given to each person twice, with a gap of two tothree weeks between doses.

By deploying a substantial health promotion effort in advance, the teams were able to reach more than132,000 people with both doses of the vaccine.

The MSF teams were supported by staff from GOAL, IOM, Medair, Relief International, Solidarités,and the Ministry of Health.

“The logistical difficulty of this vaccination campaign highlights the need for further development of morefield-adapted vaccines,” says Dr Jennifer Cohn, medical director for MSF’s Access Campaign.

“While it is helpful that the vaccine is an oral administration, which assists in the ease of itsadministration, it comes in one dose per vial and must be kept in a cold chain, which means the sheerbulk and logistics of supplying some 290,000 doses makes using this vaccine challenging in locationswhere it may have the greatest benefit.

An MSF team member administers the oral vaccinefrom a vial © Corinne Baker/MSF

"The vaccine also must be given in two doses, at least 14 days apart. Ensuring both doses are given isdifficult in situations of disaster or with mobile populations.

"A formulation that can be packaged in multi-dose vials and can be used without strict cold chain wouldgreatly improve the logistical challenges of such important vaccination activities.

"Further, the price is an issue. If the cost could be reduced, that would further increase the scope forwidespread use of the vaccine.”

While providing individuals vaccinated with significant immunity to cholera, this vaccine alone does notguarantee that there will be no outbreak. While the high vaccine coverage achieved will help tosubstantially limit the spread of any outbreak, all efforts possible must still be made by theorganisations working on water and sanitation in the camps, both to control the hepatitis E epidemic,and to limit the risk of a cholera outbreak.

MSF in Maban, South Sudan

MSF has worked in the refugee camps in Maban since November 2011 and is currently running threefield hospitals and seven health posts, providing around 5,500 consultations per week across the fourrefugee camps.

More information on the and


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South sudan msf vaccinates 132,500 against cholera