LONDON (AlertNet) - Eight weeks after the end of hostilities in Iraq, children are once again receiving life-saving immunisations against preventable diseases as the safe delivery and storage of vaccines is restored countrywide.
The U.N. children's Fund UNICEF, which is organising the distribution of more than one million doses of vaccines for immunisation against diphtheria, polio, hepatitis, tetanus, measles and tuberculosis, is re-establishing a national immunisation programme this month. The agency is also tracking down more than 210,000 babies born during and after the war who have yet to be immunized against childhood diseases.
The vaccines would have been delivered last month, had UNICEF not run into trouble with its transport system. "The vaccines were supposed to arrive on the 28th of May," Geoffrey Keele, UNICEF's communications officer in Basra, told AlertNet. "But they were delayed because the refrigerated trucks that were hired to carry the vaccines weren't cold enough to keep the vaccines safe, so we had to repair some trucks and get new ones as well, before bringing the vaccines in."
It was not the fist time that refrigeration -- or lack of it -- had posed a serious problem. The periodic breakdown of crucial elements of the "cold chain" needed to protect vaccines en route to warehouses, hospitals and health centres has thwarted efforts to deliver them to Iraqi children since the beginning of the conflict in March.
Moreover, spotty electrical power during and after the war made Iraq's stockpiles of vaccines useless and prevented the distribution of new batches.
"Almost all vaccines have to be kept at a cold temperature to prevent them from spoiling," Keele said. "Losing electricity for even just a few hours ruins them.
"When the electricity got knocked out, the cold chain stopped functioning. The cold chain is essential, and when it wasn't working we couldn't bring in more vaccines."
COLD CHAIN NETWORK
Hospitals throughout Iraq have suffered shortages as a result. "You must have a wide cold chain network. The cold chain must be operating in remote and rural areas before vaccines can be distributed to the field," Keele said.
Where the electricity supply is unreliable, scarce or non-existent, NGOs such as CARE International are filling in the gaps.
"We're fixing primary health centres that still don't have electricity yet," Anne Morris, CARE's emergency director in Iraq, said. "We're also repairing back-up generators, but they're not equipped to supply all the energy necessary and they need to be replaced."
According to Morris, even before the conflict, back-up systems were needed to keep the cold chain running smoothly. "The country worked on an electrical grid before the war that was not one hundred percent," Morris said. "It had to rely on kerosene fridges in the outlying areas."
In the final days of war, rampant looting of laboratories, hospitals, warehouses, and other health facilities caused new problems. Countless items, medicines, medical equipment, kerosene-powered refrigerators and generators were stolen.
Looters ransacked the Iraqi Health Ministry, stealing the large refrigeration units that stored reserves of vaccines against childhood diseases.
The international community swiftly condemned the looting and donors and aid agencies lined up to lend support. The European Union released 10 million euros ($12 million) of its 100 million euro ($120 million) emergency aid package for Iraq to replenish medical supplies and vaccines and to repair damage to hospitals, and the World Health Organisation launched a "jump start" programme to rebuild Iraqi health facilities and to make sure generators were operational.
$43-MILLION CONTRACT
The U.S. Agency for International Development, under the auspices of the U.S. civil administration, or Coalition Provisional Authority -- formerly the Office of Reconstruction and Humanitarian Affairs, or ORHA -- awarded a contract worth up to $43 million to a U.S.-based consulting firm called Abt Associates. The firm will help rebuild the health system, provide medical equipment and supplies and to train staff.
In the meantime, NGOs on the ground are taking steps to protect supplies from further outbreaks of looting. They know what has been stolen, from microscopes to hospital beds, and what needs to be replaced.
"We're trying to assist with the replacement of the missing stuff," said CARE's Morris. "But we need to put up gates and special locks to make sure it doesn't happen again."
Replacing looted equipment and supplies requires close coordination among NGOs, other agencies and the U.S. civil administration in Iraq. "Everyone is working with ORHA," Keele said, referring to the Coalition Provisional Authority. "The last thing we want is to show up somewhere and find that someone else is there on the same day with the same supplies."
Coordination has been especially critical since the expulsion of senior Baath party officials from government bureaucracies, which left a power vacuum at the Ministry of Health. "The people who made decisions are gone," Morris said. "Decision-making power has been taken away."
Before the war, the Iraqi government, which was permitted to sell oil to buy humanitarian supplies under the U.N.'s oil-for-food programme, handled the procurement of medical supplies, including vaccines.
The U.N. Security Council, however, classified some vaccines, such as those for yellow fever and diphtheria, as dual-use military-civilian items, subject to special controls, a policy which had led to shortages even before the war.
U.S. Secretary of Defense Robert Gates (L) walks with U.S. Army Lt. General Kenneth Hunzeker after arriving at Baghdad International Airport December 10, 2009. Secretary Gates is in Iraq following a ...
