Vaccination: Nurses strike and the coming disease crisis

Vaccination: Nurses strike and the coming disease crisis

Kenya is staring into a huge health crisis as hundreds of thousands of children are going without vaccination due to a prolonged nurses strike

Nurses at Coast General Hospital protest outside the facility after they were threatened with dismissal letters by the Council of Governors on September 11, 2017. While politicians and technocrats have been haggling over budgets, promotions, salaries and their effects on government recurrent expenditure, few people have paused to think about what the current impasse is doing to the country’s children, who are not receiving scheduled vaccines.

Kenya is staring into a huge health crisis as hundreds of thousands of children are going without vaccination due to a prolonged nurses strike, now inching towards the fifth month.

Healthcare services in all public facilities countrywide have ground to a halt, and that means children are not getting vaccinated against some of the world’s most debilitating diseases, including polio, pneumonia, meningitis, measles, influenza, and hepatitis.

These diseases, long identified as among the biggest health threats in the region, could ravage the nation in the coming years if these hordes of vulnerable children are exposed to their vectors. For health experts, it is hard to fathom the gravity of the situation.

When we recently visited the Obama Ward at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) in Kisumu, there was neither the usual choir of wailing babies receiving vaccinations nor the pageantry of expectant mothers visiting for routine clinics.

Dr Juliana Otieno, the JOOTRH medical superintendent, says she is worried that a medical catastrophe is in the making.

“The threat of death by disease isn’t the only medical consequence of skipping vaccinations,” she says. “An unvaccinated child faces lifelong health difficulties.

The coming crisis is huge and we must prepare to address it. The cost of treating unvaccinated children will be very expensive for the government.”

She is looking at the silent, unreported consequence of the nursing strike. While politicians and technocrats have been haggling over budgets, promotions, salaries and their effects on government recurrent expenditure, few people have paused to think about what the current impasse is doing to the country’s children.

When a child misses a polio vaccine and there is an attack, for instance, the likelihood of that child going down with the virus is huge because the child is not covered. The World Health Organisation recommends an oral polio vaccine dose immediately a baby is born — called a zero dose — followed by a series of three primary doses and a minimum one inactivated dose.

Now that more women of child-bearing age and their children are going without immunisation, the disease profile in the country is likely to be affected, for the worse.

“Vaccines are the safest way to protect children and pregnant mothers from a long list of serious and potentially life-threatening illnesses,” says Dr Otieno. “They protect children by preparing their immune systems to recognise and fight serious, deadly diseases.”

Every month, 600 women deliver and over 1,000 children are vaccinated at JOOTRH, which is the leading referral hospital in western Kenya, but in the wake of the strike those women are seeking care elsewhere, including inside the huts of traditional birth attendants. Some of these mothers, of course, are getting the services from private clinics, where they are getting the necessary vaccination.

Records at the JOOTRH maternity wing tell the story of many other such government hospitals in the country. In May this year, before the strike started, over 600 mothers and 1,000 children were vaccinated at the facility. They were scheduled for a review in June, but unfortunately, that is the month nurses downed their tools.

In June, only 10 per cent went back for the scheduled vaccination, while most pregnant women who were due did not turn up to give birth at the hospital, missing the vaccinations given to infants at birth.

Over 200 women were due to give birth at the hospital in June, but none of them returned. Which means most of them might have given birth at home and those who were fortunate enough, gave birth in private hospitals.

Ms Monica Aloo is one of the women who gave birth at home.

“I went for my check-up on May 12 and was scheduled to go back in June but unfortunately the nurses went on strike,” she told HealthyNation last week from her home in Homa Bay. “I gave birth on July 8 at home aided by a nyamrerwa (community health worker) but my child was never immunised. I am aware of the consequences of not vaccinating my baby, but I do not have that money to do it in a private hospital.”

While Monica is optimistic that her baby boy will survive even if he is not vaccinated, Dr Walter Otieno, a Kisumu-based paediatrician, says the likelihood of the boy dying, or contracting a debilitating disease, before the age of five are very high.

The 2014 Kenya Demographic Health Survey shows that almost eight in 10 children — 79 per cent — aged 12 to 23 months receive all basic vaccinations (BCG, measles, and three doses each of DPT and polio vaccine, excluding polio vaccine given at birth). The other two in every ten receive no vaccines, affecting, later on, the health indicators of the country.

Basic vaccination has improved only slightly since 2008, when 77 per cent of children received all of the basic vaccines. Vaccination was slightly higher in urban than rural areas, at 83 per cent versus 77.

According to the survey, there was a tremendous variation by counties, from 36 per cent coverage in West Pokot to over 95 per cent coverage in Nyamira, Nandi, Kiambu, Kirinyaga, and Tharaka-Nithi.

Basic vaccination coverage increases with a mother’s education and household wealth. Only 57 per cent of children age 12 to 23 months whose mothers have no education have received all basic vaccinations, compared to 87 per cent of children whose mothers have secondary or higher education.

To put it simply, the majority of families in Kenya are opting to have their children vaccinated. But they can only do so when the medical care system is working like a well-oiled engine.

Dr Subiri Obwogo, a local health expert, says vaccination plays are big role in preventing at least 25 diseases, including polio, hepatitis B, whooping cough, measles, diphtheria, measles, tetanus, diarrhoea, pneumonia, and cervical cancers.

Diarrhoea and pneumonia are the two leading killers of children under the age of five in Kenya, and Dr Obwogo says the introduction of their vaccines by the National Immunisation Programme about two years ago was prudent. Together, it is estimated, the two diseases caused two million deaths in 2011 globally.

 

Source : http://www.nation.co.ke/health

 

Add comment

Security code
Refresh