For the first time ever, the trio of Aishatu, 5, her siblings Musa, 3 and Umar, 1 received vaccinations against measles, polio and yellow fever at a transit point on the outskirts of Banki town in Borno state. A World Health Organization (WHO) Special Intervention Team of community health workers caught up with Aishatu’s family on their way from Banki in Borno state to the Chad Republic. 
Although Aishatu’s family are nomadic cattle herders, the current onslaught of Boko Haram attacks have increased the movements of people across which makes it imperative for immunization programmes to devise different strategies of reaching children with lifesaving vaccines and commodities.  “How did you manage to trace us? My family and I have lived on grazing fields for more than 5 years,” Malam Ibrahim, the father of the three girls observed. 
Many children in north-east Nigeria have never received vaccinations or are behind schedule due to the highly mobile nature of the populations. To reach this high-risk population, WHO devised an innovative strategy: “Special Intervention Teams” which reach the children at strategic transit points across the north-east Nigeria. The teams consist of a vaccinator, a profiler, a recorder, a member of the civilian Joint Task Force and a community leader. They often venture into areas where people have little access to health services.
According to Yusuf Muhammad, the profiler for the Special Intervention Team 019, his team had profiled and vaccinated many children including those trapped in Marte and Abadam local government areas since 2014. “Through profiling, we were able to know where the children came from and determined their immunization status and what vaccinations they needed,” said Muhammad. Marte and Abadam are still inaccessible to humanitarian responders till date. The profiler in the Special Intervention Team captures children’s biodata including where they came from, reason for relocation, immunization status and travel history. 
Presently, WHO has engaged 400 Special Intervention Teams in Borno state who operate quasi-fixed vaccination posts at transit points, motor parks, markets and along nomadic grazing routes, host communities and internally displaced people (IDP) camps. Their job is to intercept, assess, profile and vaccinate all children on transit with the appropriate vaccines including polio, measles and yellow fever. 
In 2017, more than 2.4 million doses of oral polio vaccines were administered to eligible children and nearly 400 000 children profiled by the Special Interventions Teams, including 18 000 children from Marte and Abadam,” said Dr Mohammed Tahir Bolori, WHO focal person for internally displaced persons in Borno. 
Out of the nearly 400 000 children,  the teams tracked and profiled by the team , more than 375 000 were from populations trapped in inaccessible and partially accessible wards and settlements with no healthcare facilities, while another 21 664 children reached at transit points came from neighboring countries and other States in Nigeria. 
The violence in the north-east Nigeria has caused widespread devastation, that affects the health of more than 6.9 million people in Adamawa, Borno and Yobe States with massive displacements of people. There are 1.7 million IDPs in the three states and more than 200,000 refugees from Niger, Chad and Cameroon. 
In Borno state, two-thirds of health facilities in the conflict-affected areas have been completely or partially damaged leaving them incapable of providing urgently needed healthcare services. According to WHO’s latest Health Resources Availability Monitoring System report (known as HeRAMS), one- third of more than 700 health facilities in the state have been completely destroyed. Millions of people are unable to access even the most basic services such as vaccinations, treatment for minor ailments including malaria, diarrhea, and upper respiratory tract infections. 
The “Special Intervention Teams” are helping to fill the gap in healthcare due to the humanitarian crisis by providing children who are often extremely vulnerable protection from some of childhood’s most virulent diseases. 
 

Technical Contact:

Chima Onuekwe onuekwec [at] who.int, 08037771775