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September 2005

Serious measles outbreak on Sumba island, Indonesia

Médecins Sans Frontières (MSF) is preparing a mass measles vaccination campaign on the island of Sumba in Indonesia. The vaccination drive, organised together with health authorities in West Sumba and Jakarta, will target 170,000 children between six months and 15 years. Twenty vaccination teams are ready to start vaccinating around the affected areas and then work their way inward towards the epicentre of the outbreak.

On 24 August, MSF sent a first team consisting of one medical doctor, one nurse and two logisticians, to West Sumba to investigate reports of a measles outbreak that had killed five people in the sub-district of Kodi. They soon found that the outbreak had already spread into six of West Sumba's 15 sub-districts. This prompted MSF to start a three-month measles emergency project, integrating mobile clinic activities (case detection, management, and referral of children to health facilities) and a vaccination campaign.

The mobile clinic teams each consist of a medical doctor, two nurses and a logistician, are operating in 6 sub-districts. Between 1 and 9 September, the MSF teams provided 655 consultations where they found 102 active measles cases. The other main pathologies they have recorded are upper respiratory tract infections, skin infections, malnutrition and watery diarrhoea. Since the beginning of the outbreak, the Ministry of Health registered 1,168 measles cases, in Kodi Utara (980 cases), Kodi (79), Walandimu (17), Waimangura (20), Rada Mata (15) and Tena Teke (57). One more death case was found, taking the initial measles death toll to six.

For the vaccination campaign, MSF needs over 200,000 doses of vaccine, along with 22,000 high-protein biscuits, 125,000 Vitamin A tablets and other relevant medical materials. From Jakarta MSF has sent around 5.5 metric tons of medical and logistic supplies by charter flight to Waingapu, the capital of East Sumba, from where they were trucked to Waikabubak in the west. An additional 7.5 metric tons of similar materials will be sent later during the emergency programme.

The measles outbreak on Sumba started in June this year. It spread so quickly mainly because of the low vaccination coverage. The local health authority has not been able to respond in a timely manner to the problem, acknowledging that they lack the human resources, expertise and access needed for battling the outbreak. MSF has so far deployed around 20 workers (doctors, nurses, logisticians) and intends to staff this mission with around 35 personnel in total.

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