Get documents about "Approaching Days of Tranquility
Document Sample
Approaching
Days of Tranquility
Afghanistan Polio Eradication Initiative
February 04 08
Background
Afghanistan has the experience of practicing Days
of Tranquility in the past
• Health is neutral & each Afghan child has the
right to be immunized
• In 1990s, Days of Tranquility
– Announced for one week & observed for more than a
month
– Campaign Posters were displayed on the Tanks
– Military vehicles were used for transportation of the
vaccine & teams in difficult to approach areas
• Taliban & Northern Alliance frontline remained
quiet during the polio days
P1 & P3 Poliovirus Isolates Afghanistan 1999, 04-07
1999 2004
# #
#
# # $
2-3 year H-H Vaccination
$$ $
##$
# ##
#
#
polio cases reduced to 04 &
##
$ #
$ $
# $
$
$$
## #
$# # #
$
##
##$#
# # #
geographically restricted to the south #
NSL1= 2
# NSL1= 45 #
NSL3= 2
# # #
# $
#
$# # #
##
$
#
$ #
NSL3= 18
NSL1 NSL1 isolate from 02, Healthy Children, September 13, 05
NSL3
2005 2006 2007
#
#
$ $ # #
$ # #
$ # #
# #
# # #
#
$
#
# # ##
# #
# # #
# # $
# #
#
#
# # #
##
NSL1=06
NSL3=11
NSL1=5 NSL1=29
Data up to 26 Jan 2008
NSL3=4 NSL3= 2
Phase 01
• In second half of 2005, P1 Outbreak started
in the Southern region
• Program requested a meeting of both the
UNICEF & the WHO Country
Representatives
– Briefed on the polio situation and gravity of the
impact of security on campaign quality
– Joint letter was sent to HM & SRSG
• The HM in a Cabinet meeting & SRSG
during his weekly meeting with the President
separately briefed the President on the
deteriorating polio situation in the country
Phase 01
• The President Hamid Karzai directed the N S Council
• NSC was briefed on Polio by the WHO & UNICEF CRs
together
• Policy Action Group chaired by the President was given
briefing on Polio Situation by the UNICEF & the WHO
– Polio Action Group representing cross sectoral ministries was
constituted
– Governor of Kandahar & Helmand were directed by the
President office to lead the process.
• Efforts concluded, that the Anti Government Element’s
leadership is not visible to whom to talk
• Military started responding: campaign dates were
changed on the advise of HM. But military operation was
also delayed and started exactly on the campaign time
UN Security Map & Polio Confirmed Cases (Jan, 2008)
Very High Risk Areas
High Risk Areas
Medium Risk Areas
NSL3=11 Low Risk Area
NSL1=06 Date up to 27 Jan 2008
Phase 02
• Dr David Heymann, Advisor to WHO DG on
Polio, visited Afghanistan
– Meeting with ISAF/NATO & their Civilian
Representative
– Joint MoPH, UNICEF, WHO press briefing in
MoPH and appealed to all the parties of the
Conflict
– AGE Spokesperson responded & called to media
from unknown place and announced their
support for the polio eradication in Afghanistan
Phase 02
• The WHO DG & the RD visited Kabul
– Meeting the President Hamid Karzai, HM &
Advisor to President
– Meeting with Deputy Commander ISAF /
NATO
– Progress in the stance: Military agreed on to
have Days of De-conflict
– Campaign days and areas were shared but
still Operations were conducted during the
campaign days
Phase 03
• Briefing on Polio at the ISAF / NATO HQ
Brussels by Chris Maher & Tangermann
– Promise to keep was the de-conflict situation
• Country Team explored the possibility of
approaching AGE
– HM was briefed on the Concept
– With the advise & approval of HM, ICRC was briefed
on polio situation and the risks.
– ICRC agreed to support PE activities in Afghanistan
• Taliban issued the Letter of Support, announced in the media
and communicated their field formations
• Letter was found very useful helping polio staff in the field &
in improving access to the areas & children
– UN Peace day highlighted the need of DOT
Letter of
Support
from AGE is
issued for
each
campaign
separately
since
September
07
Comparison of Children not accessed by vaccination teams
Analysis by District, Southern Region Aug & Sept 07
August 2007 September 2007
80,000 more children
Accessed, not covered
for one year
% of missed children in the district 1-24% 25-49% 50-74% 75-100%
Results: Improved access & maintained
Southern Afghanistan, Dec. 07 & Jan. 08
Dec-07 SNID Jan-08 SNID
Window of
Opportunity
Strategy
Not Accessed because of Not Accessed because of
active fight (59271) active fight (7,428)
Not accessed because of Not accessed because of
AGE refusal (23348) AGE refusal (7,455)
Not accessed because of Not accessed because of
management (3959) management (792)
Total inaccessible 86,578 (8%) Snow (24,190
Total inaccessible 37,329 (3%) Total inaccessible 39,865 (3%)
Completely inaccessible Partially inaccessible Accessible REC File 27 Jan 2008
Continuous Technical Inputs
• Focused District Strategy was initiated in the
security compromised districts to minimize the
affect of security
– Village based team, adding SM at Cluster level, more
involvement of community & close monitoring
• Staggering Approach
– Dividing the high risk districts in to two zones &
placing all the human resource in one and shifting to
the other later
• Providing additional staff from the other regions
The Way Forward
• There is a definite progress towards understanding for
vaccination & polio eradication on DOT
• We are in a transition from Days of De-conflict to DOT
• AGE, party of the Conflict is approachable through ICRC
• Awaiting the ISAF/NATO support on Days of Tranquility
• Efforts are in progress
– The Advisor to the President on Health is keeping this
issue alive in NSC meetings
– USAID meeting the ISAF/NATO Commander on
January 31
• Looking forward to the DOT when we can supervise &
monitor the campaign and vaccination teams can access
every house & access each child and do the vaccination
safely ensuring achieving the goal.
