Health Needs of Refugees and IDP Children Including Vaccination
Remarks
Assistant Secretary, Bureau of Population, Refugees, and Migration
It is pleasure to be here. The cause that brings us all together is incredibly important and so is the work that you do. You know, here in Washington, we public officials face many conundrums. Often solutions are hard to envision, consequences hard to predict, and benefits hard to weigh against costs.
Vaccinating children is different. We know it is the right thing to do, and one of the most cost effective ways to prevent needless suffering. Science, economics, and history tell us that this simple act can end crippling and deadly diseases that once threatened us all.
I have seen for myself how vaccines can save and improve lives, even the lives of very poor people who live in some of the most precarious situations on earth. When it comes to public health, as some have said, vaccination is the closest thing we have to a miracle.
We know that just two immunizations – the rotavirus, and the pneumococcal vaccinations – could prevent the two diseases – diarrhea and pneumonia – that are the two leading killers of children around the world.
So it is a great shame that children in many developing countries do not yet have access to these important vaccinations.
The World Health Organization recommends that every child get 11 vaccinations, the two I just mentioned plus vaccinations for diphtheria, tetanus, pertussis, polio, measles, meningitis, rubella, hepatitis B and HIB (which stands for haemophilus influenza Type B).
In the world’s 73 poorest countries, only 5% of children have received these vaccines. And every year, 1.5 million children die world-wide from diseases that vaccinations could prevent.
Often, these are children living in fragile states, conflict zones, and countries with large populations of refugees.
The bureau in the State Department that I lead, the Bureau of Population Refugees and Migration, assists civilians who are endangered or driven from their homes by strife, persecution and violence.
Right now we have our hands full. The number, scale, and sheer brutality of conflicts around the world is nearly unprecedented. More people have been forcibly displaced than at any time since World War II.
The war in Syria has uprooted half of that nation’s population, and millions more have fled violence in Iraq, South Sudan, and the Central African Republic. Long simmering conflicts continue to menace and displace people in Afghanistan, Pakistan, Burma, Colombia, the Democratic Republic of Congo, Yemen and other places.
The leading causes of death for children under five in developing countries are measles, diarrhea, malaria, and respiratory infections. In wars and emergencies, children succumb to the same preventable diseases. But in countries torn by conflict they are more likely to get sick and more likely to die.
Violence and instability imperil public health and vaccination efforts in many ways. They trap countries in poverty. Conflict is a key reason some developing countries lag far behind others in improving income levels, nutrition, sanitation, health. In addition to preventable diseases, children in war-zones are vulnerable to wounds from bullets, shrapnel, explosives or landmines. And they suffer from the trauma that comes from witnessing atrocities.
By driving families from their homes, conflicts expose children to additional dangers. Families forced to flee for their lives may set off on foot and walk for hundreds of miles. Such journeys are particularly hard on the children. Their immune systems are often weakened by lack of food, a lack of sleep, stress and trauma.
U.S. government programs assist these refugee children when they arrive at border crossings, weary, sometimes emaciated and in need of care. Last July, at a border crossing where refugees from South Sudan were fleeing into Ethiopia I met a woman who was exhausted, thin, and with her two children. The mother explained how they set out for a nearby town hoping to escape the violence. She said “we got to the next town and it was gone and then the next town and it was gone.” They had ended up walking more than 300 miles to reach safety.
Most refugees today end up in cities and towns, often in places where they do not speak the language, are not allowed to work, and find it hard to secure shelter, pay rent, or get medical care. Others crowd into camps with other families. Many may be sick, have lived through horrible ordeals, and need medical help. When too many arrive too quickly, aid workers must rush to provide enough clean water, latrines, or clinics.
On top of this, civil strife and violence disrupt healthcare systems. Conflicts close clinics and can make it too dangerous to travel to them. They also endanger healthcare workers. The laws of war prohibit attacks on medical personnel, whether civilian or military, who are providing medical aid in armed conflict. They also prohibit combatants from targeting medical facilities being used to render aid. Yet militants sometimes intentionally attack hospitals, doctors, nurses, volunteers, and other humanitarian workers – people who are risking their own lives to save the lives of others.
In Syria, four years of brutal warfare have damaged or destroyed sixty percent of the hospitals. The government continues to barrel bomb health facilities and block some shipments of urgent medicine and supplies for those in need. ISIL or Daesh has killed humanitarian workers and seized assistance. Recently, ISIL also shut down the office of the Syrian Arab Red Crescent in Raqqa and confiscated its warehouses and equipment. Earlier this year in the South Kordofan region of Sudan, the Sudanese Air Force bombed a hospital that was being operated by the group Doctors Without Borders or MSF.
The number of humanitarian aid workers killed in 2013 reached 155, including unprecedented numbers of UN and Red Cross Movement staff and volunteers. This is the highest number since records have been kept.
Protecting health care workers is critical for ensuring that children in war-torn countries are vaccinated against potentially lethal diseases. And that is getting harder.
Yet we know that even under the most challenging circumstances, even where there is violence and mass displacement, vaccination campaigns can work. After polio broke out in Syria in 2013, international organizations that the U.S. government supports – the World Health Organization and UNICEF – coordinated with the Syrian Ministry of Health and many other partner organizations to launch a campaign to inoculate more than 2 million children and managed to stop what could have become an epidemic. In the past year, no new cases have been reported in Syria or elsewhere in the Middle East.
During times of crisis, offering vaccinations to children can provide broader public health benefits as well – a chance to distribute mosquito nets to mothers in areas with malaria, vitamins for young children to bolster their immune systems, and de-worming medications to help prevent children from becoming malnourished.
The United States provides more humanitarian aid to conflict victims, displaced persons, and refugees, than any other nation. My bureau does this by supporting the United Nations Refugee Agency, UNHCR, and UNRWA, which assists Palestinian refugees. In times of crisis, both these agencies work with Ministries of Health, the World Health Organization, UNICEF and non-governmental organizations, and of course refugees themselves, to bring immunizations to those in need.
PRM also contributes to the work of the International Committee of the Red Cross (ICRC). ICRC plays a vital role in providing health care, including vaccination, for populations in many of the world’s dangerous places. Because of its independence and neutrality, it can cross battle lines and negotiate with all parties to provide civilians in war torn countries with vaccinations and other basic medical services. ICRC also works closely with National Red Cross and Red Crescent Societies around the world.
And ICRC’s Health Care in Danger Initiative is making an important contribution by monitoring, and looking for ways to stop, attacks on healthcare facilities, staff and patients.
The U.S. Government is also one of the six original donors to GAVI, the Global Alliance for Vaccines and Immunization. It brings together governments and the private sector with the aim of making vaccines more affordable and accessible for children living in the world’s poorest countries.
GAVI has tried to tackle a fundamental public health problem – the fact that those with the greatest needs for vaccines and other medicines are often are the least able to pay for them. GAVI has helped to immunize nearly a half a billion children, saving 6 million lives. It has also driven down the costs of life-saving vaccinations.
So far, the United States has contributed $ 1.4 billion toward this effort. Now, under the Obama Administration, we are dramatically stepping up that commitment, with a new pledge of a record $1 billion dollars.
Your advocacy makes a tremendous difference, and helps ensure that these programs are funded.
In closing, I want to thank those of you whose engagement helps to make sure that vaccines are a priority, that existing vaccines are rolled-out, that the vaccines of tomorrow are developed. Your efforts help to ensure a healthier world in which children, no matter where they are and no matter what they have been through, are able to be vaccinated – just as my parents did for me and as I did for my children, just as we want for all American children. Thank you for the opportunity to be here today and please keep up the good work!
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Source: Dept. Of State – Releases
Collected Department Releases: Health Needs of Refugees and IDP Children Including Vaccination
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