From the sky, the Dadaab Refugee Camp in Garissa County looks like a tuft of green hair in the balding savannah that is the northern part of Kenya.
Sporadic clouds throw black splotches that look like burn scars on the pale peach-hued earth. To the sympathetic eye, the camp looks like an oasis in the middle of the parched land that stretches to the Kenya-Somalia border where terrorism has interrupted the rhythm of life.
That Dadaab looks like an oasis is no accident of history or geography. Humanitarian organisations have teamed up to sink boreholes that can produce over a million cubic litres of water at short notice. An intricate arterial network of invisible pipes distributes this water to various blocks in the refugee camp.
This is the lifeline of the 209,606 refugees, mostly Somalis, who call the camp home.
Every few metres, a nod in this system forms a water collection point from which a cluster of households collects water in yellow jerricans, which the boys take home in improvised wheelbarrows or which the women roll on the ground by pushing the jerricans with their feet.
Two-year-old Maida Abdulhakim lives in one such household in Block L4. On the second day of the polio vaccination campaign that ends today, Maida had accompanied her mother, Ms Warsan Muhamud, to the L6 health post where she and other refugee women run a demonstration kitchen garden where they learn how to grow various food crops like sukuma wiki and spinach to supplement their diets.
Those who are good at it also grow a surplus, which they sell to other families in the camp. Although the group is called the Mother-to-mother Nutrition Support Group, it has men and girls among its members. They all learn from one another on how to improve the health of their children, such as Maida.
"Has this child been vaccinated?" someone in the group asks as others water the vegetables in the demo garden. It turns out that she has not. At once, Mr Jamal Abdi, the community health promotion officer with the International Rescue Committee gets on the phone and calls the nearest team of vaccinators.
As the man in charge of co-ordinating the polio vaccination campaign in the camp, he knows where each of the 29 mobile teams of vaccinators work from.
In a short while, the team — comprising the team leader, community volunteer and vaccinator — arrives.
After explaining to Ms Muhamud what the vaccine is about, she consents to have Maida vaccinated.
It only takes two drops of the Bivalent Oral Vaccine, which Mr Mohamed Ahmed, the Unicef education specialist at Dadaab, administers for demonstration purposes.
OFFERS LITTLE FINGER
Maida proudly shows off her little finger after the vaccinator paints her nail with the black indelible ink, the sign that her immunity from the debilitating disease has been boosted. Maida, like the other 35,000 refugee children targeted in the latest campaign, can expect to be free of the incurable disease that is caused by poor sanitation or contact with infected faecal matter.
The vaccination campaign, which was launched after the polio virus was found in Eastleigh, Nairobi, in April, is just one aspect of a holistic approach to ensure that children in the camp live a healthy life.
However, ensuring that only refugee children are vaccinated from polio would be ineffective if the same is not done with children from the host community, who have constant contact with refugees since movement into and out of the camp is not restricted.
Garissa has seven sub-counties and Dadaab is one of them. This is where the Ifo and Dagahale camps, which form the larger Dadaab refugee camp, are to be found. As the sub-county health promotion officer, Mr Abdulrahman Bashir, a lanky man with a deep voice, has the responsibility of ensuring that all the children under five in the host community are immunised.
His job is more difficult than that of Mr Jamal Abdi. In the camp, it is easy to find the children since the refugees are sedentary. However, the host community is not. This means that Mr Bashir has to work harder to find the families and vaccinate their children to ensure that they are not exposed to the highly contagious polio virus.
Last Saturday, a day after the vaccination campaign for the 12 high-risk counties was launched in Garissa town by Health Cabinet Secretary Cecily Kariuki, Mr Bashir summoned his team to the Dadaab Hospital to start the onerous task of finding and vaccinating the 18,666 children under the age of five in the sub-county. As luck would have it, a baby born at the hospital that very morning was the first to be vaccinated.
Unlike the refugee community, where the vaccination campaign is supported by humanitarian organisations, the local community depends entirely on funding from the ministry of Health.
"The budget for fuel was not enough to cover the entire sub-county," he said. Although he was allocated one vehicle, he felt that an additional one would have made the campaign more successful. He also had money to hire six people to work as mobilisers although he needed more considering that some parts of the sub-county are unreachable by vehicles.
"We have had to be innovative," he told the Nation.
To his credit, on the first day of the campaign, his team vaccinated 5,994 children, translating to 95 per cent of the target for that day.
FLED FROM VIOLENCE
Thankfully, Mr Bashir and his team have two things going for them. The first is that since the refugee community has been sensitised about the importance of the vaccine, this high level of awareness has rubbed off on the host community. Secondly, the team does not need to vaccinate practically every child there is.
"When majority of the children get the vaccine, the rest get what is called 'herd immunity'," says Mr Bashir.
The last case of polio reported in Kenya was that of Awil Awad Abdoule, who got the disease in 2013 when he was 19. He had fled from the violence in Somalia at the age of 10. But because he had never been immunised, he woke up one day and found that he could not stand on his own.
WEAKNESS OF MUSCLES
He also manifested other signs associated with polio, such as fever and weakness of the muscles.
Like many Somalis fleeing to safety in Kenya, Abdoule was not screened when he crossed into the country through Liboi.
Such unregulated free movement of people across the border has major implications for public health and safety.
And although the International Organisation for Immigration has built a border check point at Liboi, Kenya is yet to send immigration staff there though having a strong health team at Liboi has the potential to reduce risks and strengthen the national health system.
Tomorrow: The challenges of being a student in Dadaab Refugee Camp and why it is more difficult to keep girls in school