Indonesian Ministry of Health leads polio partners to rapidly protect children from poliovirus in Papua and West Papua

On 8 February 2019, Indonesia reported the detection of circulating vaccine-derived poliovirus type 1 (cVDPV1) in Yahukimo District, Papua Province. Lab data and field investigations confirmed onset of paralysis of the first detected case occurred in November 2018 in a young boy of 31 months-of-age.

Evidence of virus circulation has been confirmed through detection of related poliovirus in two healthy children living in the same district.
The re-emergence of the disease in Indonesia is a reminder of the importance of ensuring high vaccination coverage in all populations until all poliovirus is eradicated everywhere.

The Indonesian Ministry of Health has rapidly responded to the emerging threat and is coordinating supporting partners like WHO and UNICEF to mount a robust response.

Coordinating structures have been established at the national level and in Papua Province and senior focal points from the national and provincial health offices have been identified to oversee the speed and quality of supplementary immunization as well as surveillance and lab strengthening.

To supplement the capacity of district and provincial health teams WHO has recruited a number of additional surveillance and immunization officers to work locally in the affected provinces. International polio experts have also been contracted to the country to help with coordination, management and communication.

The first polio outbreak response round conducted in March and April, 2019 reached 968, 977 of the 1,262,880 targeted children in Papua and West Papua with an additional dose of bivalent Oral Polio Vaccine (bOPV).

While reported coverage is high from all areas of West Papua and low-land districts of Papua. Coverage in high-land districts including Yahukimo district was hampered by severe access challenges caused by scattered populations, limited health and logistic infrastructure and dense jungle.

To ensure we have the best possible information about missed children and where they live Rapid Convenience Samples (RCA) are being conducted to supplement reported coverage. Data from the first round tells us there is high demand for the polio vaccine from parents but more work is needed to reach children on the move in highly mobile populations.

The second campaign started last week on the 28th of April in West Papua and low-land districts of Papua province. High-land districts in Papua will begin their second round of vaccination on the 13th of May once special plans are finalized, including the chartering of planes and helicopters to improve coverage in these very challenging areas.

Reaching every child

Given the challenges in this outbreak zone service delivery strategies have been designed to reach children where they can be found, including at schools for older children, at outreach and local health centers as well as in the community, sweeping house to house or at churches, mosques, markets and busy transit points. Reports from the first round indicate that teams are sparing no effort to reach all children working tirelessly in the hot sun or walking kilometers to reach small and isolated communities.

Two of the nearly 1.3 million children targeted for polio vaccination are Adrian and Merina Suu who both live in Yahukimo District. While Indonesia comes together to rapidly stop this outbreak it is important to remember and hear from those with most to gain or lose from its success.

Below are brief statements from these children, excited to be protected from this terrible disease.

Hello, my name is Adrian Suu, I'm 7 years old. I am from from Cenderawasih village, Nalca Sub-district, Yahukimo, Papua Province, Indonesia.

I am in first grade at at Lentera Harapan School. I want to be a pilot. I'm very happy, because I got polio vaccine from aunty cadre. I want to be healthy, so that I can drive a plane around the villages in Papua.

Hallooo... Sa pu nama Adrian Suu, sa pu umur 7 tahun. Sa pu asal dari distrik Nalca, Kabupaten Yahukimo, Papua. Sa tinggal di kampung Cenderawasih. Sa sekolah di Sekolah Lentera Harapan Nalca, sa sekarang kelas 1 SD. Nanti kalau sa su besar, sa mo jadi pilot. Sa senang sekali karena sa su dapat tetes vaksin polio sama mama-mama kader kesehatan. Sa mo jadi sehat supaya sa bisa bawa pesawat keliling kampung-kampung yang ada di Papua.

Hello, my name is Merina Suu. I'm 3 years old. I live at Nalca Subdistrict, Yahukimo district, Papua Province, Indonesia. I'm glad because I got polio vaccine from nurse in the church. So that I can run fast around the garden with my mom. I'm very happy..

Helloo…sa pu nama Merina Suu, sa pu umur 3 tahun. Sa tinggal di distrik Nalca, kabupaten Yahukimo, Papua. Sa senang sekali karena sa su dapat tetes vaksin polio sama mama-mama perawat di gereja jadi sa bisa lari-lari di kebun sama sa pung mama. Sa senang sekali…

Adrien Suu, seven years old from Yahukimo District, Papua province happy to receive a dose of oral polio vaccine. Adrien would like to become a pilot so he can help other remote villages in Papua.
Dr Indreni/WHO Indonesia