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Anti-Vaxxers Brought Their War to Minnesota—Then Came Measles



MINNEAPOLIS — ON the first Saturday this May, residents of the Cedar-Riverside neighborhood socialized in the shadows of their towering public housing complexes. Chattering men sat for haircuts while headscarved women shopped the stalls lining the blue-bricked Riverside Mall. At nearby Currie Park, training-wheeled biker boys chased each other, circling a drained wading pool where girls played a game of tag. Their relatives picnicked in the shade.

Not so visible was the fact that this Somali-American community—Minnesota’s largest—is currently experiencing the state’s worst measles outbreak in nearly three decades. On Thursday, the count rose to 44 confirmed cases across three counties. Public health officials are now scrambling to keep the disease from reaching pockets of unvaccinated kids in other parts of the state. This means advising accelerated shot schedules to doctors and parents, and considering quarantine orders for anyone who has been exposed. The health officials know that once a measles outbreak gets going, it can be very difficult to contain, even if they expected it.

And they totally expected it. Over the last decade, anti-vaxxers have fortified this corner of Minneapolis into a bastion for pseudo-science. It all began with higher-than-normal rates of severe autism in the Somali community. And when state and university researchers failed to understand why the disorder hit so hard here, families went looking for answers elsewhere: friends, and the all-knowing internet. In came the anti-vax partisans, whose success with these frightened parents has turned the neighborhood into a beachhead for what should be a totally preventable disease.

Measles kills about 10,000 children a year in Somalia. So, when the first wave of refugees from that country’s civil war brought their kids to Minneapolis in the 1990s, vaccination rates were high—around 90 percent by 2004. Four years later, Somali parents began noticing a rising number of autistic children in their community. The cried out to city officials, who enlisted researchers from the University of Minnesota, CDC, and NIH, to launch an investigation. Those epidemiologists found that autism rates in Minneapolis’s Somali community were higher than the national average. But, the rate was identical to autism in Minneapolis’ white population.

What was different is that Somali children didn’t just get autism, they consistently got the most extreme version of it. By comparison, only about a third of non-Somali kids with autism were also diagnosed with intellectual disabilities—such as delayed speech, or difficulty understanding abstract concepts and social rules. For Somali autistics, it was 100 percent.

“In some ways that finding was very consistent with what we were hearing from the community—that autism hits Somali kids much harder,” says the study’s lead author, Amy Hewitt. But her results only told people what they already suspected, not what they were looking for: What was causing the autism.

Not that it would have mattered much if she had. By the time Hewitt’s study was published in 2013, anti-vaccination activists had already claimed Cedar-Riverside. Andrew Wakefield—the study-falsifying founder of the modern anti-vaxx movement—met with upset Somali families three times between 2010 and 2011. And Minneapolis health officials say it’s not hard to draw a line between this targeted misinformation campaign and the current measles outbreak. Kris Ehresmann, director of the health department’s Infectious Disease Division points to the precipitous drop in vaccination rates in recent years: Today, only 4 out of every 10 Somali kids in the city are protected against the disease. Even as recently as last Sunday, groups like the Vaccine Safety Council for Minnesota organized a public meeting to help Somali families understand their legal rights to refuse the same vaccinations public health officials are anxiously urging them to get.

“The answer used to be education—the more educated you were on the issue the more likely you were to get vaccinated,” says Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research. Those days are over, he says. In no small part thanks to the proliferation of misleading information on the web. “The challenge is for scientists to be humble and acknowledge that in this day and age facts will not win the day,” he says.

Minnesota’s Health Department has been trying to take a page from that playbook. It has changed up its tactics in the past few years—hiring Somali nurses and outreach workers to pave inroads into the community, and working with imams and other leaders to create a network of trusted individuals who can combat internet-fueled fears. And they’ve begun taking up alternative communication strategies. Rather than use bullet-pointed barrages of facts, they illustrate their points with stories about, say, how someone whose child came down with measles.

Catherine Mary Healy, the director of the Center for Vaccine Awareness and Research at Texas Children’s Hospital says this is a better strategy for communities that haven’t been exposed to an outbreak of vaccine-preventable diseases. “When they come across misinformation they interpret it in a different way than you or I might because they’re unable to weight the risk/benefit ratio appropriately,” she says. Healy works with many Latino immigrant groups in Texas, where she says vaccination efforts are highly successful because so many of them have experienced measles first-hand.

This echoes what officials around Minnesota have been clear about from the beginning of the outbreak: This isn’t an immigrant problem, or a Somali problem, it’s an unvaccinated problem. But there is reason to be hopeful that evidence-based information can still win the day. Research shows that the most important factor for parents making the decision whether or not to immunize comes down to their doctors’ opinion. And the investments Minnesota has made in providing tailored health care services to Somali families, especially those with autistic children may be beginning to pay off.

The Brian Coyle Community Center, which bustles with basketball-crazed kids, is in the middle of the Cedar-Riverside neighborhood—the outbreak’s epicenter. And just a few days ago, the community center’s walls had been pasted with flyers promoting the connection between the vaccine and autism either. But the Somali staff decided to take them down. On request, the man working the front desk Saturday afternoon (who didn’t want to share his name), produces a crumpled advertisement for last weekend’s anti-vaxx public meeting. “I don’t understand these people,” he says, shaking his head. “With my children, if the doctor says to do something, we do it. They know best.”



Somalia, UN seek to vaccinate over 700,000 children against polio



XINHUA — Somalia’s health ministry and two United Nations agencies on Sunday launched a three-day oral polio vaccination campaign, targeting 726,699 children under five years of age in two districts.

A joint statement issued in Mogadishu said the campaign backed by the World Health Organization (WHO) and UNICEF is taking place in Banadir and Lower and Middle Shabelle regions.

Ghulam Popal, WHO Representative for Somalia said the campaign will be conducted in two rounds through house-to-house visits by vaccination teams, noting that no cases of polio have been detected in Somalia since August 2014.

“However, as a preventative measure; it is imperative that all children under five years of age in targeted locations, whether previously immunized or not, receive two drops of oral polio vaccine,” Popal said.

Banadir region reported the highest number of wild poliovirus cases in Somalia (72 out of 199) during the Horn of Africa outbreak in 2013-2014.

“We urge all families to get their children vaccinated to protect them against this dangerous disease,” he added.

The UN health agencies said the first and second round will involve the use of oral polio vaccine for children under five years of age.

Inactivated polio vaccine (IPV) will be used in the third round to boost immunity among children between 2 and 23 months of age.

According to the UN, conflict and insecurity in South and Central Somalia especially has continued to hinder access to children during polio immunization campaigns in 2017, with about 240,000 children under five years of age reported as not accessible for more than a year.

“This campaign has been carefully planned to make sure that all children in the chosen areas, particularly those who have been missed in previous vaccination campaigns, are reached this time,” said UNICEF Somalia Representative Steven Lauwerier.

The UN agencies said over 4,400 vaccinators and monitors, and around 800,000 doses of vaccine have been mobilized to conduct the activity.

The Horn of Africa nation has been polio free since August 2014, when the last case of polio was reported from Hobyo district of Mudug region.

The declaration by WHO two years ago keeps Somalia outside the last group of countries which still record cased of polio in the world.

WHO has however warned Somalia remains at risk of importation of the virus from these countries.

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Can your blood not be moved for Somalia?



On Oct. 14, I was participating in “Somali Studies in Canada: Resilience and Resistance,” a multidisciplinary colloquium held at Carleton University.

It was the first of its kind in Canada, and more than 50 brilliant, bright and eager academics, artists, frontline workers, and grassroots activists from Ontario and Quebec gathered to discuss the Somali diaspora’s resilience and resistance over the past 30 years in Canada.

But that was abruptly interrupted as attendees began to hear news of a massive explosion in Mogadishu, Somalia. Two hundred casualties were immediately reported; in just a few hours, more than 300 people were believed to be dead. It is being described as the deadliest attack to take place in the region.

Just two weeks later, on Oct. 28, a car bomb detonated in front of a busy hotel and restaurant as gunmen took hostages inside; later that day, a vehicle carrying government troops triggered a roadside bomb planted by the militant group al-Shabaab. In the end, at least 23 people were declared dead in Mogadishu.

For those of us in Canada who arrived in the early 1990s and who left family and people behind, stories of death and violence have become achingly familiar.

Families that have made difficult decisions to leave loved ones and a homeland behind are constantly forced to relive them in the immediate moments after horrific events have taken place.
It felt like I had barely been given a moment to breathe before I began to call family members and friends to make sure everyone was accounted for. This in-between place—of frantic calls, racing hearts, guilt for the relief that everyone is just fine, frustration, anger and fatigue—was eerily familiar.

Since the explosion, the question at the top of the general public’s mind is: “will your community mobilize?”

To me, the question isn’t worth asking. Over the summer, thousands in Somalia were displaced and put at risk of starvation due to a rapidly escalating drought. According to the UN Office for the Coordination of Humanitarian Affairs, Somalia is facing a humanitarian crisis and is at risk of a severe famine—all of this coming just six years after the last deadly drought.

They note that between November 2016 and May 2017, an estimated 739,000 people were displaced by the drought; more than 480,000 of the displaced, or 65 per cent, are younger than 18.

Shortly after learning this information, a vast majority of the Somalis I knew in Canada mobilized. Elders added extra remittance payments to their monthly spends; young people coordinated events and fundraised money. Even those who could not give money retweeted, shared statuses and ensured the public was aware of the dangerous situation Somalia was in. Young Somalis became #FamineResistors with many in our city doing the work to garner attention, collect donations and forward to the appropriate hands in Somalia.

The question, then, is not whether we will mobilize. The question is: will you?

On Oct. 8, just six days before the horror in Mogadishu, 16-year-old Zakariye Ali was killed in a Toronto junior high school parking lot; three days before that, 29-year-old Abdulkadir Bihi was shot to death in Etobicoke: Allahu naxariisto. Mustafa Mattan, 28, was fatally shot through the door of his apartment building on Feb. 9, 2015; no killer has been apprehended.

He is just one of at least 100 young Somali men between Toronto and Alberta whose deaths continue to go unsolved by local police despite active work by community members and agencies such as Positive Change that have worked to address the lack of information provided by RCMP and other authorities. Somalis continue to be deported by the Canadian government by Immigration Minister Ahmed Hussen. Despite Hussen’s identification as Somali, it’s important to remember that representation does not always mean we are allowed to stay.

On top of this, Somalis continue to face negative media depictions that work to present the general public with correlations to terrorism, piracy, and gangsters. Media narratives like Vice’s documentary This is Dixon and the now-discontinued CBC drama Shoot the Messenger which looked to fictionalize the Rob Ford crack scandal.

This scandal saw “Project Traveller” come to a head in June 2013 when police stormed an apartment building on Dixon Road in pre-dawn raids that resulted in more than 60 arrests of primarily young Somali men. When the Canadian public and media only know us through the analysis of violence and terror—a characterization all too frequently and easily deployed—there is only attention granted to us in our deaths.
Why do you only want us when we are dead?

In early October 2017, our mothers cried on camera for the kids they raise here. In July 2017, they wept while they watched Abdirahman Abdi be brutally murdered by police. This week, they weep silently for the family they have lost back home. This middle place they’ve come to reminds them they are not wanted—and still, all everyone offers is prayer.
What happens when the prayers are not enough?

After every death, every drought, every instance of violence, I am hard-pressed to feel grateful that Somalis are granted prayers. We did not get here all by ourselves. We get up and face the onslaught: “Your community again? But how are you feeling?” The answer does not change, and the emotions are the same each time: grief, relief guilt, fatigue, rage, frustration.

We will pray for Somalia, politicians tell us; we will not forget you. But you can not forget those you do not remember. The City of Toronto may light the Toronto sign blue and white, but Mayor John Tory rarely makes commitments to address the violence that lies at the doorsteps of Somali communities.

Somali-British poet Warsan Shire reminds us that “in Somali, when we see injustice, we say ‘dhiiga kuma dhaqaaqo?’ which translates into ‘does your blood not move?’ ”

Can your blood not be moved?

For those of you who are willing to pray and willing to gather in vigil, try something different. Call out false narratives of terror and deficit when you see them. Ask the Ontario Ministry of Children and Youth Services what specific long-term and sustainable services they are allocating to Somali youth in Ontario. Pressure the Toronto Police Services, Ontario Provincial Police and the RCMP to appropriately investigate the deaths of young Somali men.

Stand in the streets when we tell you the Minister of Immigration has deported us. Pay attention to the counter violent extremism programs that criminalize Somali youth that are being funded by Public Safety and Emergency Preparedness Canada.
Prayer is an act of empathy; action is an act of solidarity. We need both if any of us are to survive.

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Somalia Opens First Forensic Lab Dedicated to Rape Investigation



Somalia has opened its first forensic laboratory to process rape kits. Sexual assault is widespread in the country, according to human rights groups, but few victims come forward and few perpetrators are punished. The new forensic lab in Somalia’s Puntland region has been hailed as a step in the right direction, but a long road remains to end impunity for gender-based violence. Neha Wadekar reports for VOA from Garowe, Somalia.

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