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Minnesota Hoping for All-clear After Measles Outbreak in Somali-American Community



Carol Pearson

WASHINGTON — Minnesota has had 78 cases of measles so far this year, eight more than in the entire United States in 2016.

There have been no new cases in the state since June 16, but health officials are waiting for two 21-day incubation periods to pass without new infections before they declare the outbreak over.

The virus broke out in the Somali-American community in Minneapolis. No one knows how measles came to Minnesota, since the disease no longer occurs naturally in the U.S.

State health workers identified nearly 9,000 people who were exposed to the measles infection. Those people had to be watched, immunized, if they were not vaccinated, and isolated if they became sick. Most of those who were exposed had already been vaccinated.

“It tells us that the vaccine works really, really well,” said Patsy Stinchfield, an infectious disease nurse practitioner who said she worked in “the eye of the storm” at Children’s Minnesota hospital.

Previous outbreak

Stinchfield has been involved in vaccine work since a measles outbreak in 1990 claimed the lives of three children, two at Children’s Minnesota.

“Measles is such a highly contagious disease; all you have to do is be in the same room with someone who is breathing it,” Stinchfield said during an interview with VOA via Skype. Ninety percent of those exposed will go on to develop the disease unless they have been vaccinated or have already suffered the infection.

Stinchfield described efforts at Children’s Minnesota to contain the infectious disease. She said nurses wearing face masks met people at the doors of the hospital emergency room and at the facility’s clinics. They also required the patients to do the same.

All but two of those who contracted measles were children. Twenty-one were hospitalized, mostly for dehydration. There is no treatment for measles, only for its symptoms.

The virus broke out in the mostly Muslim Somali-American community so health workers met with the community’s religious leaders, who invited Stinchfield and others to provide information to their followers about the vaccine and measles itself. The imams also encouraged parents to have their children vaccinated.

Stinchfield said Somali-Americans, at one time, had the highest rates of vaccinations against measles in the entire state. Then, she said, the vaccination rate dropped dramatically after anti-vaccination groups told the community that the MMR vaccine, which protects against measles, mumps and rubella, could cause autism.

“I would say almost exclusively the whole responsibility lands on the anti-vaccine movement, and the reason is misinformation and myths spread about a link between MMR and autism, of which there is none, and science has proven that not to be true,” Stinchfield said.

In interviews with Somali mothers last month, VOA’s Somali Service found that anti-vaccine views in the state are widespread.

Known history with measles

In Somalia, measles is widespread, Stinchfield said, and those in the Somali-American community are familiar with the disease and know that it can kill.

“They did not think that measles would be in the United States, and so the level of fear was greater for autism,” Stinchfield said. “This has now shifted, because the level of fear and the level of fear for measles is great because these families know measles. They’ve had loved ones die of measles in Somalia.”

Measles can cause a number of medical problems.

“The people who decline vaccines are actually increasing their risk for neurological problems … encephalitis, brain infections, developmental delay, and it is absolutely taking a risk to do nothing, to decline vaccines,” Stinchfield said.

Some researchers, such as Daniel Salmon at the Johns Hopkins University’s Institute for Vaccine Safety, maintain that the rubella vaccine can prevent autism. Rubella, which is also prevented by the MMR vaccine, is generally a mild disease, but 90 percent of infants suffer complications, including brain damage, if a pregnant woman contracts it during her first trimester.

Members of anti-vaccine groups, however, say that vaccines expose children to health risks and can cause harm. But, Stinchfield cites the higher health risks of not being vaccinated.

“Anything that can cause neurological impairment should be avoided and so, for example, with measles disease, one in a thousand cases from measles can have encephalitis with permanent brain damage, whereas one in one million doses of measles, mumps, rubella vaccine can have anaphylaxis,” a severe, potentially life-threatening allergic reaction to the vaccine, “and so it really is important to prevent the disease, which is a greater chance of having brain issues.”


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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