The video above shows Part 1 of how the measles outbreak was detected by CBS volunteers and how a response was mobilised. Part 2 and Part 3 of the video can also be viewed online.
Community Based Surveillance (CBS) is an active process of community participation in detecting, reporting, responding to and monitoring of events of public health significance within a community-by-community members. With technical and financial support from the Norwegian Red Cross (NorCross), CBS was first implemented in Somaliland during May 2018, and is currently functioning in 129 sites, 10 districts, and 3 regions, namely Togdheer, Awdal, and most recently, Sool. A total of 315 volunteers have been trained to submit reports via coded SMS to a platform called “Nyss” on selected health risks at community level. Nyss allows SRCS to collect, analyze, and interpret information on health risks andproduce alerts to enable early action by the health authorities and thus save lives.
Between the 14th and 16th of August 2021, SRCS Community Based Volunteers reported 5 cases of fever and rash symptoms in a village in Oodweine District of Togdheer region in Somaliland. The SRCS CBS officer in Togdheer region, upon receiving the alerts through Nyss, followed up with the volunteers and verified them according to the community case definition. The alert was then escalated to Somaliland's Ministry of Health Development (MoHD) in Togdheer region. A team comprising of MoHD, SRCS, and WHO representatives were sent to the area to collect blood samples and conduct clinical investigations.
The collected samples were sent to the National Medical Lab in Hargeisa for further investigation and on the 21st of August, 2 out of the 5 samples came back positive. Immediately after the confirmation of the measles cases, SRCS in Somaliland deployed a mobile medical team close to the area to conduct immunization campaigns, and health and hygiene promotion activities. In addition, the CBS team in Togdheer region informed volunteers in the surrounding villages on the identification of measles cases in Qalo'ato village and to step-up surveillance of suspected fever and rash cases or any other symptoms in their respective villages and to communicate to the communities on preventative measures.
The MoH declared a measles outbreak and called for a meeting to coordinate the response. The ministry requested SRCS to support with 3 additional mobile teams to be mobilized in communities surrounding the village to conduct vaccination and health promotion campaigns. SRCS, with the financial support from NorCross, accepted the ministry’s request and deployed the mobile clinics for 9 days. The MoHD provided SRCS with the vaccines and data collection tools. As a result, a total of 2,637 children aged between 9 months and 9 years were vaccinated against measles and 1,774 children aged between 6 to 59 months were provided with Vitamin A supplements. In addition, 5,568 people were reached with community mobilization, awareness raising and health education against measles. The outbreak of measles in Odweine district, Togdheer region in Somaliland was prevented from spreading due to early detection by community volunteers, using the Nyss platform, and early action. No other new cases were reported.