Children at risk of measles outbreak in Rokero, Sudan

“For weeks, we didn’t know what to do,” said Fatima, a mother of three. “My youngest was coughing and had a fever, and others in our village were getting sick too. When we heard about the vaccination team coming, we made sure to get to them.”

In Rokero, Central Darfur, where the healthcare system has collapsed under the weight of war, a measles outbreak swept through the region between June and October 2024, affecting over 1,000 people—mostly children under five. To control the outbreak and protect vulnerable lives, Médecins Sans Frontières (MSF) launched a vaccination campaign that reached 9,634 children, primarily vaccinating children aged 6-59 months who are at most risk of severe complications from measles.

Blocked roads and lack of awareness

“We faced significant challenge [to ensure the vaccination campaign], from difficult roads to unstable provisions of vaccines,” said Marwan Taher, MSF’s Project Coordinator in Rokero. “It wasn’t easy, but we knew how important this was.”.

MSF teams travel to remote villages on donkeys, in tuk-tuks and cars. The teams set up the clinics in whatever public space was available: schools, markets, and health facilities, ensuring accessibility for local communities. This is crucial in a region where rugged terrain and blocked roads often limit healthcare access.

While it´s difficult for MSF teams to reach those areas, it´s also a challenge for families with sick children. Many families had to walk for hours to reach vaccination points, often navigating dangerous terrain. Abdurrahman, a father of five, explained: “The road was rough, and it had rained the night before. But with so many children falling ill in our village, we had to make the trip. Now, I’m relieved my children are protected.”

At the same time, informing people can be challenging without the help of the local community leaders. MSF teams worked together with the leaders of the community to spread awareness of the vaccination campaign to reach those most vulnerable.

“This isn’t just about vaccinations,” said Marwan. “It’s about working together to prevent a health crisis from getting worse. The community’s cooperation and determination were essential to achieving this.”

Measles isn’t the only health challenge in Rokero

“We can’t afford for this to happen again,” said Fatima. “Now that my children are vaccinated, I’m less afraid. But we still need help to keep them healthy in the future.”

While the measles outbreak has been contained for now, MSF is calling for sustained efforts to address the region’s broader health needs. Sudan has faced a humanitarian crisis for years that has gotten worse since the war broke out between Rapid Support Forces and Sudanese Armed Forces. With a lack of international humanitarian response in the country, people do not have proper access to basic needs, including food, increasing the malnutrition rates to devastating levels.

During the vaccination campaign, MSF teams screened vaccinated children for malnutrition and referred severe cases for treatment. Our teams found that 299 children under 5 presented severe acute malnutrition and 1062 children aged between 6 to 59 months were moderate acute malnourished.

"The malnutrition situation in Rokero is alarming and is a result of the decreased access to food,” says Merce Rocaspana, MSF´s Emergency Health Adviser . “The war continues to create a humanitarian catastrophe with serious health complications.”

Routine immunization programs, nutritional support, and investments in healthcare infrastructure are critical to preventing future outbreaks.