Sudanese refugees began streaming across the border into South Sudan in June 2011 when conflict erupted between the Khartoum government and the rebels of the Sudan People’s Liberation Movement-North (SPLM-N) in Sudan’s South Kordofan State. At the height of the crisis in Yida camp last summer, high mortality rates were reported among young children admitted to MSF’s hospital with respiratory tract infections, such as pneumonia, one of the leading causes of death. Photograph by Yann Libessart Photograph by Yann Libessart
Feature story |

Pneumonia in Ethiopia: The absurdity of dying of a disease that is preventable

Photograph by Yann Libessart
Sudanese refugees began streaming across the border into South Sudan in June 2011 when conflict erupted between the Khartoum government and the rebels of the Sudan People’s Liberation Movement-North (SPLM-N) in Sudan’s South Kordofan State. At the height of the crisis in Yida camp last summer, high mortality rates were reported among young children admitted to MSF’s hospital with respiratory tract infections, such as pneumonia, one of the leading causes of death. Photograph by Yann Libessart Photograph by Yann Libessart
Ana Leticia, a doctor working in Ethiopia for Médecins Sans Frontières/Doctors Without Borders (MSF), brings us her story from a pneumonia vaccination campaign in Leitchuor refugee camp, 2014.
Ana Leticia, a doctor working in Ethiopia for Médecins Sans Frontières/Doctors Without Borders (MSF), brings us her story from a pneumonia vaccination campaign in Leitchuor refugee camp.

Laying in a bed in the hospital ward dedicated to malnutrition, Nyamal is fighting for her life. She is one of our patients admitted with pneumonia (low respiratory tract infection), and every breath for her is laborious and difficult.

Her little chest indraws in her ribs as all her muscles need to be used to suck in the precious air. Her palms are pale and her lips are bluish revealing signs of low oxygen in the blood. She is febrile and unconscious. As I put the oxygen mask in her face and start to give Nyamal the antibiotics she desperately needs to help her fight the infection, I notice her mother holding her hand as tightly as she can. She lost one baby like this before, and she can’t afford to lose another one, she says.

"The vaccination campaign is giving these children a chance.”

Photograph by Julie Remy
Hoden Mohamed, a 2 year old girl from East Imey is not well. After examination, Hoden will be given drugs for treating pneumonia and intestinal parasites. Photograph by Julie Remy

Nyamal is one of many patients admitted in the hospital I work in as a doctor in Leitchuor, a refugee camp in Ethiopia. Our hospital serves over forty thousand South Sudanese refugees. Running away from war and starvation in South Sudan, these people cross the border only to discover that conditions in the camp are not so different from back home – living in overcrowded and poorly ventilated tents in dire hygiene conditions, it is easy for diseases to spread.

Pneumonia accounts for a huge number of admissions in our hospital, second only to malaria – and many patients arrive in critical condition. The disease affects mainly the more vulnerable – children under five. Their immune system is not mature enough to fight infections, and is especially weak when they are severely malnourished, as is the case with many of the children in the camp. A cold turns quickly into pneumonia, and unless the parents seek help many die of the disease.

The good news is that there is a vaccine that primes the immune system of the children against the more common and lethal types of the pneumococcal bacteria and the Hemoephilus virus that cause pneumonia, making it easier for their bodies to fight the disease. As it is expensive, most poor countries don’t have it available in their health system.

" The disease affects mainly the more vulnerable – children under five.”

Aware of the burden of pneumonia in child mortality in the refugee crisis in Ethiopia, MSF has organized a huge vaccination campaign in the refugee camps, offering protection for all children with no cost. During the campaign, 50 000 children were targeted to be vaccinated against pneumococcal infection, and 26 000 vaccinated against Haemophilus virus.

As I and the medical team watched through the hospital door throngs of children passing by in their mother’s lap, holding the orange vaccination cards they receive when they are vaccinated, we gained hope. The vaccination campaign is giving these children a chance. The chance to overcome the absurdity of dying of a disease that is preventable and treatable. As it turns out, it is not only Nyamal’s mother who can’t afford to lose another one. Médecins sans frontières/Doctors without borders (MSF) are demanding that pharmaceutical firms bring own the price pneumonia vaccines to $5 per child, so more children can be vaccinated for this deadly disease and are given a fair shot.