MOGADISHU, Somalia — Two dozen babies sat on the laps of their mothers, who dressed in a rainbow of headscarves at the Medina Maternal Child Health Center. They are among Somalia's luckiest — the first to receive a new vaccine that protects against five dangerous diseases.
With more regions of Somalia, including the capital Mogadishu, at peace for the first time in 20 years, health care workers are expanding vaccination programs and can now access 40 percent of south-central Somalia, where the influence of hardline Islamic insurgents is highest. Three years ago, health workers could access only 15 to 20 percent of that territory.
With one in five Somali children dying before his or her fifth birthday, the international community is rolling out the new five-in-one child vaccine they say will save thousands of lives.
The roll-out of the vaccine against diphtheria, tetanus, whooping cough, hepatitis B and an influenza known as Hib comes as health leaders on Thursday held the Global Vaccine Summit in the United Arab Emirates, where a six-year plan to eradicate polio was unveiled.
Violence and insecurity cost children dearly when it comes to preventable diseases. Polio remains endemic in only three countries: Afghanistan, Pakistan and Nigeria. All three experience heavy violence.
In February, gunmen believed to belong to a radical Islamic sect known as Boko Haram shot and killed at least nine women taking part in a polio vaccination drive in northern Nigeria.
In Somalia, efforts by African Union forces — from Kenya, Uganda and Burundi primarily — have beaten al-Shabab back from areas it once controlled. As evidence of the improved security, Britain's foreign secretary traveled to Mogadishu on Thursday to open the British Embassy, the first time Britain has had an embassy in Somalia since 1991, when violence forced an embassy evacuation.
When al-Shabab is forced out, health officials rush in and vaccinate children, said Marthe Everard, the World Health Organization country director for Somalia. After Kenyan forces took the coastal city of Kisumu last year from al-Shabab, health officials immediately vaccinated nearly 13,000 children, but districts around the city remain off-limits, she said.
President Hassan Sheikh Mohamud, speaking at the new vaccine's launch in Mogadishu on Wednesday, said all Somali children deserve the good health that children from rich countries enjoy. He blamed much of the country's vaccination problem on al-Shabab, the al-Qaida-linked militant group that controls much of south-central Somalia and up until August 2011 controlled Mogadishu.
Al-Shabab, the president said, is killing people with attacks and explosions, but also by forbidding children access to vaccines. Maryan Qasim Ahmed, the country's health minister, said al-Shabab kills aid workers who try to better health in south-central Somalia, "so they are contributing to child and infant mortality."
"The state of child health in Somalia is one of the worst in the whole world," said Ahmed. "The children of Somalia are dying from diseases that don't exist in the rest of the world."
Al-Shabab distributes false propaganda against vaccines, Everard said, such as claims the vaccines will make girls infertile, or that the vaccines are made by Christian countries. The vaccines are actually made in Indonesia and Pakistan, Muslim countries.
Sikander Khan, the head of UNICEF in Somalia, said the health sector must take advantage of Somalia's improved security: "There's more confidence and there's more hope. I don't think we can afford to let go of this opportunity."
But the remote stretches of the arid Horn of Africa nation also hamper aid workers.
Saqa Farah is the mother of 12 children from a nomadic goat-herding family in Somalia's north, where al-Shabab is not prominent. Only her youngest child, Abdi, was vaccinated. But even Abdi didn't get a full cycle and he's now in a Mogadishu hospital with measles.
"There is no medicine," Farah said. "I'm a nomad. When one of us gets sick we either get medicine or we die."
Omar Mayuw Mahdi, the nurse in charge of the Medina Maternal Child Health Center, where the two dozen mothers waited on Wednesday, said Somali mothers know that prevention is better than cure, but in the country's Bay and Bakool regions, where al-Shabab still reigns, there are no vaccines. "The situation does not allow it."
Global health leaders face similar security problems in trying to stamp out the last few remaining patches of polio around the world. The crippling disease is at its lowest level ever. Nineteen children have been paralyzed by polio so far this year; 223 were paralyzed last year.
The new anti-polio push will cost $5.5 billion, three-quarters of which has already been pledged, including $1.8 billion from the Bill and Melinda Gates Foundation.
"After millennia battling polio, this plan puts us within sight of the endgame," said World Health Organization Director-General Margaret Chan.
The six-year plan to end polio addresses such challenges as insecurity and hard-to-reach populations.