Delays in childhood immunization in a conflict area: a study from Sierra Leone during civil war

ABSTRACT: BACKGROUND: Sierra Leone has undergone a decade of civil war from 1991 to 2001. From this period few data on immunization coverage are available, and conflict-related delays in immunization according to the Expanded Programme on Immunization (EPI) schedule have not been investigated. We aimed to study delays in childhood immunization in the context of civil war in a Sierra Leonean community. METHODS: We conducted an immunization survey in Kissy Mess-Mess in the Greater Freetown area in 1998/99 using a two-stage sampling method. Based on immunization cards and verbal history we collected data on immunization for tuberculosis, diphtheria, tetanus, pertussis, polio, and measles by age group (0-8/9-11/12-23/24-35 months). We studied differences between age groups and explored temporal associations with war-related hostilities taking place in the community. RESULTS: We included 286 children who received 1690 vaccine doses; card retention was 87%. In 243 children (85%, 95% confidence interval (CI): 80-89%) immunization was up-to-date. In 161 of these children (56%, 95%CI: 50-62%) full age-appropriate immunization was achieved; in 82 (29%, 95%CI: 24-34%) immunization was not appropriate for age. In the remaining 43 children immunization was partial in 37 (13%, 95%CI: 9-17) and absent in 6 (2%, 95%CI: 1-5). Immunization status varied across age groups. In children aged 9-11 months the proportion with age-inappropriate (delayed) immunization was higher than in other age groups suggesting an association with war-related hostilities in the community. CONCLUSION: Only about half of children under three years received full age-appropriate immunization. In children born during a period of increased hostilities, immunization was mostly inappropriate for age, but recommended immunizations were not completely abandoned. Missing or delayed immunization represents an additional threat to the health of children living in conflict areas.

Nordic Film Series: "To My Son in Spain: Finnish Canadians in the Spanish Civil War"

Finlandia University's Nordic Film Series, a free event open to the public, will feature two viewings of "To My Son in Spain: Finnish Canadians in the Spanish Civil War," with writer Dr. Saku Pinta available for questions. This documentary features the story of Jules Päiviö (1916-2013), who was the last surviving Canadian volunteer of the Mackenzie-Papineau Battallion of the “International Brigades”.

Nordic Film Series: "To My Son in Spain: Finnish Canadians in the Spanish Civil War"

Finlandia University's Nordic Film Series, a free event open to the public, will feature two viewings of "To My Son in Spain: Finnish Canadians in the Spanish Civil War," with writer Dr. Saku Pinta available for questions. This documentary features the story of Jules Päiviö (1916-2013), who was the last surviving Canadian volunteer of the Mackenzie-Papineau Battallion of the “International Brigades”.

"Army of One" to "Army Strong" : visual media and U.S. Army recruitment during Bush"s "War on Terror"

From Bush’s September 20, 2001 “War on Terror” speech to Congress to President-Elect Barack Obama’s acceptance speech on November 4, 2008, the U.S. Army produced visual recruitment material that addressed the concerns of falling enlistment numbers—due to the prolonged and difficult war in Iraq—with quickly-evolving and compelling rhetorical appeals: from the introduction of an “Army of One” (2001) to “Army Strong” (2006); from messages focused on education and individual identity to high-energy adventure and simulated combat scenarios, distributed through everything from printed posters and music videos to first-person tactical-shooter video games. These highly polished, professional visual appeals introduced to the American public during a time of an unpopular war fought by volunteers provide rich subject matter for research and analysis. This dissertation takes a multidisciplinary approach to the visual media utilized as part of the Army’s recruitment efforts during the War on Terror, focusing on American myths—as defined by Barthes—and how these myths are both revealed and reinforced through design across media platforms. Placing each selection in its historical context, this dissertation analyzes how printed materials changed as the War on Terror continued. It examines the television ad that introduced “Army Strong” to the American public, considering how the combination of moving image, text, and music structure the message and the way we receive it. This dissertation also analyzes the video game America’s Army, focusing on how the interaction of the human player and the computer-generated player combine to enhance the persuasive qualities of the recruitment message. Each chapter discusses how the design of the particular medium facilitates engagement/interactivity of the viewer. The conclusion considers what recruitment material produced during this time period suggests about the persuasive strategies of different media and how they create distinct relationships with their spectators. It also addresses how theoretical frameworks and critical concepts used by a variety of disciplines can be combined to analyze recruitment media utilizing a Selber inspired three literacy framework (functional, critical, rhetorical) and how this framework can contribute to the multimodal classroom by allowing instructors and students to do a comparative analysis of multiple forms of visual media with similar content.