Jakarta - MSF has just completed the first phase of a measles campaign in the south of Papua, a province in the far east of Indonesia. A total of 13,659 children between the ages of six months and 15 years have been vaccinated. This outbreak highlights the high burden of infectious disease in the province and the lack of health services resulting in poor routine vaccination.

In February this year, MSF started receiving the first reports of measles cases in Papua's southern Asmat region. When it was clear the disease was spreading, MSF, together with the Ministry of Health, District Health Office and Papua Province Health Office, launched a mass vaccination campaign, with MSF covering four out of seven sub-districts - a population of 43,904.

Over the next month they succeeded in vaccinating 80% of the target population in an area where there had previously the vaccination level had been about 39% vaccination coverage. Now that the vaccination phase is complete, MSF medical teams are continuing with measles case management, vaccination of low coverage areas, and mobile clinics for other illnesses in the region.

Also last month, MSF responded to a cholera outbreak in the highlands region of Wamena after sending an emergency team out to investigate and set up a treatment centre to support Wamena General Hospital. This treatment centre was staffed by Indonesian and international medical staff.

Papua's health status is the lowest in Indonesia. Limited access to health facilities, lack of health education and poor sanitation leave large parts of the population vulnerable to outbreaks of disease.

"People are living in conditions that I did not think were possible in Indonesia, and are dying from simple, curable illnesses," says MSF Dr Kabul Priyantoro. "More needs to be done to ensure Papuans have better access to health care or we will continue to see epidemics such as this."

Responding to emergencies in Papua is particularly challenging as the lack of infrastructure and isolation of many communities places them out of the immediate reach of health facilities.

"Papua is without a doubt one of the toughest places to provide emergency medical care in," said MSF Head of Mission, Wim Fransen. "Just reaching people is a battle in itself."

Papua also has one of the highest incidences of malaria in Indonesia. Last month MSF, the Government of Indonesia and the Global Fund organised a conference attended by health officials and malaria experts from across the country to discuss a common approach to reduce and effectively treat the disease in the region. MSF research has confirmed the efficiency of artesunate combination therapy (ACT).

In Indonesia, MSF currently has projects in Papua, Aceh, Ambon and is running a surgical programme, mobile clinics and distributing non-food items to survivors of the earthquake in Yogyakarta and Bantul.