The moment Julie Kanjinga laid her eyes on 17-month-old Marina, she had flashbacks of haunting memories from 15 years as a nurse in the Democratic Republic of Congo (DRC).

 

Her memory took her back to 2022, when five children, three girls and two boys, were brought to Promesse Health Centre, the health facility she runs in Kipushi in Haut-Katanga Province. They showed classical signs of measles, one of the most contagious diseases in the world.

When she asked the mothers whether the children had received any vaccinations — the only definite way the babies could be protected from measles — the answer broke her heart.

They had not been vaccinated.

Three of them died, despite her efforts to save them. After that, the nurse swore no child in her care would miss a vaccine.

Now, talking with Marina’s mother Vicky Tshidibi, Vicky, she learnt that the little girl had missed some vaccinations that her peers had already received at nine months, as per the country’s vaccination plan, the Mashako Plan. The baby was not only vulnerable to measles, but also to other preventable diseases such as polio.

Julie’s fears were not unfounded, as measles has hit the country. In the past 10 years, DRC has recorded an average of 33,000 cases of measles annually, according to the World Health Organization (WHO).

In 2025, the humanitarian response group Doctors Without Borders (Médecins Sans Frontières) reported that 1,175 people died of measles. So far in 2026, the WHO has reported 370 confirmed measles cases in the DRC.

Dr Ngoy Kitenge Claude, chief medical officer of Kipushi, shares Julie’s fears, noting vaccination rates need to be above 95 per cent to stem the spread of the virus.

According to the most recent DRC national health survey, Kinshasa is far from meeting that goal: Only two in 10 (21 per cent) children aged between one and two years are fully vaccinated against all basic antigens, and only one in 10 are vaccinated according to the national schedule. Another 23 per cent of children have received no vaccines at all.

“There are areas that are remote, as far as 150 kilometres from a health facility. Some guardians have work, which makes it impossible for them to come get vaccines, while others don't believe in vaccines,” Dr Ngoy said.

When the vaccines have to be transported in cooler boxes through rough terrain, by the time the health care workers reach the children, the vaccines are hardly potent.

In response to this, the national and provincial health teams are changing tact, especially with dwindling resources for vaccination.

Stephane Kapumba, a physician and a public health specialist at global health non-profit VillageReach, told The EastAfrican that, with dwindling resources, DRC is channelling the resources to where they would reach the most children.

One of the government’s strategies was Periodic Intensification of Routine Immunisation, where the health zone teams take vaccination to the areas they are needed.“We pick places that have many unvaccinated children, experience outbreaks and this is done periodically; it is not permanent,” Dr Kapumba said.

With public health and data specialists from VillageReach — expertise that the government often needs — DRC’s Ministry of Health chose three of the 26 provinces where they would make the most impact — Haut-Lomami, Haut-Katanga and Tanganyika — through December last year. For three months, the Ministry of Health, working with non-profits like VillageReach, vaccinated more than 400,000 children.

The teams set up vaccination sites in open markets, churches and other social gatherings.“In this way, the country has significantly reduced the number of zero-dose and unvaccinated children in our communities, especially in hard-to-reach communities, increased vaccination coverage and broken transmission of diseases like measles,” Dr Kapumba said.

Measles virus is particularly dangerous for children. According to the US Centers for Disease Control and Prevention, three out of every 1,000 children with measles die from respiratory and neurological complications.

Many children with measles go on to develop deadly respiratory diseases such as pneumonia. Caring for children who are very sick requires providers who are trained in paediatric care and healthcare facilities with the capacity, such as intensive care systems.

In some cases where neurological complications appear, Dr Kapumba said children can experience brain swelling, which can leave them with lifelong hearing damage or intellectual disabilities.

Additionally, even if the baby survives, measles wipes out the child's immune system, which leaves them vulnerable to other infections for years after a bout of measles.

While routine immunisation goes on, the DRC government is increasingly relying on community health workers, known as Relais Communautaires, or Recos, to reach children for vaccination, and their involvement is already yielding fruit.

Aimerance is not medically trained, but the Ministry of Health recruits community health workers who are known and respected. She visits homes to check basic, but critical health needs, such as vaccination, breastfeeding, hygiene and other health needs.“From Monday to Wednesday, I visit homes and I tell families about many things, like vaccination, nutrition and cleanliness,” Aimerance said.

When she saw Marina, she checked the booklet in which the child’s developmental progress is recorded, and found that she had missed her vaccines and was severely malnourished.

She educated Vicky on the importance of a child having all vaccinations. Then she wrote a note for her that when she presented to Promesse Health Centre, nurse Julie immediately knew baby Marina needed to catch up on some vaccines.

The nurse — committed to not seeing a repeat of the children that she lost years ago — ensured that Marina got other vaccines, such as the measles vaccine.

Funding for life-saving interventions like vaccination is dwindling as the disease outbreaks increase. Governments in Eastern Africa must prioritise where they would spend the resources available to save the most lives. The DRC has demonstrated that targeted strategies, such as PIRIs, can complement routine immunisation and yield results.

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