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April 29, 2004
Avoidable losses
Thousands of children are dying due to a vaccine-preventable disease as a result of negligence, misuse and inappropriate storage, reports Jan Khaskheli
My wife has been deeply disturbed ever since our baby daughter passed away in a hospital in Karachi. Everyday she carries around her photo albums and recalls her every move including the way she talked, when she showed her displeasure and her smile.
She weeps constantly and the doctors have advised her complete rest, whereas traditional healers say she should recite the Holy Quran in the mornings, and say her prayers which will be therapeutic and enable her to relax her mind. I am very concerned about my wife’s failing health. She does not believe that the measles vaccines administered to our three daughters were authentic.
On the second day when our daughter had fever we took her to a well-known child specialist’s clinic. He advised my wife to keep the child in an open area, as she appeared to have measles. He added that no medicines were needed and there would be no complications. We did just as the doctor had advised.
On the third day our baby collapsed. We took her to another doctor close to our home who, after a thorough examination, told us to get the child admitted in a major hospital because she required oxygen immediately. With the help of relatives we took her to a hospital, but it was too late; she died while we were still on the way.
A close friend said: “Why are you depending on clinics in low income areas? You should not go there. Always go to major hospitals when family members need check-ups.” Another friend while condoling the baby’s death said: “We have told you to move to another locality.” A doctor friend of mine said: “You shouldn’t have kept the child in the open. Patients who have measles should be kept safe in a closed room as even the air can be detrimental for their health.”
It has been claimed that since the government has made efforts to vaccinate children throughout the country, the disease has declined. But according to newspaper reports it is still prevalent and is killing babies who are as young as five years old, mostly in the rural areas.
Four children died of measles in Budhni Goth in Hawksebay recently. Bashir Ahmed, father of a deceased girl, said: “Measles infected three of my daughters of whom one died in hospital. The doctors tried very hard but they could not save her life.”
According to reports three children from Kamal Jageerani a village near Pir Jo Goth, died of this disease within a week. While criticizing the health department’s negligence people said: “Despite protests by the community, the officials concerned did not take steps to save the lives of these children.” Other news items revealed that the disease had infected 50 other children, but fortunately they were saved by timely diagnosis.
Dr Shafi Patoli, a child specialist, says: “Ninety per cent of the people go to government-run health centres in low-income areas for vaccinations. The staff there does not care if the vaccine has expired or is inappropriate. Frequent power failure is another problem that damages the vaccines, since they need to be consistently maintained at certain temperature. While being transported over long distances it is imperative that they are stored and carried in a suitable manner that ensures they will not spoil. If doctors and the staff inform the head of the health department about these problems they risk losing their jobs.” No one appears to bother about maintaining the ‘cold chain’.
He added: “Measles is caused by a highly infectious virus. It infects children nine months old and the infected child needs a vaccination. A single case of measles is capable of infecting 90 out of 100 children present in a room. It can also cause complications.”
Dr Shahzeb, a young practitioner, said: “Sometimes, a measles vaccine is administered at the beginning of nine months though it should be administered at the completion of nine months.”
Dr Razzaq Lasi of the Aga Khan University said: “WHO, Unicef and other organizations that provide these vaccines to Pakistan are unaware about what is happening in the country. These agencies provide life saving medicines, but they are being misused. Those living in remote parts of the country do not have access to health facilities and their lives are at stake. Carelessness of the clinic’s staff creates problems. Although the villagers trust the government clinics, they do not check the expiry date of the vaccines.”
The federal government’s target was to reduce measles mortality by 95 per cent and measles morbidity by 90 per cent by 2005. On the other hand current reports show that cases are increasing with thousands reported from Sindh alone. A report estimates that 50,000 children suffered from measles in Karachi in 2001. During that period in interior Sindh more than 50,000 children got the disease. Its caused more than 500 deaths.
In Pakistan the incidence of measles continues throughout the year. According to a report, measles causes more deaths than any other vaccine-preventable disease. Globally, nearly one million children die annually.
Complications of measles include diarrhoea, cough, acute respiratory infections, pneumonia, ear infections and encephalitis. Complications cause disabilities like brain damage, blindness and deafness. Children infected with measles are severely deficient in vitamin A. Hence vitamin A in sufficient doses should be provided.
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