Pakistan: Measles causes deaths of over 300 children in 2012
Outbreak of measles causes deaths of over 300 children in Pakistan in 2012
January 2, 2013
Recently, the Pakistani print and electronic media displayed the pictures and details of the sad deaths of children due to an infectious disease; measles. The World Health Organization (WHO) also substantiates the news reports and informed that 306 children have been died in the country in 2012 due to the infectious disease. A large number of these deaths were reported in the month of December 2012 in second most populated Sindh province of Pakistan.
It is really unfortunate that all the deaths could be preventable if the government and health department properly and timely manage the anti-measles immunization campaign in all parts of the country. In 1990, the government of Pakistan ratified the UN Convention on the Rights of the Child (CRC) which recognizes that children are vulnerable and therefore require special care and assistance. Article 24 of CRC:
1. States Parties recognize the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health. States Parties shall strive to ensure that no child is deprived of his or her right of access to such health care services.
2. States Parties shall pursue full implementation of this right and, in particular, shall take appropriate measures:
(a) To diminish infant and child mortality;
(b) To ensure the provision of necessary medical assistance and health care to all children with emphasis on the development of primary health care;
(c) To combat disease and malnutrition, including within the framework of primary health care, through, inter alia, the application of readily available technology and through the provision of adequate nutritious foods and clean drinking-water, taking into consideration the dangers and risks of environmental pollution;
(d) To ensure appropriate pre-natal and post-natal health care for mothers;
(e) To ensure that all segments of society, in particular parents and children, are informed, have access to education and are supported in the use of basic knowledge of child health and nutrition, the advantages of breastfeeding, hygiene and environmental sanitation and the prevention of accidents;
(f) To develop preventive health care, guidance for parents and family planning education and services.
3. States Parties shall take all effective and appropriate measures with a view to abolishing traditional practices prejudicial to the health of children.
Health practitioners described measles as a very contagious viral disease that spreads through the air by breathing, coughing or sneezing. It is highly contagious that any child who is exposed to it and is not immune will probably get other diseases and other fatal complications, including pneumonia and encephalitis.
According to the Centers for Disease Control and Prevention, “About one out of 10 children with measles also gets an ear infection, and up to one out of 20 gets pneumonia. About one out of 1,000 gets encephalitis, and one or two out of 1,000 die”.
It is a fact that Pakistani health care management system is sliding in downward track due to lack of direction and resources, and is aggravated by endemic corruption and inefficiency. The situation is compounded with a general lack of awareness about the importance of immunization to prevent diseases such as measles and polio. Additionally, the uncertain situation in many areas of the country and gruesome attack on anti-polio health workers have made it difficult to fight against diseases, which have been wiped out not only in developed countries but even in developing countries as well.
Dr. Iftikhar Ahmed, an official of a health focused INGO, observed that besides polio, a disease which only present in three countries namely Afghanistan, Nigeria and Pakistan, measles is a biggest threat to the survival, protection and development of Pakistani children. Dr. Iftikhar Ahmed added that the loss of so many precious lives of children clearly indicate that the government ministries and allied departments have been failed miserably to administer measles immunization campaign, especially in flood affected areas of Sindh province.
It has been reported that most of the children died in Sindh province belong to areas affected by the super floods in 2010 and 2011. Tufail Khaskheli, an NGO staff member, informed that survival of children in flood affected areas is already on a high stake and added that, “A majority children’s deaths occurred in poor and displaced families, where availability of adequate and appropriate food is a serious issue.”
Malnourishment among women and children, no matter living in rural or urban areas, is not an unusual phenomenon. Availability of a balanced diet for women and children is major concern in the country. The lack of healthy food makes the vulnerable groups more prone towards health problems and diseases due to their low physical resistant.
It is important to mention that according to a survey conducted by National Nutritional Survey (NNS) in 2011, almost 58% of Pakistanis are food insecure. A high inflation rate, an increase in food and kitchen item prices and dwindling employment opportunities have further worsened the situation.
Dr. Ali, a public health practitioner working in a national NGO, informed that measles epidemics across the world are mostly seen in areas with low or no uptake of its vaccine at the appropriate age, and the situation is further aggravated by malnourishment, and congested living. He added that a closer look at the present surge in measles cases and resulted fatalities in Sindh validates the global findings as mentioned earlier. The province of Sindh witnessed super floods and rain in the last two years, which has resulted in death and destruction of immense proportion. The public health expert added that due to limited capacity of the public institutions, the affected population is struggling to bring back a sense of normalcy in their lives. A number of people are still living in the make shift homes with no basic amenities. Generalized malnourish and congested living enhance their vulnerabilities to all sorts of diseases, including measles.
The alarming situation requires immediate action from the government and health focused organizations to apply plausible strategies and utilize all available resources to protect the exposed children in vulnerable areas. Special efforts should be directed not only ensure Measles vaccination to all children under the age of five years, but also to improve their nutritional status. It is a proven fact that Vitamin A levels in the body are usually depleted during Measles infection, which results in respiratory tract infections and diarrhoea, two leading causes of death in children affected by Measles virus. While Vitamin A supplementation is being done across the country with Polio campaign, the vitamin is abundant in mother’s milk, green leafy vegetables, milk and milk products and yellow fruits. Fish also has very high contents of vitamin A.
Primary health care, if practice in its true sense still can provide remedies to a lot of health issues in our country. There is a dire need to understand that the basic purpose of an ideal health care system is to provide services to common and needy people, especially those who have limited or no capacity to utilize the health services from private sector.