National 3 (Spotlight Weekly)

ANTI-MEASLES DRIVE
Shooting Down The Disease

The nationwide immunization drive against measles is expected to reduce the child mortality due to the disease by 50 percent

By THAKUR AMGAI

Child in a health camp : Inereased awarences

If things go as planned, at least 500 children could be saved every year from dying an untimely death and thousands of others from physical or mental disability. The government has decided and already started work to start an anti-measles campaign beginning this September. It has decided to give doses of anti-measles vaccine to all children between 9 months and 15 years of age throughout the country by the end of this year. Even those children who have already received the vaccine from the immunization centers will get another supplementary dose of vaccines, which will strengthen their immunity against the disease.

The drive will be launched in three phases to be completed by 2005 April. The first phase will be launched in 35 districts of the Eastern and Central Developmental regions from September 21.

Measles is the largest killer diseases in children that can be prevented by vaccination. According to the reports of the World Health Organization (WHO), among the total number of children who die of diseases that can be prevented through immunization, 48 percent die of measles alone. In Nepal, out of 8899 reported cases of measles, 1068 had died in 2002. However, the officials term it as 'under-reporting'. The actual figure of the cases of measles is estimated to be around 1,33,440.

Although, the process of vaccination started in Nepal a long time back, many children have missed it. According to the Child Health Division (CHD), 20 percent of the children miss immunization every year. The reason for this is lack of awareness. Adds Dr. Mahendra Bahadur Bista, Director of the Epedemiology and Disease Control Division, "People fear vaccination by syringe." Even out of those immunized, the efficacy is only 85 percent - 15 per cent of the children who have received measles vaccine, get measles again. The reason for this is improper infrastructure and lack of skilled manpower. "Cold chain needs to be maintained for the vaccines to work," says Dr. Bista.

The present drive is focused at these people who have missed the regular immunization and to re-immunize those who have already received it earlier. "Additional doses of the immunization does no harm, instead it enhances the immunity of the children," said Parshu Ram Shrestha, senior Public Health Officer at the CHD. "This drive is aimed at averting the outbreak of measles in the future and to contain it in initial phase." That apart, it is also expected to increase awareness among the people, so that the rate of immunization improves to above 90 percent from the present 80 percent.

The drive will be conducted by mobilization of skilled manpower in the communities. "As it is a syringe immunization, it requires skilled manpower," informed Shrestha. "The village health workers(VHW), maternal child health worker (MCHW) and other health workers will be mobilized in the VDCs". The division expects to finish the immunization in one VDC within a maximum of nine days. Along with the measles vaccination, vitamin A capsules, which is considered vital for enhancing immunity, will also be administered. The project is funded by the WHO, the UNICEF and the government.

Measles is a highly contagious air-borne disease that reduces immunity and enhances malnutrition. Like all viral diseases it does not have a direct treatment, but wanes away by itself. Measles itself might not be harmful, but it is dangerous because it triggers immunity complications in the body. Among the major complications arising are inflammation of brain and ears, meningitis, diarrhea, pneumonia, among others. Says Dr. Bista, "Children affected with measles mostly die of pneumonia."

According to Dr. Bista, this year alone, in less than four months, 1500 cases of measles have been reported out of which 30 children have died because of measles-related complications. However, the real number of people affected as well as deaths could be much more as most of the patients do not contact hospitals or health posts. "

According to the reports of the WHO, the cases of measles have continually increased since 1990. The number has risen to 13,344 in 2003, compared to 182 cases in 1992. This, however, is not the indicator of the number of patients increasing. Instead it shows that the awareness among the people have increased and more people have started to visit the health facilities to seek immunization and treatments.

Meanwhile, a team headed by Dr. Gaurishankar Lal Das, a member of the National Human Rights Commission (NHRC), has been formed to facilitate the nationwide anti-measles immunization drive. The team is expected to convince even the Maoists not to disturb the drive.