Hearing bad news has become a routine in Pakistan. People listen or read such news, feel pity for some time and indulge into their routine works of this mortal world. Same has become the case with the news of those children who are losing their lives in the battle against measles, a mortal disease which has infected a large number of children. Every other day we come to know about the increasing number of infecting and dying children because of measles. According to the Health Department as many as 185 children have died and 21,817 have been infected over the last six months in an ongoing measles epidemic in the Punjab. People at the helm of the affairs vow to control this epidemic but facts and figures show something contrary to their loud slogans.

Measles outbreak was reported first in 2008 with little number of infected children but the number increased in the successive years. According to reports the number of confirmed cases reported in 2011 was 2,533and 2,975 in 2012. The major outbreak of measles in 2012 was reported in Punjab with 1,152 confirmed cases, compared to 898 in 2011. While in the current year it turned into an epidemic disease which devoured so many innocent lives. In the beginning five districts — Lahore, Gujranwala, Muzaffargarh, Dera Ghazi Khan and Rawalpindi —declared on high risk with the provincial capital among the top. What is noteworthy that why the number of reported cases increased instead of decreasing every year. It arises many questions that why the children mostly belong to poor families are dying and not from well-to-do families; why these deaths are mostly reported from the government hospitals and not from any private hospital; why the government and concerned authorities have failed to control this fatal disease from spreading at such a large scale and who are responsible of this negligence.

Talking to different concerned persons revealed some major reasons which caused of spreading measles as an epidemic. Dr Salman Kazmi talking to Sunday Plus said that a large number of children who were admitted in different hospitals for measles treatment were not vaccinated. “According to an estimate, 80 per cent of the total measles-affected children were not administered vaccine during routine immunization coverage which is the main factor behind the outbreak of the disease in Punjab. There are always two doses of measles vaccine which are given to all children, first at 9 months of age and second dose during the second year of life. Unfortunately, a large number of children have not even received a single dose of measles vaccine. In many cases children received the first dose but did not get the second one which gives 90 to 98 percent immunity against this disease. If the case always remains so and the children remain unvaccinated then epidemics like the current one are almost guaranteed to occur every 2-3 years,” he said.

The other big reason is malnourishment of our children. He said, “Malnourished children are the easy prey to this disease. All the children coming for the treatment of measles are malnourished. They are operating on an already compromised immune system.” People may judge the fact that almost all the deaths because of measles are reported in the government hospitals and not a single death was reported in any private one. Those children whose parents can afford nutritious diets have a better immunity level against any disease. Secondly, such children are not dependent on vaccines given by the state whose quality is always under question.

Dr Kazmi portrays a dismal picture of routine immunisation in Pakistan and the pathetic cold storage system for vaccines. “Keeping vaccine stored at low temperatures is essential to maintaining its quality and safety. If the cold storage system isn’t proper, nobody can guarantee the efficacy of the vaccine. Anti-measles campaigns have been launched in all these districts, but if these vaccines are not preserved properly then the anti-measles drive is futile,” said the doctor. A vaccinator on the condition of anonymity accepted the fact that the vaccines they carry often lose their efficiency because they carry those in water cooler which is not a proper way of storage.

There is another grim fact that UNICEF came to rescue the innocent lives of many children and provided refrigerators to the Health Department aiming to store these vaccines properly to maintain their efficiency. But alas many of them went missing in a very short span of time and no one was made responsible and punished for the misdeed. According to news which was published in an English newspaper from 81 refrigerators handed over to the Health Department in Sheikhupura for proper storage of measles vaccines 36 went missing. All these shows that in every department some people have their monopoly and no one can challenge them.

When asked the Health Department or the concerned authorities about the current measles situation, they said that everything is smooth and good but the reality is somewhat different. There are many deficiencies in their system. Sources tell that the Health Department does not have any proper record through which they can judge that how many children have been vaccinated and how many are unvaccinated. They simply go to different areas and vaccinate to available children. They do not maintain any record that how many have got the first dose and have got the second. An officer in the Health Department says that there is insufficient investment into the EPI (Expanded Programme on Immunisation) infrastructure at the federal and provincial levels. Secondly the surveillance system of monitoring the vaccinator staff is extremely fragmented and unreliable. He also mentions that the bulk of trained manpower, financial resources and administrative energies are being taken up by the polio eradication campaigns and no importance was given to measles. No massive awareness campaign about measles was launched as was done in case of dengue.

The Federal Ombudsman report points out many loopholes in vaccination campaigns and mentions many reasons that why measles spread like an epidemic. According to report the ‘failure of the routine immunisation system, widespread discrepancy between reported and assessed coverage, miserable state of the cold chain, ineffective and unreliable monitoring, and a fragmented surveillance system’, are the key deficiencies that contributed to the measles outbreak in Pakistan from January 2012 to February 2013.

Other factors behind the measles outbreak include “inadequate response in the wake of floods and disasters, absence of quality control system for all child-related vaccines, non-availability of vaccine at the grass root level and inadequacies of the system.”

All these issues show that government and the Health Department did not take measles seriously. Even the government has not made any prominent arrest or made anyone responsible. It means that health is not a priority of federal provincial governments. Precious lives of many children could have been saved if corruption in the Health Department and negligent persons had been admonished.