In Lahore, the capital of the Punjab province, hospitals have been struggling to cope with the number of sick and dying children being admitted. Speaking to the BBC, a doctor at the Lahore Children’s Hospital said he hadn’t seen a measles epidemic of such severity in more than twenty years. At one stage, as many as 70 new cases were being brought in each day.
According to the doctor, at least 40 children in his hospital have died since the epidemic spread from southern areas of Pakistan. The high death rate is partly the result of parents leaving it very late to bring their children for treatment, since most Pakistanis have to pay for health care. The lack of national health insurance has recently been outlined in a new report as one of the key reasons why the health system of Pakistan is failing children.
In addition, two-fifths of young children in Pakistan are malnourished. Malnutrition leaves children with low immunity to infection. Therefore, when they catch measles, undernourished youngsters are more likely to develop life-threatening complications such as meningitis and pneumonia.
The high number of children contracting measles in the first place is due to a lack of immunity across the population. Even when children have received an initial dose of the measles vaccine which gives 60-70% immunity, many have not had a second dose which provides 95% immunity. Low immunity levels are therefore allowing the measles epidemic to spread quickly and already there have been over 260 deaths since the start of 2013.
Across the Punjab province as a whole, vaccination coverage of children is estimated to be a mere 58% on average, though there are certain pockets or remote areas where no vaccinations have been carried out. To redress this situation, poor-performing health managers in nine districts have been replaced and emergency vaccination programmes are now being carried out. In Lahore, around 2.6 million children are being targeted and next month, another 11 million children across Punjab are due to be inoculated.
In Sindh province, where the epidemic first gained ground, families will have to wait longer. A mass vaccination programme is being planned, but will not get underway until the autumn. Doctors here are therefore bracing themselves for many more cases and deaths among young children which could have been prevented.