Measles outbreak linked to conflict

PESHAWAR, 16 May 2012 (IRIN) - The recent outbreak of measles which claimed the lives of at least 12 children and one adult in Pakistan's North Waziristan's tribal agency is directly linked to conflict between militants and the army, according to local experts.

”Long curfews, road blockades and also the power cuts that take place mean the vaccines we receive expire," said Muhammad Ali Shah, who heads the main hospital in Miramshah, the headquarters of the agency. "The measles vaccine needs to be stored at a proper temperature.”

The hospital, Shah said, was receiving 5-10 cases of measles daily. “This is unusual," he told IRIN. "We do not usually see more than one or two deaths a year due to measles.”

North Waziristan, a poor area bordering Afghanistan, is a stronghold of the Taliban and affiliated militants. It is largely inaccessible, which makes it difficult for vaccination teams to move and for other humanitarian organizations to operate safely.

“We are basically on our own here,” Shah added, noting that it was unclear how many people were affected by the virus in remote mountainous areas.

According to official figures, healthcare facilities in the Federally Administered Tribal Areas - made up of seven agencies of which North Waziristan is one - are poor, with only one doctor for every 6,993 people. For the rest of the country the figure is 1,225 people per doctor, scattered among the 33 hospitals in the territory.

“Vaccination campaigns in our areas are frequently interrupted. The militancy here has affected us all, and this measles epidemic we hear of is the latest manifestation of this,” Rahim Khan, a 55-year-old villager said. "In my village of Hurmaz there are several sick children. We don’t know what they are suffering from - though one has high fever and mottled skin,” he added, saying bad roads and a lack of transport had made it “very hard” to take the children to a medical facility.

Policy concerns

Experts say the situation raises questions about overall health policy. "Outbreaks of disease can be prevented only if, rather than a focus on polio alone, we concentrate on vaccinating against all preventable diseases," Anita Zaidi, professor of paediatrics at the Aga Khan University Hospital in Karachi, told IRIN. “This is also the only way to combat polio."

Azmat Siddique, a doctor based at a clinic near Miramshah, said: ‘We need more help to tackle the problem." He said help was “unlikely to come”, given the situation in the agency.

Jamil Wazir, an office assistant at a clinic in Peshawar, underscored the irony of the situation. “My sister’s two-year-old son died from complications after contracting measles," he told IRIN. "Here, as part of my job at this clinic, I purchase dozens of measles vaccines to administer to children, so they are kept safe from such disease."

According to the World Health Organization (WHO), measles is a highly contagious disease caused by a virus. More than 95 percent of measles deaths occur in low-income countries with weak health infrastructure.


Theme (s): Children, Conflict, Health & Nutrition, Human Rights,


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