KARACHI: “I begged the doctor to save my Moomal as I didn’t have enough money to buy the drugs he had prescribed but he ignored my pleas and said, ‘what can I do? Just go home’. I left the clinic without buying drugs and my baby died early in the morning the following day.”

Overwhelmed by grief Gul Bano, a young mother, narrates how her 14-month-old daughter recently died of measles that has stalked dozens of children in her village, Rawal Kandra, in Sujawal district.

The village is the worst hit in the newly created district where, according to unofficial sources, 12 children have so far died in recent weeks of measles, which is otherwise a curable and preventable disease.

For Bano, the death of her second child within two weeks is heartbreaking. Her eldest child, three-year-old Gul Naz, was the first to be struck with the disease.

Her husband, a farmer, earns barely Rs200 a day that the family had to pay as the doctor’s fee on that fateful day. Sitting on a charpoy in her mud-brick house, Bano loses her calm when she recalls how her daughters died in front of her.

“We barely subsist on the small income my husband brings home. At times, we go to bed without a meal. I can never forget that I lost my daughters only because I couldn’t pay for their treatment,” she says amid sobs.

According to her, Moomal, had never received any kind of vaccination since she was born at home. Gulnaz, however, had been administered with some injections (she doesn’t know what kind of injections) after her birth and later at another hospital.

“Gulnaz had high fever, rash skin and inflamed eyes when I took her to the same doctor. He said that she didn’t have measles. Go home and buy the drugs I wrote you,” she quoted him as saying.

To a question why she did not go to a government health facility where she could have received drugs for free or at discounted prices, she said: “The same doctor works at the government hospital (Civil Hospital Sujawal) and it was he who instructed us to bring our child to his clinic for treatment.”

A number of villagers the Dawn spoke to whose children had contracted measles in recent weeks voiced similar complaints. They alleged the doctor, who was the only child specialist at the civil hospital, refused to admit serious patients who later died. Many children in not-so-serious condition did survive though who the doctor treated properly at his private clinic.

“The doctor charges Rs350 for one vaccine dose. Our children recovered and are better now but we had to spend a lot of money on their treatment,” says Mohammad who spent Rs2,500 on her 10-month-old daughter’s treatment.

The village comprising around 500 households has neither a health facility nor a school. “The Sujawal hospital is the only health facility in our taluka that has some facilities for patients but it is 12km away from the village. If we had had a health facility, these deaths might have been prevented,” believes Babu, a local social activist, adding that it was only because of media pressure that the government had started paying some attention to their neglected area.

“There is no arrangement for routine immunisation in our village where we only see anti-polio teams at times vaccinating children,” he says.

Accurate mortality number

At Civil Hospital, Sujawal, Chutti, an elderly woman from Rawal Kandra village who has brought her granddaughter with measles, says that seven children in her family contracted the same infection and two of them died.

“We couldn’t bring those children here on time because we couldn’t afford transport. But, when deaths occurred, the family decided to bring other affected children here,” she says.

Contrary to media reports that have put death toll from measles outbreak in Thatta and Sujawal at 30-40, government has put mortality figures in both districts at 12. The other mortality in the province is officially reported in Tando Mohammad Khan.

Aside from the controversy over figures, if one goes by the living conditions particularly in lower Sindh it could be safely said that they had all the prerequisites for a health disaster; basic health facilities in remote areas are non-existent and people living in abject poverty have little knowledge about health education.

The official interest in public health is also evident from the pathetic state of Civil Hospital, Sujawal. The hospital with dilapidated infrastructure has only one child specialist and that, too, according to people, asks patients to come to his private clinic for treatment.

The doctors, however, denied the charges. “It’s a lie. I have never asked patients to come to my clinic that I run after 2pm,” contends Dr Ameer Aman Sheikh.

No death had occurred due to measles at the hospital, which, he said, had received 40 to 50 patients of measles over the past two months. “The high-ups were kept informed of all cases and they were later attended by the government through anti-measles drives targeting specific areas,” he said.

According to data on measles provided by Dr Rafique Khokhar, director at DG Health Services, Hyderabad, 696 measles cases were reported in 2014 in Sindh; 3,014 cases with 119 deaths were reported in 2013 and 2,709 with 210 deaths were reported in 2012.

Asked about the health issues in Rawal Kandra village, Dr Zahoor Ahmed, district health officer of Thatta-Sujawal, said that though he would not deny gaps in the government’s healthcare delivery system, lack of health awareness and misconceptions also prevented people from seeking timely medical intervention.

“I will look into the complaint about the Sujawal civil hospital that is the only health facility in the entire district of Sujawal which has a child specialist. Taluka hospitals of Jati, Bathoro and Mirpur Sakro do not have a paediatrician. The hospitals are understaffed; out of 570 doctors’ posts only 243 are filled,” he said.

Measles vaccine, he said, could not be administered door-to-door as it had a short life span once it was reconstituted. “We have only 155 vaccinators and of them only 13 have motorcycles. They can’t go to remote areas on foot,” he explained.

Vaccination only solution

“There’s only one reason behind repeated outbreak of measles; lack of vaccination coverage against the disease (Sindh currently has only 29pc immunisation coverage).

Measles is one of the most contagious viral infections known to man so even if one case occurs in a population where there are many unimmunised, the disease spreads like wildfire.

“Thatta and Sujawal have particularly low vaccination coverage and many areas have no functioning vaccination centres. Secondly, measles can kill if children are malnourished and both these districts have very high malnutrition rates in children,” points out Dr Anita Zaidi, senior paediatric specialist at Aga Khan University Hospital.

Rejecting the misconception that contaminated water was causing spread of measles, Dr Ayesha Mehnaz who heads Civil Hospital Karachi’s paediatrics department, said that measles virus was airborne and congested living condition helped in its spread.

“We are getting a number of cases these days that included those from coastal belt. Children are coming with complications like pneumonia and encephalitis,” she said, adding they were all those from the unimmunised population.

Measles-stricken villagers protest against health dept

A large number of relatives and supporters of measles-stricken villagers took out a procession in Sujawal on Sunday in collaboration with the Qaumi Awami Tehreek in protest against the district health department’s failure to combat the infectious disease.

Villagers Mohammad Kandra and Ali Kandra and QAT leaders Junaid Azad and Asharaf Baran who led the protest said that instead of taking serious steps to fight and contain the disease the health department kept hiding facts and attempted to divert public attention by claiming the disease was not measles but Rubella.

Though Rubella was also a kind of measles which required similar treatment and vaccination but the officials concerned did nothing to stop it and let the disease stalk children one by one, they said.

They warned if the department did not take concrete steps immediately to combat the disease the villagers would move court for justice.