more than 1,000 cases of measles in slums

Despite progress in recent years, the disease has not yet been defeated. In the slums, parents are wary of injections. In addition to increasing the number of vaccinations, the government must simultaneously reduce levels of child malnutrition.

Mumbai () – A measles outbreak began last month in one of Mumbai’s slums and has now spread to an area on the outskirts called Rafi Nagar and other areas of the city. In 2020 the capital of Maharashtra had registered only 25 cases, which fell to 9 last year. However, in this last week, more than 1,070 suspected infections were reported, 68 children were hospitalized and at least 5 are in intensive care. So far 7 children have died. Some of them were not vaccinated and others presented severe malnutrition.

It seems a paradox that in India, one of the main producers and exporters of medicines and vaccines, there are children who have not received the measles vaccine. However, for various reasons, Indian parents, especially in the poorest neighborhoods, often do not take their children to be vaccinated.

The number of cases is increasing worldwide and according to Unicef ​​​​and the World Health Organization (WHO) in the first months of the year there was an increase of 79%. Between April and September, India reported 9,489 infections, ranking first in the world ranking, ahead of Somalia and Yemen.

The causes must be sought in the suspension of vaccination campaigns during the Covid-19 pandemic. An estimated 23 million children have not received basic vaccinations, the highest number since 2009 and 3.7 million more than in 2019.

Although in many countries the suspension of vaccination campaigns is related to conflicts and situations of instability, in the case of India the new outbreaks seem to depend more on situations of severe poverty and low educational level. Indian parents living in slums are day laborers: staying home with a sick child with a fever after receiving the vaccine means having to give up a day’s work. Many mothers accept the first dose at 9 months, but not the second at 16, because they are afraid of injections and afraid of side effects.

According to data from the Indian government, in the urban area of ​​Mumbai, which also includes slums, 30% of children under the age of two have not received their first dose of the measles vaccine, but health workers consider that the percentage it is much higher. Often it is the older siblings who care for the younger ones while both parents are away to work. And they don’t always manage to eat every day.

Last month the Indian government rejected the results published in the latest Global Hunger Index Report, which ranks India 107th out of 121 countries. In a statement almost identical to the one from the previous year, Delhi accused the organizations Concern Worldwide and Welthungerhilfe, authors of the report, of conducting biased investigations that do not reflect the complex reality of India.

In reality, government data also shows that in recent years there have been no great advances in child malnutrition. In Uttar Pradesh, the most populous state in the Federation, only 6.1% of children between 6 and 23 months receive adequate nutrition. In Mumbai, 9.3% of them are underweight, rising to 10.5% and 18% in some slums. Complications related to the virus affect malnourished children much more than healthy ones, but other factors also contribute to reducing the number of children vaccinated, including the level of education of the parents -according to a study, 92% of the unvaccinated children have parents with a basic level of education- and postpartum migrations to the villages of origin, where there are often no vaccination centers.

In 2019, India was achieving excellent results in eradicating several diseases, including tetanus and polio, and had also set a goal of eliminating measles and rubella by 2020. However, it is clear that the government’s attention should be focused on marginal areas and must act on several factors at the same time: nutrition, increased levels of information and the spread of vaccination centers even in rural areas.

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