Measles Outbreaks Highlight Regime’s Irresponsibility

MAE SOT — It was a routine, sweltering mid-April day for Naw Say, a medic treating internally displaced persons (IDPs) in Karen State’s Takreh Township, just one kilometer from the Thai border.

Mothers cradled crying children, giving Naw Say the opportunity to place two drops of polio vaccine into open mouths.

A young measles victim.

Immunization sessions not only prevent crippling diseases like polio, they also give medics an opportunity to gauge the overall health of IDP children, whose families come from far and wide for care. The most common complaints are malnutrition, diarrhea, malaria and respiratory infections.

This day appeared at first to be no different from others, until the presence of several children with similar symptoms set alarm bells ringing for Naw Say.

“There were five kids on that first day,” she recalled. “They had a cough, conjunctivitis [pink eye] and a red rash all over the body.” Naw Say asked the parents if there were any more children with these symptoms in their village. “They said yes—many.”

Naw Say’s heart sank. This was almost certainly measles, a vaccine-preventable disease. Although the fatality rate of measles is low, the highly contagious virus can spread quickly, especially where malnutrition is rife and healthcare systems almost non-existent.

Blood samples being prepared for shipment to Bangkok for laboratory testing.

The five children examined by Naw Say that day heralded the start of the largest outbreak of measles documented so far in the IDPs of Karen State, threatening a total population of 16,500.

Naw Say and her colleagues quickly collected blood samples to send to a Bangkok laboratory for confirmation. At the same time, a team of medics delivered measles vaccines for a catch-up immunization program, following World Health Organization guidelines.

The tests confirmed a measles outbreak, affecting several districts of Karen State. By the time it was controlled in September, 512 people had fallen ill and four had died.

The outbreak could have been far more severe. In five months, medics immunized over 7,700 children, 87.1 percent of those living in and around the affected areas, including districts deep inside Karen State. The border-based intervention curbed the spread of the virus—at least for the time being.

An IDP child is inoculated against measles.

Burma’s once vaunted healthcare system is yet another casualty of decades of military rule. The current junta, the State Peace and Development Council (SPDC), spends the equivalent of less than half a US dollar per capita annually on health and provides no childhood vaccines, perhaps the most cost-effective public health intervention available.

Today, UNICEF provides 90 percent of the vaccines given to Burmese children. But the vaccines rarely reach children living in the conflict areas of ethnic states. In stark contrast, the Thai government’s equivalent figures are $61 and 100 percent. The result is that 10 percent of Burmese children die before their fifth birthday, the second highest childhood mortality rate in Asia after Afghanistan.

The situation is even more dire in the conflict zones of eastern Burma, where ongoing clashes and widespread abuses of civilians have forced more 500,000 people to live as IDPs, including 66,000 who have been displaced in the past year alone, according to the Thailand Burma Border Consortium.

“When the SPDC forces villagers to flee to the jungle or to IDP camps, their health status falls because they do not have good access to food.