Determined to protect every child in Pakistan from measles
By A. Sami Malik
QUETTA, Pakistan, 2 May 2013 - As Kausar Parveen (48), prepares an injection to vaccinate a child, her face reflects the high level of devotion with which she has been vaccinating children for the last 25 years. To her, protecting children from communicable diseases is a godly act. Her resolve to vaccinate every child within her reach is undying and has kept her going with the same vigour for quarter of a century.
"I love children and want every child in my area, city and country to be protected against communicable diseases, especially measles," says Kausar, an experienced vaccinator who lives and works in Quetta, the capital of Pakistan's western province, Balochistan.
"As a young woman, I wanted to become a doctor but got married at an early age and could not fulfil my ambition. My sister-in-law was a vaccinator and that inspired me to become one. I did a six month training course and since 1988, have been vaccinating children in this city. I have vaccinated my own children, grandchildren and every child born in my family."
Kausar lives in Hussainabad, a locality predominantly inhabited by the Persian speaking Hazara community. Hazaras are believed to be of Mongolian decedent and had moved many years ago from Central Asia to Balochistan.
Balochistan, which is the largest province of the country in terms of area, has seen a sudden rise in the incidence of measles over the last few years. Conflict, low population density, low literacy rate and rugged mountainous terrain make access to health service a major challenge for the people of Balochistan.
Every working day, Kausar leaves her house in the morning and walks to the Municipal Dispensary Vaccination Centre, Hussainabad. This is her base from where she operates to ensure that every child under five years of age is vaccinated against communicable diseases. Here, she not only vaccinates children but also maintains a complete record of every child who is brought to the centre for vaccination.
"Wednesday is the vaccination day in the centre. We do all kinds of vaccinations including BCG, pentavalent, polio and measles. Mothers know about this day. They fondly bring their children and we happily vaccinate them hoping that they will come again for the next dose."
Twice a week, Kausar goes to the two major hospitals in Quetta city, the Bolan Medical Complex Hospital and the Civil Hospital Quetta. She visits the children's wards and tries to find out if any child admitted there has not been vaccinated against measles. In case a child has missed out, Kausar invites the parents over to her vaccination centre and if they don't show up, she even goes over to their house to vaccinate the child.
"When I find out that a child has not been vaccinated and can't come to the centre, I pick up my kit and go to their house to vaccinate. At times, I come across mothers whom I had vaccinated when they were children and it is such a good feeling to vaccinate their children - the second generation," says Kausar with a lot of pride.
Kausar's resolve to eliminate measles and other diseases that affect children is so strong that she manages her professional and domestic responsibilities with sheer determination and hard work.
"I am a mother, also a grandmother and there are lots of domestic responsibilities on me. However, as a vaccinator I do my job to the best of my ability. If our children are healthy today, our future generations will also healthy."
Religious leaders enjoy a strong influence in the close nit Hazara community living in Hussainabad. People refer their concerns to the religious leaders and abide by their advice. Syed Ishaq Naqvi is one of the most prominent religious leaders in the area. He is a strong exponent of vaccinating children against communicable diseases. He says, "Vaccination is extremely important for the health of our children and I emphasise that we must pay attention to it."
Increase in the number of measles cases in Balochistan, has made health service providers to responsd on war footing. From vaccinators like Kausar to the senior health managers in major hospitals are endeavouring to maximise vaccine coverage and treat children with measles on priority basis.
"Measles is quite common here," says Dr. Bashir Kakar, Head of the Paediatric Department, Civil Hospital Quetta. "We are receiving measles cases even after vaccinating the children. If we do not stop it here, measles will spread very fast and because of it TB (Tuberculosis) will also spread among our children to a dangerous extent. We still have time and must wipe out measles before it kills any more of our children."
In Pakistan, the incidence of measles started to increase in 2010 due to countrywide floods. In the following two years, successive flooding made things worse. More than 10,000 cases of measles and around 400 deaths were reported in 2012. It is believed that in countries where an outbreak of measles takes place, one in five children is not reached with vital vaccination due to reasons such as geographical exclusion, lack of resources, conflict or weak health delivery systems.
Nayab (4) lives with her family on the outer peripheries of Hussainabad. The terrain is hilly and there is a high chance that families living here are not reached by mobile vaccination teams. Lack of awareness and social seclusion prevents women from taking their children to a vaccination centre.
Apparently healthy and blissful, Nayab, could be the fifth child who had missed out on being vaccinated. In the recent outbreak of measles in Balochistan, a number of children brought to various medical facilities were those who had not been vaccinated against measles. This emphasises the need to reach the most disadvantaged and marginalised communities with vaccination services and to reach them before measles reaches their children.