Facts behind the measles outbreak in Sajek

Upon hearing that a medical team had arrived, Potimala Tripura rushed to Sajek Road adjacent to her village Saat Nong Para with her five children. Two of her children, aged below five, are suffering from measles.

She gives the sick children only lukewarm water to drink, but no food. As medicine, she boils Puji leaves – a kind of aromatic leaf that grows on the hills – in water, strains it and gives it to her children to drink. 

Potimala also boils different herbs and leaves in water and bathes her children in that water.

Dhonendrolal Tripura of the same village is also treating his two measles-affected children in the same way. But in addition, he also gives his children water mixed with pig faeces to drink. 

Gopoti Tripura of Shib Para village said if sick children eat eggs, fish, meat and oily food, the rash increases, so they are only given lukewarm water to drink, he explained. All the villagers do the same thing. 

"Vaccine causes fever. Besides, the children cry a lot after they are vaccinated. Moreover, I do not know the benefits of taking vaccines," said Gopoti.

Most people in several other villages of Sajek union under Baghaichhari upazila, Rangamati think the same.

According to local government and NGO healthcare officials, more than 200 children of these villages have been affected with measles. Nine children died of the disease between February 16 and March 31. 

The medical assistance provided to patients

There is only one community clinic in Machalong Bazar to serve around 50,000 people living in different remote villages under Sajek union. But in the absence of a physician, a paramedic, a pharmacist and an office attendant tend to patients. 

Though people working in the district healthcare services say that several medical teams are working on containing the measles outbreak, it was found that a single team comprising of three to four members is working on it. 

Though an MBBS doctor is supposed to be on the team, an assistant to a doctor or a paramedic was seen performing the role of physician. Usually, a paramedic, a pharmacist and another staff member of the Baghaichhari Upazila Health Complex go to one of the affected areas per day.  Then the next day another paramedic or pharmacist leads the team and go to another area.

On March 30, a medical team led by Dr Bishnupada Devnath from the upazila health complex went to Saat Nong Para village where they saw a total of 31 patients suffering from various ailments.

Of the 18 were children among the patients, four had measles. Later that night, rashes appeared on the skin of two more children, but the medical team had already left the village by then.

"People in these areas are ignorant and prejudiced. Instead of giving the patients nutritious food, they totally stop giving them food," said Dr Bishnupada, adding "A long-term programme is needed here to change the attitude."

Sajek's children deprived of vaccines

Vaccines are not available to the children of different remote villages under Sajek union. 

As the villages are far away from the upazila Sadar and it takes a long time to reach the remote areas, the ice boxes which carry vaccines overheat, rendering them unusable. The vaccines in the ice boxes expire after 24 hours. But it takes more than 48 hours to reach some areas.

There is only one person designated to give vaccines for the large number of people living in the villages. 

Besides, the villagers are prejudiced against vaccines. They fear it. 

Nelson Chakma, the union parishad chairman, said there is a rumour that eight children died even after being treated by physicians. So, many patients are not accepting treatment, he said. They prefer praying for a cure to the disease, said the chairman.

Chiranjib Tripura, village head of Noy Nong Para, said, "The children of this village do not get vaccines. The union parishad does not give birth registration certificates for the children because they do not have vaccine cards."

What physicians say

Dr Bipash Khisha, civil surgeon of the district, said the measles outbreak has not been brought under control. They have to work regularly over the next nine months, Bipash said, adding that a total of 11,000 children will be vaccinated under this programme.

He said, "We need more manpower. We need to preserve vaccines in solar-powered refrigerators in several points of the remote areas to make the vaccination programme successful. 

"Sajek is a large area. With the current manpower, it is not possible to contain the measles outbreak here. We need long-term planning. A minimum of five clinics need to be set up here, and every clinic needs five healthcare workers. Besides, to carry the ice boxes, each healthcare worker needs an assistant. It requires a separate allocation," said the civil surgeon.

Dr Shahid Talukdar, former civil surgeon of the district, said it was urgent to identify affected areas and inform people there about proper treatment. 

"The Tripura community can also take an initiative for that. Their religious leaders can inform people. They have to make the villagers understand that if patients do not take the medicines given by physicians, they will not be cured," said Dr Shahid.