More than a thousand new measles cases in Mumbai slum

Despite recent progress, the disease has not yet been wiped out. In slums, parents are wary of injections. In addition to increasing the number of vaccinations, the government must also reduce child malnutrition.

Mumbai (AsiaNews) – A measles outbreak that began last month in Rafi Nagar, a Mumbai slum, is spreading to other parts of the city.

Only 25 cases were reported in the capital of Maharashtra in 2020, and only nine last year; however, more than 1,070 were reported just last week.

Some 68 children have been hospitalised, at least five in intensive care, while seven have died. Some of the latter were unvaccinated, others were severely malnourished.

It is hard to believe that a country like India, one of the world’s main manufacturers and exporters of drugs and vaccines, still has children who are not vaccinated against measles.

For various reasons, Indian parents, especially those living in poorer areas, often do not bring their children to be vaccinated.

The problem transcends India. According to UNICEF and the World Health Organisation (WHO), the number of cases is increasing worldwide, with a 79 per cent jump in the first months of the year.

India reported 9,489 infections between April and September, first in global ranking, ahead of Somalia and Yemen.

The main reason for this is the COVID-19 pandemic, which halted regular vaccination campaigns.

It is estimated that 23 million children did not get basic vaccines, the highest figure since 2009, and 3.7 million more than in 2019.

While vaccination campaigns stopped in many countries because of conflicts and instability, in India the new outbreaks seem to be more closely linked to extreme poverty and poor education.

In slums, Indian parents are mostly day labourers; for many of them, staying at home with a sick child with fever after receiving the vaccine means giving up a day's wages.

Many mothers agree to the first dose at nine months, but not to the second at 16 because they are afraid of injections and fear side effects.

According to Indian government data, in Mumbai Metropolitan Region, which includes slums, 30 per cent of children under two have not received the first dose of measles vaccine. For healthcare workers, the percentage is much higher.

Often it is the older siblings who take care of the younger ones while both parents are away working. And they don't always get to eat every day.

Last month, the Indian government rejected findings published in the latest Global Hunger Index Report, which ranks India 107th out of 121 countries.

In a statement almost identical to that of the previous year, Indian authorities accused Concern Worldwide and Welthungerhilfe, the organisations responsible for the report, of conducting partial investigations that do not reflect India’s complex reality.

In fact, even government data show that little progress has been made in recent years to reduce child malnutrition. In Uttar Pradesh, India’s most populous state, only 6.1 per cent of children between 6 and 23 months receive a proper diet. In Mumbai, 9.3 per cent of children  are underweight, rising to 10.5 per cent and 18 per cent in some slums.

Complications related to the virus affect malnourished children much more than healthy ones, but other factors keep the number of vaccinated children low, like parents’ level of education.

According to one study, 92 per cent of unvaccinated children have parents with an elementary level of education. Often pregnant women travel to their village of origin to have their babies, but the latter are not equipped with vaccination centres.

In 2019, India was achieving excellent results in eradicating several diseases, including tetanus and polio, and had set itself the goal of eliminating measles and rubella by 2020.

However, it is clear the government must focus on marginal areas and act on several factors simultaneously: nutrition, better information, and setting up vaccination centres in rural areas.