Malnourished Afghan Children in The Grasp of Measles Outbreak
A mother and her child in the Haji camp for internally displaced people in Kandahar, Afghanistan.

More and more children are losing their lives to a measles outbreak in Afghanistan as the country struggles with a humanitarian crisis under the US sanctions on the country’s Taliban regime.

Following the Taliban’s takeover of Afghanistan, the US Department of the Treasury froze Afghanistan Central Bank’s reserves, mostly held in US banks, as the Taliban has been on its “specially designated global terrorist group” since 2002, and any support for the group is illegal.

The measles outbreak has hit the malnourished children hard in some of the already marginalized and poor communities in Paktika, Ghor, Badakhshan and other provinces of Afghanistan.

The World Health Organization (WHO) last week confirmed that the number of cases and deaths increased by 18% in the week of 24 January, and 40% in the week of 31 January. Health Policy Watch reported last week that WHO Director-General Dr Tedros Adhanom Ghebreyesus met with the Taliban in Geneva to discuss Afghanistan’s health challenges.

Struggle for meals in the pandemic  

According to the global health body, as many as 35,319 suspected cases of measles and 156 deaths have been reported in Afghanistan between 1 January 2021 and 29 January 2022. Of these, 3,221 cases were laboratory confirmed while 91% of these cases and 97% of these deaths were in children under five years of age.

The WHO says that the rise in measles cases is especially concerning because of the extremely high levels of malnutrition in Afghanistan. This weakens immunity, making people more vulnerable to illness and death from diseases like measles – especially children.

Local civil society activist in Paktika, Abdul Bari, mentioned that with the fall of the previous government, thousands of people lost their jobs and could not support families for months now that ultimately led to malnourishment and spread of the diseases.

 “Many families who were doing relatively well in the past now find them among the so many very poor in the society that struggle to feed one or two meals in Paktika”, he said.

Authorities in Badakhshan province told the Health Policy Watch about an outbreak of measles worst affecting the remote Kuf Ab and Kohistan districts of the province where poverty is widespread.

“The measles outbreak has been spreading in the province for the past two months and has spread to ten districts, including the capital Faiz Abad”, he said, adding that so far no organization or health institution has come to their aid and many children have died due to the disease in Kuf Ab and Kohistan districts.

Equally remote and poor, Ghor province in the central highlands of Afghanistan is the second flashpoint for the measles outbreak according to the Afghan authorities. 

The provincial health department head, Mohammad Nazim, told the Health Policy Watch that more than a thousand children have been referred to the province’s central hospital recently and 21 of whom have died because of measles.

“The reason for the spread of measles is the non-implementation of the vaccination program firstly due to the coronavirus pandemic and then the security concerns and lack of funds”, he said.

 Crumbling Healthcare System

In December 2021, a measles outbreak response immunisation campaign was carried out with the support of the WHO in some of the most affected provinces, reaching 1.5 million children.

Battling for survival, Afghanistan’s fragile health system has been on the edge for months in the wake of the COVID-19 pandemic, the Taliban takeover of power and the subsequent US freezing of Afghanistan’s state reserves.

In Ghor, the regional public hospital sources said the doctors and support staff is so overstretched and under-paid that it can collapse any moment in the wake of mounting cases of COVID-19 and now the measles outbreak.

Kabul-based paediatrician Dr Zar Wali told the Health Policy Watch that malnutrition among children was severely compromising their immune system. “On a daily basis I am receiving dozens of child patients from the city (Kabul) as well as the nearby provinces, and there is this clear pattern of malnourishment in almost all, which makes them susceptible to all sorts of diseases”.

This was echoed by the UN Children Fund (UNICEF) last week when it warned that as the humanitarian crisis deepens in Afghanistan, hospitals were receiving so many cases each day of children suffering complications associated with severe acute malnutrition.

After relatively low transmission in 2019 and 2020, new infection cases have been increasing in all provinces since the end of July 2021, with the highest weekly toll observed so far occurring over the last four weeks.

The WHO has warned that although the number of deaths is relatively low, the rapid rise in cases in January 2022 suggests that the number of deaths due to measles is likely to increase sharply in the coming weeks.

Being endemic in Afghanistan, more than 25,000 children get killed by the measles virus annually, according to the Ministry of Public Health, and many more struggle with its impacts.

The WHO has expressed willingness to prepare a plan for a larger measles outbreak response immunisation campaign, which will start in May (or earlier, if possible), aiming to reach more than 3 million children in Afghanistan.


Image Credits: © UNICEF Afghanistan.

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