Three months ago, Fatema Khatun's son Hossain died in her arms. Hossain was one of the nearly 20,000 Bangladeshi children who die every year from measles, the fifth-leading cause of death for children under five-years-old in Bangladesh.
Hossain was also just three months short of being vaccinated through the Measles Catch Up Campaign (MCUC), one of the largest public-health campaigns ever conducted. On 25 February, Bangladesh began the three-week vaccination campaign, in which an estimated 33.5 million children, aged nine months to 10 years, will get their 'catch up' measles vaccine, regardless of whether they have had the disease or the vaccine before. Another 1.5 million were vaccinated in the campaign's first phase, in September last year. About one-in-four children miss out on routine measles vaccines in Bangladesh. About 40 percent of children in each age group are left vulnerable to measles, because the vaccine only has an 85 percent efficacy when given to children aged nine months.
Hossain had been out playing as usual, Fatema says, when he first got sick with a fever that lasted three days. When it started, she took him to a doctor who prescribed paracetamol and rest. After the third day, when the measles rash came, Fatema's neighbours said there was no need to go to the doctor again. "Then he got a bit better, and the rash went down for three days," she says. Fatema had left for work early the morning that Hossain died. She earns between BDT 500-600 per month sorting rubbish and recycling, which is about the same as the rent for the family's small bamboo hut in their Dhaka slum. The family relies on the eldest daughter Khadeza's monthly earnings of BDT 700 as a child domestic worker to survive.
When Fatema arrived home, she found Hossain lying on the floor of their hut. "I came back and held him in my lap to give him a little bit of water," she recalls. "He drank one sip and died. I was holding him when he died." Hossain was one of the 15 percent for whom the vaccine proved useless. But the MCUC safety net, the 'catch up', could save other children from a similar fate. Fatema is certainly making sure her three under-10 children are getting their catch up vaccination. She is also alerting her neighbours in the slum — many of whom had children infected in the outbreak that took Hossain — about the service that is arriving on their doorsteps.