Neighbor Tuesday: Measles

There’s a concerning uptick in Measles cases in the US. Measles, one of the most contagious diseases, is preventable through vaccines. Unfortunately, there has been a decrease in children’s vaccination rates over the past few years. It’s estimated that 250,000 children in the US were not vaccinated for recommended vaccines (MMR, DTAP, etc) last year, leaving them especially vulnerable to awful diseases like measles. Conspiracies are rampant against these vaccines right now, I think in part due to conspiracies about the COVID-19 vaccines. I want to go across the globe and talk about why Measles is also a problem there - this time, though, it’s due more to conflict and poverty.

I remember in 2017 when my study team sent back the first batch of data from Somaliland on children’s health. We were assessing what children were coming into the hospital for and most conditions were for malnutrition, congenital diseases, or complications after birth. But then I saw two words that stopped me: Polio, Measles. We rarely saw that in the US. Here, though, it was still happening.

Right across the Gulf of Aden from Somaliland is Yemen.

How the crisis in the Gulf could spread to East Africa (bbc.com)

In 2022, the WHO recorded 27,000 suspected cases of measles with 220 deaths. In 2023, that number had nearly doubled to 50,795 suspected cases and 560 deaths. Yemen has gone through a staggering nine years of conflict which has driven 4.5 million people from their homes. Currently, 24 million are in need of humanitarian assistance. The country’s population is 35 million people. This equates to nearly 75% of the population needing assistance. Yemen has the second-worst ranking on the Global Hunger Index, the lowest Human Development Index out of all non-African countries, and highest on the Fragile States Index.

Improving Measles Vaccination Coverage to Advance Elimination (csis.org)

The lengthy conflict has nearly collapsed the fragile health system. Before the conflict, there were over 5,000 health facilities of which 90% were fully functional. Currently, only 54% of the facilities are fully functional, with inconsistent water supplies and electricity.

Let’s go back to the vaccines for children. Vaccines, in general, require a cold chain - in other words, electricity. And good coordination. A new UNICEF report shows that strained health systems disrupted 67 million children’s vaccine receipt.

Children who are malnourished are affected the most by Measles. The triple whammy of poverty, food insecurity, and conflict compounds on one another, creating health inequities that are vastly different than what we see in the US.

I know these statistics are hard to read and even harder to comprehend. Many of us can’t do anything directly to help in Yemen. Yet, I think it changes us when we stand in solidarity with our neighbors around the world living in conflict. Some of us can give money, some of us can raise our voices and use whatever power we have to change laws or policies, some of us can work directly to help. Others of us can raise our children with a heart towards helping so that they will act as neighbors when they are older. Others of us can change how we talk about our neighbors away from shaming towards solidarity and neighboring.

I guess I’m trying to say that we can do something. These types of situations are so complicated, full of years of messy conflict, and decades of poverty and lack of assistance. The ones caught in the middle are too often the children and families. Those already on the margins of society. When you read about the ongoing instability in Yemen or see it on the news, remember the children and their families. Remember the health systems that are broken.

This year at UNGA, the annual meeting at the United Nations, a “Summit of the Future” will be held. You can also see the “Pact for the Future” draft here.

Summit of the Future | United Nations

The Summit marks the mid-point towards the Sustainable Development Goals 2030. Unfortunately, the pandemic has disrupted lots of progress towards the goals and the Summit gives world leaders a chance to chart the course forward to make up the deficits. I am hoping that the Summit includes intersections that sometimes get ignored. For example, we often hear talks about security or poverty or debt at UNGA. But we do not hear about how poverty affects debt and global security…and then affects global health which in turn affects people’s ability to live, thrive, and get out of poverty. It’s all intersectional and related. I’m hoping the Summit has more of those talks. We shall see and I’ll keep you posted.

-Emily

PS: If you want to read a great book about some of Yemen’s history, I would recommend Jane Ferguson’s new book, No Ordinary Assignment. It’s fantastic.