When Gita Chepang’s four-year-old son Rabin developed a raging fever, started vomiting, had diarrhea, body pain, and rashes she feared it might be the “corona” everyone was talking about. Then a neighbour, 29-year-old Ram Maya Chepang, also complained of similar symptoms.
They failed to respond to an expensive allergy medicine given by a local pharmacy. So, Gita called Jhalak Maya, a doctor at a nearby health post.
“She checked my son, and said he had measles,” she recalls, “she scolded me for giving the boy the allergy medicine, and told me to isolate him.”
Ram Maya Chepang is a single mother, and her school-age daughter and son go to the market to sell vegetables and there is no one to take care of her all day. Three other children from one household in the village of Huiling also got measles, and had raging fever for two weeks before they got better.
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In late April, local health officials started getting reports that the Chepang neighbours were not the only ones infected. More than 160 people in two villages along the Dhading and Gorkha districts in central Nepal were affected.
The villages of Benighat in Dhading and Gandaki in Gorkha which first saw the outbreak a month ago are on either side of the Trisuli River. Villagers from here go down to the highway to sell their produce, which is why there is a danger of it spreading further.
The Chepangs living in these remote areas were already in missing pockets where vaccination campaigns did not reach even in the best of times. But this year, the government’s immunisation drive for measles and other diseases has been delayed because of the COVID-19 lockdown.
Sita Shakya, who heads the local health department says there are many other remote villages along the border between the two districts who have not been immunised and are at risk of getting measles.
“The local vaccination centre is in Syadul, which is a three-hour walk away from the two villages, and most mothers do not want to make the journey with their children,” she says. Two children have already died in Dhading during the current outbreak.
The two who dies were two-year-old Anisha Chepang and an eight-month-old baby who had not been vaccinated for measles, according to Benighat mayor Shankar Duwadi. In fact, he says, none of the 160 infected in the two districts had ever been innoculated.
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Shyam Bahadur Chepang from the area believes that the disease was spread during the weekly market when people mingled. “You go to sell your vegetables, and then return with the disease,” he said.
Simulatenous with the COVID-19 scare, measles outbreaks have also been reported from several districts including Kathmandu, Lalitpur, and the eastern Tarai. Health officials blame the restrictions on mobility, lack of public transport and suspension of vaccination drives for the sudden outbreak.
Measles is a highly contagious viral disease that spreads through droplets after sneezing and coughing just like the COVID-19. Although about 100,000 measles cases used to be reported in Nepal annually till 20 years ago, it had dropped to 100 in annual cases in the past few years.
Lack of awareness about the diseases appears to be a part of the problem. Bhim Lal Chepang, who lives in one of the villages where the outbreak happened says most people in the village know nothing about the disease. “We do not know how it spreads, and we don’t even know if there is a cure,” he says, adding that most in the village still go to local shamans.
Hoping to educate the locals, Jhalak Maya Chepang, a member of the Prajapati Community Health Unit, instructed the villagers not to touch one another and warned mothers to protect their children from going out. Yet, many locals are not following instructions.
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“Along with my four-year-old, I also have a two-year-old son and his cousins often play together. It is impossible to tell them to stay away from each other,” says Gita Chepang.
Ram Maya Chepang also did not physically distance herself from her children, yet got infected even though her children are fine.
Ward Chair Tulsi Regmi says an immunisation drive is being launched in the two villages and surrounding settlements, and 11,154 children were vaccinated last week. He admitted that awareness drives had not been carried out because of the remoteness of the villages and the lockdown.
However, Sumana Gurung of the Syadul public health unit says mothers were suspicious of a recent vaccination drive. “The picked up their children and ran away when we approached. They were worried that their children would cry, or even die. Most mothers were scared of their husbands scolding them for immunising their children,” Gurung added.
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