The people of Monrovia’s Peace Island ghetto — refugees of civil war, who found themselves suddenly overwhelmed and outmaneuvered by the deadly Ebola epidemic, are used to life under siege.
Yet with Liberia emerging from the worst outbreak in history a year to the day since Ebola was first identified in west Africa, the slum-dwellers are facing an even deadlier threat — the measles virus. Experts say Liberia, and neighboring Guinea and Sierra Leone, are ripe for an outbreak that could infect hundreds of thousands, dwarfing the carnage wrought by Ebola.
Death once again stalks impoverished communities like Peace Island, a cramped spit of land surrounded by swamp where 30,000 people sought refuge behind the abandoned Ministry of Defense after Liberia’s civil wars in 1989 and 2003.
At this time of year, coastal Liberia is already mercilessly hot and healthcare workers sweat as they pass through the slum in a truck, calling out to mothers via a loudspeaker to bring out their babies.
“I am happy to have the opportunity to bring my child for the measles vaccine because in this community children are dying,” Marie Bassa said after climbing down from the vehicle with her nine-month-old baby.
The government on Friday last week said a woman in Monrovia had tested positive for Ebola, but the case was the first in the country for more than a month and officials said they were not concerned that it would lead to a wider outbreak.
Despite the setback, Liberia is considered to be well on the road to recovery from an outbreak that brought the country to its knees, claiming more than 4,000 of the 10,000 lives lost across west Africa.
One consequence of the crisis has been a dramatic drop in measles vaccinations, with overburdened hospitals unable to keep up, leaving millions of children potentially at risk, experts said.
Medical aid agency Doctors Without Borders — known by its French initials MSF — believes that of Monrovia’s myriad slums, Peace Island faces the greatest risk.
MSF’s initial target is to get 700 children aged between nine months and five years into its makeshift community vaccination center, MSF vaccination supervisor Denis Besdevant said, adding that 250 infants were seen on the first day of the campaign last week. Aid workers said convincing mothers, already deeply suspicious of Western healthcare, to hand over their children is one of the biggest challenges they face.
Measles causes fever and a rash, and complications can include pneumonia, fatal brain swelling, blindness and hearing loss.
Outbreaks often follow humanitarian crises, as vaccination rates decline because of violence, fear of infection and health systems that are overwhelmed with casualties.
The west African Ebola outbreak has infected about 25,000 people. Crucially, some 852 of those cases have been healthcare workers, 492 of whom have died.
Researchers estimate that measles immunizations in the region — typically ranging between 60 and 80 percent of children — had fallen by 75 percent because of the Ebola crisis.
As a result, 100,000 more children could contract measles, in addition to the 127,000 cases already anticipated among children who have not been vaccinated in Guinea, Sierra Leone and Liberia.
Researchers forecast that on top of the 7,000 measles deaths that the nations would normally anticipate, up to 16,000 additional children could die from measles due to Ebola-related disruptions to healthcare.
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