"It's my 6-year-old daughter who had measles first. She had a lot of fever." "I called the doctor but it was Friday. He had already gone to town. I went to see another doctor who told me that my daughter had an allergy." "This misdiagnosis was almost fatal." Erika Hantriniaina, Ambalavao, Madagascar
"Vitamin A is given to children to increase their immunity. We try to reduce the fever. If there is a cough, we give antibiotics." Dr. Boniface Maronko, World Health Organization
"The epidemic unfortunately continues to expand in size. Malnutrition is the bed of measles." "But immunization is not the only strategy for the response to this epidemic. We still need resources for care, monitoring and social mobilization." Dr. Dossou Vincent Sodjinou, WHO epidemiologist
"He has a fever. I think it's measles because there are these little pimples that have appeared on his face." "I'm so scared for him because in the village everyone says it kills babies." Nifaliana Razaijafisoa, Ambalavao, Madagascar
A
volunteer nurse examines six-month-old Sarobidy, who is infected with
measles, while her mother Nifaliana Razaijafisoa looks on at a
healthcare centre in Larintsena, Madagascar. (Laetitia Bezain/Associated Press)
Madagascar has logged beyond 115,000 cases of the largest measles outbreak in its history. Misinformation and hesitation born of deliberate campaigns to turn people away from having their children inoculated have resulted in measles cases rising globally. It is a lack of resources in Madagascar, however, that has driven the rise of measles infections.
On Madagascar's main island only 58 percent of people have been vaccinated, representing a major feature in the spread of the outbreak. One of the most infectious diseases, immunization rates are required to be at least 90 to 95 percent, even higher, for the herd immunity effect to prevail in the prevention of measles outbreaks.
It is mostly children under age 15 that have died from the measles infections since the outbreak began in September, according to the World Health Organization. Close to fifty percent of Madagascar's child population is malnourished, complicating the outbreak. For rural dwellers, simply reaching a clinic for help can represent a challenge.
Health centres in the country are often understaffed or are staffed with poorly qualified workers and many people living in Madagascar cannot afford to see a doctor, or to buy medicine. Information on health issues can be lacking entirely or be unreliable.That vaccines are free in public health centres doesn't reach all parents.
There are no specific treatments for measles; instead the symptoms are treated. Highly infectious, the disease is spread by coughing, sneezing, close contact or infected surfaces. Should the disease fail to be treated in its early stages by antibiotics, complications including diarrhea, bronchitis, pneumonia and convulsions can manifest.
Free medications have been sent to regions most affected by the outbreak, by Madagascar's health ministry. Dr. Maronko supervises efforts to contain the outbreak, reminding heads of health centres in the Ambalavao region not to ask parents to pay, having seen some doctors asking them for money. WHO began a third mass vaccination campaign with the goal of reaching 7.2 million children, six months of age to nine years, in Madagascar last month.
Mothers wait to have their babies vaccinated against measles, at a healthcare center in Larintsena, Madagascar. Laetitia Bezain / AP
"It's child labour and child abuse." "These kids earn. They feed their families and their promoters with their winning. We are destroying our children for sport." Dr. Jiraporn Laothamatas, neuroadiologist, Thailand
"This [limits on fights; barring children under 12 from competitive boxing] will destroy muay Thai. We should be focused on prevention instead of pushing kids away." "They are fighting for their lives." "It's in our blood to fight. These laws will only push people away from doing it safely." Dr. Sudhichai Chokekijchai, professional boxing medic, fight enthusiast
Chai in the red corner, moments before the start of his fight. Forbes
Child boxing called muay Thai is honoured throughout the country. Its greatest proponents and source of child boxers is in poor, rural regions of the country. There is little doubt that its allure has much to do with children earning prize money that can make a huge difference in their families' lives. Farm families may earn $200 for a month's labour whereas a successful child fighter can bring home $60 to $600 for a winning fight or a knockout.
For these children devotion to muay Thai reflects the need for instilling discipline at an early age where in small, makeshift training camps in rural areas children are taught to fight. They use rotting gloves and donated punching bags and the most successful are soon recruited by fight gyms in Bangkok, which act as makeshift boarding schools where elite young fighters live together in place of being with their families.
There, a rigorous training schedule becomes their lifestyle where at 4:30 a.m. they spurt through a 10-kilometer run, box from 5:30 to 7 and attend school until the afternoon when another training session is scheduled. Going professional is their aspiration and that of their parents, for them. Muay Thai bouts are held four times weekly at the Rajadamnern Stadium in the capital city where middle-aged Thai men and foreign tourists pack the stadium, drinking beer and betting during fight bouts.
The fighting ring at a typical festival. Forbes
Muay Thai is sacred in Thailand, a kickboxing sport favoured by all strata of society. For the wealthy it acts as a gambling forum where tens of thousands can be won or lost. For the far more numerous poor, muay Thai can represent a form of social mobility, honours, a means through which well-muscled young boxers -- boys and girls -- can fight toward success, heralding their families' entry into the growing middle class.
The country suddenly sat back in November when thirteen-year-old Anucha Tasako, knocked out in a muay Thai fight, died of a brain hemorrhage. The knockout occurred after five fierce head blows caused Anucha to buckle to the ground, limp, detailed on video. He died two days later after a career that saw him since the age of eight, fighting 174 bouts. Thailand is experiencing reluctant second thoughts about the brutality of such a sport for underage fighters.
A charge to ban boxing by children is being led by neuroradiologist Dr. Jiraporn Laothamatas who released a seven-year study on the effect of muay Thai on children's brains which indicated a steady drop in I.Q. and brain functions for those who fight. Thai lawmakers have proposed a measure to place limits on fights and to bar children under age twelve from competitive boxing.
Fellow fighters in the training ring of Chai's gym. Forbes
At the present time, national rules require boxes over 15 to register to fight officially. Rules are vague, requiring merely parental permission for competitors under age fifteen, and most fights are unofficial. Only 10,373 child fighters had registered between 2010 to 2017,according to a Thai investigative journalism center; on the other hand, close to 200,000 children under fifteen regularly compete, according to boxing officials.
Kicking, punching, kneeing and elbowing to defeat an opponent is typical of muay Thai, with fights of five rounds or three minutes of fighting with no headgear, and competitors wearing 10-ounce gloves. The competitions remain outside the child protection and labour laws stating that only salaried children are considered to be workers, while money won in muay Thai fights is considered an award, and as such legal.
Chai watches Phetsiam practice the clinch on the punching bag Forbes
This represents a general opinion site for its author. It also offers a space for the author to record her experiences and perceptions,both personal and public. This is rendered obvious by the content contained in the blog, but the space is here inviting me to write. And so I do.
