By Matt Underwood Tiny coffins, far too many of them, are a heartbreaking reality in the Congo. Measles, a disease preventable with a readily available vaccine, is claiming the lives of thousands of children. In 2023 alone, over 311,000 cases were reported, tragically resulting in over 6,000 child deaths; these were children who succumbed to fever and rash, their young lives ending far too soon. While the number of cases has decreased this year, to approximately 97,000, the mortality rate has alarmingly increased, with over 2,100 children losing their lives. The reasons behind this increased lethality remain unclear, adding another layer of complexity to this devastating situation.
This surge in measles deaths is not isolated to the Congo. Globally, measles cases rose by 20% in 2023, exceeding 10.3 million cases and causing over 107,000 deaths. Many countries, including some regions within the United States, are experiencing significant outbreaks. This resurgence is concerning, especially considering the measles vaccine has existed since 1963 and is widely credited with saving countless lives. In some areas, vaccine hesitancy and misinformation contribute to lower vaccination rates, increasing vulnerability to this preventable disease.
The lack of access to healthcare contributes heavily to the high mortality rate in places like the Congo. Consider Olive, a child who lived miles from the nearest health center, a journey too far for her when her breathing worsened. She arrived at the hospital to find limited resources: no blood bank for a needed transfusion, resulting in her death hours after arriving. This is a devastating glimpse into the realities faced by many Congolese children. In addition to the immediate effects of measles, the disease weakens the immune system, increasing susceptibility to other infections like pneumonia and diarrhea, which are often deadly in already malnourished children; 4.5 million Congolese children are acutely malnourished, further highlighting the precarious situation.
Measles can cause serious complications like deafness, blindness, and encephalitis. However, in the Congo, children frequently succumb to pneumonia and diarrhea before these other conditions develop, creating a deadly cocktail that overwhelms their fragile systems. The Congo, along with Ethiopia, Nigeria, and Pakistan, are among the few large, populous countries that have struggled to control measles outbreaks. Achieving and maintaining over 95% vaccination coverage is crucial for controlling the disease, a rate that Congo has yet to achieve, even while the US rate has dropped below 95% recently.
Decades of civil conflict have significantly hampered healthcare access in the Congo. Millions are internally displaced, many living in areas where healthcare is inaccessible. Although aid organizations try to provide targeted immunizations in displacement camps, the ongoing conflict hinders broader vaccination efforts. The constant instability makes even the simplest preventative measures incredibly difficult to implement effectively, compounding the already dire situation.
Beyond the immediate tragedy of children dying from measles, the broader context needs to be understood. This is not merely a healthcare crisis; it is a multifaceted problem deeply rooted in societal, political, and economic factors. The challenges of poverty, conflict, and limited access to healthcare infrastructure prevent widespread vaccination, creating fertile ground for diseases like measles to thrive. This is a profound humanitarian crisis that requires not only medical intervention, but also long-term solutions to address the underlying systemic issues. The tragic reality of tiny coffins should serve as a stark reminder of the urgency and scale of this crisis and the need for global cooperation to address it effectively. We have the tools to prevent these deaths; what we need is the collective will to ensure that everyone has access to them.