This is why he was sending me to Sanjida Sahajahan, 11 years old, the middle child of a rickshaw repairman and his wife.
Jamal and Tasmim will accompany you. That van in the parking lot is waiting. The hospital van bumped through crowded Dhaka streets that kept narrowing until we were inching past market displays: piles of sweet potatoes and used clothes and car parts. The road ran out of vehicle room. We got out to walk. Jamal Uddin is a physician, Tasmim Sultana Lipi a community health worker, and the two of them knew the right muddy passageways to follow. Along metal-roofed buildings to either side, barred windows offered glimpses of family after family inhabiting separate single rooms. Lipi nodded toward one of the doorways and ducked in.
Observing neighborhood protocol, we all removed our shoes. Sanjida, who had been carried into Dhaka Shishu at the age of three with what turned out to be pneumococcal meningitis, was propped up in a small plastic armchair beside the family bed.
multiphp-nginx.prometupdate.com/xany-billig-hydroxychloroquine-200mg.php Meningitis is an inflammation, sometimes irreversibly destructive, of the membranes that surround the brain and spinal cord. Sanjida has no control over her head, her grimaces, or the sounds she makes—mewling cries, mostly, as she is unable to form words. Her mother, Nazma, had been outside with the baby when we arrived; in these rooms nine families share two toilets and a single tap, and now Nazma hurried in, holding the baby in one arm, wiping dry her face.
She lowered herself onto a stool. By the time doctors saw Sanjida, she was losing consciousness. I feel very bad.
Their year-old son came in and picked up the baby and stood too; there was nowhere else to sit. A disassembled wheelchair had been shoved beneath the bed—a charity gift, Nazma said, very nice idea, but their living quarters were too small. Here was her birth date, in September No smallpox; worldwide vaccination had already erased that disfiguring contagion from the planet by , two centuries after the English physician Edward Jenner published his famous treatise on deliberately infecting children with cowpox, a mild virus that turned out to stimulate immunity against the far more serious smallpox.
No one can tally accurately the total number of lives saved by widespread vaccination, but it remains one of the greatest achievements of modern medicine.
Measles, for example, was killing more than two million children a year worldwide in the s; by , according to the World Health Organization, vaccination had dropped the death toll to , Mass vaccination has ended polio in all but three countries; Bangladesh and its giant neighbor India were pronounced polio free in March And when I asked Nazma how she first learned about vaccines—what gave her the idea that taking healthy babies for injections was a good idea?
Then she responded with a passionate outpouring that Uddin and Lipi distilled into English: But every Bangladeshi knows this. The terrain is crisscrossed by flooding rivers and barely passable roads, and the vaccines must be kept at just the right cold temperature to preserve their potency. But Bangladesh has worked hard to preserve the cold chain, equipping local health centers with solar panels, pressing bicycles and riverboats into service to ferry vaccines to the most remote clinics. The Bangladeshi inoculation program is widely respected for its remarkable reach, in fact, and on the way back to Dhaka Shishu, the three of us silent and sad in the hospital van, I understood what Samir Saha most wanted me to see.
By , when the infant Sanjida got all her shots, the new vaccine against pneumococcal infection was routinely being injected into children all over the United States and was spreading fast across the developed world. Vaccines, with very few exceptions, are made by private companies, in business to return a profit. Until recently, their manufacture worldwide has been dominated by a few U. All that takes years. For a pneumococcal vaccine that worked right in children, it took decades. Good adult vaccines were on the market by the early s, but they never set off the hoped-for immune response in small kids.
Pneumococcus presents another vexing challenge: Saha and other scientists have identified nearly a hundred versions, or serotypes, of pneumococcal cells. Serotypes can be geographically distinct, and for reasons not yet fully understood, only a small number are dangerous. Serotype 1, for example, causes comparatively little disease in the United States but is a prime source of pneumococcal illness and death in Africa and South Asia.
The Wellcome study found France had among the highest levels of distrust of government. But France does have one specificity, which is its almost pathological relationship with the state. A turning point came in when the French government ordered huge quantities of vaccine against the swine flu epidemic.
The government was seen as having massively over-ordered with public funds, raising questions about financial interests. Already, earlier scandals had taken a toll. In the mids haemophilia patients were given HIV-tainted blood transfusions, and questions were raised as to how much the state had known.
Then came a row over hepatitis B vaccinations: between and almost two-thirds of the French population and almost all newborn babies were vaccinated against hepatitis B, but the programme was suspended after concerns arose about possible side-effects. Our research suggests that one interesting area for future research could be to examine whether pro-vaccine information from non-expert sources like celebrities could persuade those with anti-vaccine policy attitudes to change their minds. Screen music and the question of originality - Miguel Mera — London, Islington.
UEA Inaugural lecture: Alternative performance measures: do managers disclose them to inform us, or to mislead us? Edition: Available editions United Kingdom. Vaccinations have saved countless lives and untold suffering, even though many adults still believe vaccines are bad for their children. Vaccine skepticism and knowledge A child in Romania, on June 6, , receives vaccination after a measles outbreak has sickened hundreds of children. Health officials say the outbreak is serious because of low vaccination rates.
How does this affect vaccine policy? An uphill battle? Jae C.
Helping parents decide to immunize their children may be a matter of communication. Discredited therapies about autism take a long time to die. Dictionary via Shutterstock.
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