Best for your kid, best for the country

DECEMBER 17 — I spoke to a parent whose child was admitted for measles recently and we discussed the potential places he could have contracted the infection from.

But given that it’s the school holidays and how diligent Malaysians are at covering their mouths when coughing and sneezing, the child could have gotten it from anywhere.

The conversation reminded me of the national Measles Elimination Program I read as a medical student sometime in 2004 that aims to eliminate measles by 2010.

A timeline that was extended to 2018 — yes, this year.

But given that measles has increased by 340 per cent in 2017 compared to 2016, and that Malaysia was recently ranked 10th behind Philippines and China for the number of measles cases in the country, I consider the program a failure and setting the country back years on the Public Health front.

Not only have we not managed to eliminate measles, diphtheria — a preventable infection that was once endemic only in Third World countries like the Dominican Republic, Laos, South Africa, Sudan and Pakistan — is also making a comeback in Malaysia.

There were 32 cases of diphtheria with seven reported deaths in 2017. And this year, we’ve lost a three-year-old in June and a 14-month-old in October to diphtheria.

Their deaths were gut-wrenching, but even more devastating and distressing is that we have not done much to better vaccinate our children.

Diphtheria infection leads to coating on the throat, and it can get so thick that it dislodges and blocks your airway — suffocating you in the process. It also releases toxins that can injure your heart, the nerves – leading to abnormal heart rhythms, heart failure, paralysis and yes, even death.

I can’t imagine anyone suffering such a fate. What more a 14-month-old.

One in 10 people who get diphtheria dies. If you are less than five years old, it goes up to one in five. It spreads when you cough or sneeze and you remain infectious for up to two weeks after infection.

Preventing it and protecting our population should be made a public health thrust.

Vaccination is similar to putting seat belts in the car.

Many including myself have tried arguing that vaccinations are essential to promote community welfare. We’ve appealed based on scientific facts, recommendations and endorsements on the need to vaccinate.

That vaccines are generally safe, effective.

We’ve also quoted scientific evidence pointing to the need to vaccinate enough of the population to achieve herd immunity. A community effort to protect people who cannot be vaccinated — for instance those who are too young, and those who are immunocompromised.

So instead of going through that again, I would like to touch on the argument that parents have an unquestionable right to make decisions regarding vaccination on behalf of their children.

One that they can exercise to exempt their child from forced medical intervention when it interferes with personal beliefs and preferences.

A right that I feel is ethically unfounded.

The law requires that medical decisions be left in the hands of capable individuals. And since most vaccines are administered during childhood, when the children lack the capacity to make decisions, the decision to vaccinate is made by a legal appointee — most often the parents.

Given that the decision is made on behalf of their children, the process should be based on one that objectively promotes and advances the best interests of the child. Not on what the parents believe or disbelieve. Politically, socially, or even religiously.

And if a decision is made against the best interest of the child, the state should step in to protect the child.

Protecting children against preventable diseases is to safeguard their interest and it is no different than making sure they receive food, education and shelter, or getting them to wear a seat belt while travelling in a car.

If parents can’t say it is their right whether or not to secure their child in the car, whether or not to send the child to school, vaccinations should be seen in the same manner.

Because vaccines protect against diseases and provides immunity to deadly diseases. And just like not wearing seat belts, failing to immunise a child exposes him or her to a preventable danger that could lead to lifelong disability.

And even death.

The freedom to decide, choose, doesn’t mean the right to make one that would harm the child, the community or the country.

Vaccination, the only thing to do.

So even if we put aside arguments about social good, herd immunity and preventing harm to others, vaccinating a child is not just the right thing to do, but also the only thing to do.

Because better sanitation, eating natural and healthy foods, cutting ties with the outside world, homeopathic remedies will not protect children from diseases like measles, diphtheria and tetanus.

Vaccinations could.

The Ministry of Health can no longer rely on parents who resist vaccines to reach this conclusion. They need to step in and mandate vaccination to secure the child’s best interests.

Only then can we focus on making parents understand, encourage and engage their participation to make this happen.

The death of kids to diphtheria mustn’t be in vain.

*This is the personal opinion of the columnist.

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