In India, hope rises that a child blinded by disease may be the last

Boy in black stocking cap sitting on his mother's lap.

Blindness struck Satish suddenly, at age six. Photo: PATH/Gabe Bienczycki.

If six-year-old Satish had received all his vaccinations, he might still be able to see the water buffalo by the rice fields, his mother’s anxious smile, and the packet of cookies that Dr. Arvind Kumar Nagariya holds in front of him.

Not far away, at immunization day in the village of Bataiganj, women with babies in their laps sit cross-legged in a crowded and lively courtyard. Vijay Kumar, PATH’s field coordinator for the Saving Children’s Lives Through Immunization Project, turns the pages of a flip chart that shows the symptoms of vaccine-preventable diseases.

Measles and vitamin A deficiency can lead to blindness, he says, especially in malnourished children. He points to a picture of a child with a red splotchy face. “This is what measles looks like.”

A world disappears

Satish reaches tentatively here and there, but can’t find the packet of cookies. Dr. Nagariya shines a flashlight into his eyes and reports, “No light perception in the left eye, only a slight amount in the right.”

Satish begins to cry and his mother, Pushia, picks him up. She is a tiny woman and has to stand spread-legged to support him, even though Satish’s long legs are wasting away in their knee-high pink socks.

Three months earlier, Pushia tells the doctor, Satish had a fever, vomiting, and diarrhea. Then a rash developed on his face and spread. “One day, I was pointing out the water buffalo and cows to him, and he said, ‘Where? I can’t see them.’ I thought he was kidding.”

Pushia is widowed. Her meager pay from working as a day laborer harvesting rice, mustard, and other crops is not nearly enough to pay for the medical care that Satish needs. But Dr. Nagariya doesn’t ask for payment. The district immunization officer has come to see how this child slipped through the cracks of the immunization program and if there is hope for a better outcome for the boy.

A preventable tragedy

Not only can measles lead to serious complications such as blindness, it is the leading cause of vaccine-preventable deaths in children worldwide. Nowhere is this more true than in India, where almost three-fourths of the world’s measles deaths occurred in 2008 (the most recent available statistics). In response, India is strengthening routine immunization programs. In the state of Madhya Pradesh, where Satish lives, immunization rates are so low that PATH was asked to lend our expertise.

Toddler boy holding a packet of cookies.

A measles vaccine and a spoonful of vitamin A help protect Narendra’s sight. Photo: PATH/Gabe Bienczycki.

Dr. Nagariya can’t count the number of children he’s seen with measles, tetanus, polio, and other vaccine-preventable diseases during his three decades of work as a physician and immunization officer. But he can count the ways PATH has helped his team reach more children with better immunization services: providing technical support to ensure reliable vaccine supplies, training frontline health care workers, educating parents about the importance of vaccines, improving immunization sessions, and “giving unbiased feedback so we’re better able to take action.”

“We’ve really seen the number of cases come down,” he says. “I’ve spent my entire life working in the rural areas around here and witnessed the changes in the lives of villagers. I’m very happy about it.”

The sight of a cookie

Immunization days now happen monthly throughout the areas where PATH works. In Bataiganj, Vijay asks, “Why is immunizing important?”

A young woman in a worn purple sari raises her hand. “It’s good for the future of our children to prevent disease,” she says. Her one-year-old son clings tightly to his packet of cookies when it’s his turn to get a spoonful of vitamin A and a measles shot. The boy has now completed his full set of vaccinations, and happily eats the cookie he finds inside the bright orange wrapper.

At Satish’s house, Dr. Nagariya promises Pushia free medical care if she can get Satish to the district hospital. Satish might not get his sight back, but cases like his are becoming increasingly rare. In its first year, the Saving Children’s Lives Through Immunization project reached 2 million people in Madhya Pradesh who previously had not received immunization services. In Batainganj and other villages, the vaccinations bring hope that no child will have to endure what Satish has.