Sakchhyam Adhikari was administered the measles vaccine on December 11, 2008, at his school, Bibhuti Vidya Mandir, in Chandragadhi, Jhapa district. The same day the first grader, who was then in upper KG, started vomiting and developed rashes.
“My mother-in-law could not understand the severity of the case and so did not take him to hospital. He turned seriously ill after a week and we took him to Mechi Zonal Hospital at Bhadrapur,” says the boy´s mother Ramala, an assistant nurse midwife at the Anarmani Health Post.
Sakchhyam was given his first dose of measles vaccine when he was 10 months and he had shown no adverse reaction, his mother recalls. But after the booster dose his eyes, nostrils, lips and the anal and genital regions became swollen and he secreted massive amounts of mucus for about three weeks.
The zonal hospital diagnosed the disease as Steven Johnson´s Syndrome (SJS) and referred the case to BP Koirala Institute of Health Sciences, Dharan, which confirmed the disease and called it vaccine-induced.
SJS is said to be very rare, with one case per million, and the majority of them are believed to be idiopathic (arising spontaneously).
The swelling of the genital and anal areas has decreased significantly but Sakchhyam´s lips and nostrils are still swollen. And more alarmingly, his eyesight is getting weaker by the day. The prognosis by Dr Rita Gurung at Tilganga Institute of Ophthalmology a couple of days ago has come as a devastating blow to the Adhikari family.
“He will not lose his eyesight completely but he will never regain full vision either,” says Dr Gurung. She, however, looks at the positive side, pointing out that the boy did not lose his life.
“Just surviving is a big thing in such a case which could have been a lot worse. He is better off than most other victims of the disease,” Dr Gurung adds.
The boy, who is currently staying with maternal uncle Laxmi Guragain in Kathmandu, is given eye droplets (Refresh Tears) every hour to keep his eyes moist, apart from other medicines. The 10ml dose of the droplets, which has to be given lifelong, costs Rs 170 and the indigent Adhikari family is seeking help from the government.
“He has become a victim of vaccination provided by the government. The government can never restore his eyesight, but the least it can do is help make him self-dependent. We have somehow managed the cost till now but can´t afford it forever and we also have a one-year-old daughter to support,” says 31-year-old Ramala.
The Child Health Division of the Health Ministry says that there isn´t any provision for compensation in a case of this kind. There is an independent Adverse Event Following Immunization (AEFI) Committee headed by Dr Neelam Adhikari, which looks into such matters.
“It may be due to human error in the procedure for administering vaccine, storage or sterilization. But there is no provision for compensation,” says Director of the Division Dr Shyam Raj Upreti, adding that the disease may also be due to other medicines taken after the vaccine.
But Ramala denies that her son was given any other medicine at the time. “If the government doesn´t provide compensation, we are thinking about legal remedy,” Ramala says.
Sakchhyam is still sprightly like any child of his age and he doesn´t truly understand the severity of his condition. But failing eyesight and high cost of medicine, his mother fears, may eventually render him asakchhyam (incapable) in life.
premdhakal@myrepublica.com
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