In the fall of 2004, my last year of medical school, I spent nearly 3 months in South Asia.
India, the country where my parents were born and raised and where nearly all my relatives still live, had historically been a regular destination for me. The fall of 2004 was an opportunity to visit my grandparents, uncles and aunts, and cousins, experience Diwali and a host of other festivals in India for the first time, explore the city of Mumbai independently, and travel through historic cities of Sri Lanka and Tamil Nadu state in Southern India.
The technical reason I was in India, however, was to complete two month-long elective rotations as part of my medical education. I spent a month in Surat (Gujarat State’s second city, a few hours north of Mumbai) at a private pediatrics hospital seeing burgeoning services for the rising middle class, with some additional time at an aunt’s homeopathic clinic. I also spent a month at KEM Hospital in Mumbai, a government hospital for Mumbai’s indigent population.
My experience at KEM seemed out of a novel or well done movie, seeing both clinical and practice management operations I could not have previously fathomed. On the operations side, there were interns doing 50 admissions each night, large rooms of hospital beds reminding me of post-battle scenes from Gone With the Wind, families responsible for basic nursing duties for ill patients, an outpatient HIV clinic with dozens of people crowded in a large room where patient care was dispensed.
Privacy, Western standards of cleanliness, and individualized care were not options, but the indigent of Mumbai had somewhere they could turn for sound health care.
Clinically, things were also a world apart. During my week on the TB Ward, I managed chest tubes set ups that probably haven’t been used in the West for decades. I’m still shocked that I survived that experience and remain PPD negative! The differential for fever for otherwise healthy kids and adults I learned in the US was irrelevant in India. Viral syndrome, strep, and UTI morphed into malaria, typhoid, and dengue.
And I saw numerous patients with active diseases and sequelae of diseases that I had not seen before in the U.S. because we had conquered those diseases through universal childhood vaccinations. In Mumbai, I saw patients with one leg tapered down to thumb-width at the ankle due to polio. I saw a swollen scrotum from mumps invading and destroying a child’s testicles. At the pediatrics hospital in Surat, I saw a newborn dealing with the host of birth defects due to contracting rubella in utero.
In the U.S., we read and talk about these diseases as if they came from fairy tales — the goose who laid the golden mumps, or the evil witch who gave Hansel and Gretel measles — far removed from reality.
Having seen these diseases first hand, it’s hard to imagine a day when 35,000 people were paralyzed each year from polio in the U.S., or 12.5 million people contracted rubella in just three years in the 1960s, and over 33,000 fetuses and newborns suffered consequences of congenital rubella. In the last decade or so, the U.S. has seen hundreds and thousands of kids sick from and dying of diseases that we thought were in the past, such as measles and pertussis.
All because we are no longer scared of these diseases that we think are in our past.
The developing world is clamoring to catch up to the U.S. and the rest of the industrialized world in their vaccination rates. Many vaccines are reaching 85% world-wide penetration, according to the WHO.
But in the U.S., we’re unfortunately trending the other way, and some states have vaccination rates barely reaching that 85% threshold!
What I’ve learned about vaccinations goes beyond the medical textbooks to experiences garnered with my own eyes. I know that the diseases they prevent are real. They affect real lives. And they’re really very scary.
And they are preventable by vaccines that are safe and effective.
So, without any doubt or hesitation, my daughter was vaccinated on time for each and every preventable illness in our arsenal. And along side supporting laws that mandate parents utilize car seats for infants and bike helmets for children, I support laws that, without anything but medical exception, mandate vaccination for children.
Because no child should suffer the effects of infectious disease preventable by safe and effective vaccines.