Measles: Parents carrying their twin daughters, one dead, another critically ill

The father held one daughter. She was dead, her entire body wrapped in cloth. The mother held the other child. She was alive, but unwell. She had not yet fully recovered from measles.

The couple was leaving the emergency department of Dhaka Medical College Hospital. Seeing them, I asked what had happened.

They explained that their twin daughters were Raisa and Rumaisa. Both had contracted measles. Raisa could not be saved.

The parents are Kamruzzaman and Jannati Begum. They are among the hundreds of parents who have lost children during this year’s measles outbreak. Their home is in Faridpur.

I had gone to Dhaka Medical College Hospital to work on a report concerning fistula among women. There, at around 1:30 pm on Wednesday, I encountered the family.

They were preparing to return home. An ambulance had already been called, and they were packing their belongings. During that time, I had the opportunity to speak with them briefly.

The family said that five-month-old Raisa and Rumaisa had been born at Dhaka Medical College Hospital. After birth, the twins spent 15 days in the neonatal intensive care unit because of various complications.

On Wednesday morning, the two sisters returned to the same hospital in their parents’ arms after contracting measles.

Their father, Kamruzzaman, said that they had brought both daughters from Faridpur Sadar Hospital to Dhaka Medical on Wednesday morning. Raisa died at around 11:00 am.

The death certificate issued by the hospital states that the cause of death was complications following measles, as well as measles itself.

To prevent any difficulties in transporting the body by ambulance, the hospital also issued another document stating that the death was not a “police case”. It confirmed that the child had died from post-measles complications.

The family explained that both Raisa and Rumaisa had developed several complications, including measles, and were admitted to Faridpur Sadar Hospital nine days earlier.

Kamruzzaman briefly said that they had been rushing between hospitals with their two daughters for the past nine days. Although Rumaisa’s condition had improved slightly, Raisa’s health continued to deteriorate.

Faridpur Sadar Hospital does not have a pediatric intensive care unit (PICU). The physicians there had advised them three days earlier to transfer the child to a hospital equipped with a PICU.

Standing beside him, Jannati Begum said, “We could not come earlier because we did not have the money. By the time we managed to arrange it and came here, our daughter had already died.”

A report published in Prothom Alo on 16 April, under the headline “Measles: Parents overwhelmed by treatment costs”, stated that parents of children suffering from measles were struggling to meet treatment expenses.

In January 2023, the government’s Health Economics Unit published a report titled “Bangladesh National Health Accounts 1997–2020”, which showed that for every Tk 100 spent annually on healthcare, the government covers Tk 23, while individuals pay Tk 69 themselves.

The report also noted that personal healthcare expenditure continues to rise each year, pushing many families below the poverty line.

Kamruzzaman further explained that the family had already spent a large amount during the twins’ initial 15-day stay in hospital after birth. Since both girls contracted measles and pneumonia, the expenses had continued to mount.

He said, “At every step, there is only more money to spend. The ambulance fare alone will cost more than Tk 5,000.”

Kamruzzaman survives on irregular work. He was not in a condition to speak in detail.

His family had travelled from Faridpur to the hospital with considerable preparation for the two girls. The twins’ maternal grandmother, paternal grandmother, and other relatives had accompanied them.

Their bags were filled with various belongings, including tins of milk formula for the two infants.

As they prepared to board the ambulance, I saw the mother, Jannati Begum, remove the cloth covering Raisa’s face and look at her daughter one last time.

She gently stroked the child’s face and head. Then she covered her daughter’s face again and quietly stepped away.

Kamruzzaman carefully laid his daughter’s small body on the long rear seat inside the ambulance. Jannati Begum broke down in tears and insisted on sitting beside her daughter’s body.

Their relatives did not allow her to sit there. Instead, they seated her at the front beside Rumaisa, who was in her grandmother’s arms. The ambulance then departed.

Parents from different districts continue to bring their children to Dhaka Medical College Hospital in similar circumstances. Some has to return home carrying the bodies of their children.

Meanwhile, by 8:00 am yesterday, Wednesday another eight children had died from measles and measles-related symptoms during the previous 24 hours. The total death toll has now reached 432.

The Directorate General of Health Services (DGHS) began publishing data on measles infections and deaths on 15 March.

Many people have blamed the sharp rise in infections on the interim government’s failure to administer vaccinations on time during its tenure.

At the same time, government hospitals at district and divisional levels lack pediatric intensive care units (PICUs), forcing physicians to refer critically ill children to Dhaka. In many cases, children die while waiting for a PICU bed.

Hospitals in Dhaka struggle to provide PICU beds for children referred from district and divisional hospitals because the number of patients far exceeds available capacity.

For example, Dhaka Medical College Hospital has only 17 PICU beds, despite demand being significantly higher.

The hospital’s director, Brigadier General Md Asaduzzaman, said on Wednesday night, “The number of PICU beds we currently have is not even sufficient for patients admitted to this hospital. It is difficult to provide beds for patients arriving from outside, so we have to refer them to other hospitals.”

There have been other cases in which one of a pair of twins died from measles. On 27 March at around 10:30 pm, a child named Hasan died at the Infectious Diseases Hospital in the capital.

His twin brother, Hossain, survived. Their mother, Sumaiya, had died during childbirth. Hasan and Hossain were being raised by their paternal aunt and occasionally stayed with their maternal grandmother.

On 5 May, Prothom Alo published another report of twin children struggling with measles. The twin sisters, Khadija and Fatema, were seven months old.

Fatema died on 23 April while receiving treatment in the PICU of Bangladesh Neonatal Hospital. Although her twin sister Khadija survived, she has not fully recovered.

Physician Shreebas Pal oversees the measles ward at the Infectious Diseases Hospital in Dhaka.

He said that when one twin contracts measles, it becomes almost impossible to keep the other sibling separated. Because the twins stay together, the second child usually becomes infected as well.

He explained that families with twins face greater hardship than others. “Mothers of twins infected with measles require greater family support. It becomes extremely difficult for one person to care for two sick children alone,” he added.

After Kamruzzaman and Jannati Begum began their journey back to Faridpur, I returned to the office at around 3:00 pm. One statement from Kamruzzaman continued to echo in my mind.

In anger and frustration, he said, “The Sadar Hospital does not have a PICU. There are no vacant beds in the PICU at Dhaka Medical College Hospital either. Where are parents supposed to go for treatment for children suffering from measles?”