THE recent death of yet another young child from diphtheria, a disease that can be easily prevented by immunisation, is a national tragedy.We should ask ourselves some searching questions: When a young child dies from a preventable disease, whose responsibility is it?It is of course the parents who failed to vaccinate the child. These are not “bad” parents who intentionally want to harm their child, but there is no denying the fact that their reluctance to immunise the child caused his death. Were they unaware of the other children who died recently?There has been sufficient media coverage to know that in 2018, there were 18 cases of young children with diphtheria, and that five died. So why did they expose their child to such a risk?

 So why do these parents take such a risky course of action?A certain group of people is also responsible for this child and other children’s death. This is the group that is very loud on social media and quick to give “expert” opinions but fail to be present to take responsibility when children die from easily preventable diseases.They are the alternative and complementary medicine practitioners and some medical doctors. They have brainwashed and misled parents. Religious sensitivities to them are more important than the lives of children.No one is denying the fact that vaccines have side-effects but any sensible review of historical and scientific data will show how vaccines have helped to control many lethal diseases that used to kill and damage thousands of children. The re-emergence of diseases long controlled in the past is due to these anti-vaccine practitioners.I want to ask everyone why we are not taking these anti-vaccine proponents to task. They are the ones who are primarily responsible for the death of the young boy in this latest case.

The health department and government authorities cannot absolve themselves of responsibility either. They have the authority and power to act.The Child Act is a powerful legislation that has been crafted to protect children. Why don’t we use it when a child dies from negligence? Firm action of this nature would be a deterrent to others who are hesitating about vaccinating their children.When parents fail to protect children, the state must do so; that is the reason laws to protect children are created. The health department and government authorities also have a responsibility to vulnerable children (those with cancer on chemotherapy, young babies, those with autoimmune diseases and etc.) who cannot yet be vaccinated. They are at high risk of dying if we do not have herd immunity in the community.

Finally, all of us are also responsible. We as a society can advocate together for our government to act. It is our responsibility as a society to push for compulsory vaccination today, before more children die.I have experienced a number of epidemics, including two diphtheria epidemics in the 1980s, and I would not want us to return to the days when we lost so many children. We cannot regress to becoming a third world nation.

Here are some suggestions on what may work:

1. Make the primary immunisation schedule compulsory for all children (i.e the critical vaccines covered by the Health Ministry). This will not be easy to enforce but we should aim to protect every child. All elected representatives should advocate for and support this initiative.

2. Actively address misinformation that is circulated. This is not just the role of Health Ministry but of all healthcare practitioners both government and private. Parents want what’s best for their children and we should offer them evidence-based information.

3. Recognise that a segment of the population distrusts the government and healthcare professionals, and hence are more likely to use alternative medicine. Therefore, it is important that the government and Health Ministry are very transparent and honest about vaccines and their side- effects. Data on this should be readily available online.

4. Use the Child Act. The government, welfare and health department should use this Act when children die or are injured by common vaccine-preventable diseases. Neglecting a child’s health is not an acceptable practice for any parent.

We must recognise and acknowledge that we have failed our children again and again. How many children will need to die before we act? The health department, government and society (all of us) must act now to make sure it does not happen again.

DATUK DR AMAR-SINGH HSS

Senior consultant paediatrician

Ipoh