THE outbreak of measles, with 63,134 hospital admissions and 612 deaths since March, is not merely a public health emergency but also a growing economic crisis for thousands of families. As hospitals struggle to cope with the influx of patients, the burden of treatment is falling heavily on households, particularly those with limited incomes. Parents are selling assets, borrowing from relatives and neighbours and accumulating debts to pay for treatment. Some families report spending Tk 9–10 lakh while others claim expenses exceeding Tk 16 lakh as children require prolonged intensive hospital care. Beyond direct medical expenses, many parents are also losing income because they stop working to remain at their children’s bedside. For low-income households already living on the margins, the loss of daily earning compounds the financial shock. Further alarming is the cost of intensive care as complications such as pneumonia and respiratory distress make paediatric ICU admission essential but often financially devastating. Three months after the initial cases were reported, the government’s response remains fragmented and largely focused on restoring the immunisation programme. The government has not yet been able to launch a comprehensive health emergency response with provisions to support people in economic hardship.
The outbreak has also exposed serious weaknesses in the emergency response and outbreak management. Firstly, delayed diagnosis and treatment appear to be contributing to severe complications. Several parents reported initially treating symptoms as minor illnesses before children deteriorated and required emergency care. Early detection and referral remain critical in preventing severe outcomes. Secondly, reports of children returning to hospital with measles symptoms shortly after discharge raise concern about whether treatment protocols, follow-up care and monitoring are consistently implemented. The recurrence of symptoms among multiple patients warrants urgent clinical investigation. Thirdly, the shortage of publicly-funded paediatric intensive care facilities is forcing families to move from one hospital to another in search of beds. This not only delays treatment but also increases costs and, potentially, mortality. The lack of adequate paediatric ICU capacity has become one of the most visible weaknesses in the response.
The government must, therefore, act on both short- and long-term fronts. In the short term, emergency financial support should be made available to affected families while additional intensive care and high-dependency beds should be rapidly mobilised in public hospitals. Clinical guidelines for diagnosis, referral, treatment and discharge should be reinforced and closely monitored. The authorities must also strengthen surveillance and community awareness to ensure and early detection of cases. In the long term, the government needs sustained investment in paediatric critical care infrastructure, strong outbreak preparedness mechanisms and universal access to affordable treatment during public health emergencies.
