World Pneumonia Day is the perfect reminder that so many devastating conditions are vaccine preventable.

Pneumonia is the leading global cause of childhood death and kills nearly one million children each year.

Yet despite there being an effective vaccine only a quarter the world’s children have been immunised against it.

This World Pneumonia Day, Australian doctor Jill Smith, shares her experiences from South Sudan where she has seen too many children suffer and die from vaccine preventable diseases.

Whilst I always try to appreciate the different perspective on any topic, I find it hard to understand people who do not vaccinate their children, particularly after seeing the devastating conditions here that are vaccine preventable.

An MSF nurse administers a drip to two and half year old Mishaki whilst he is held by his mother, Furaha, in the Democratic Republic of the Congo. Mishaki is suffering severe pneumonia, complicated by dehydration and respiratory problems. (Copyright: Phil Moore)

Watching a child’s body spasm with their backs forced into extension, their face contorted in a joker like grimace and their lungs paralysed as a result of the toxins that come from being infected with tetanus is one of the most traumatic things I have seen in my medical career. I have seen small bodies try and fight this condition, but ultimately they simply can’t take a breath and they die. It’s a horrible death.

Last year in Yida refugee camp where I am currently working, we experienced a measles outbreak and many children died. We are bracing ourselves for this again this year.

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I have seen of numerous cases of severe pneumonia and the faces of many small children, both that survived and died from their illness come to mind. I often remember the face of a one and a half year old girl. She came into our clinic short of breath, belly breathing and her head was bobbing as she fought to get in enough air. She tried helplessly to clutch her mother’s breast. She was stuck between the urge and need to breast feed and being so short of breath that even just breathing was taking all her energy.

Pneumonia Vaccination Campaign in Yida Camp, South Sudan. (Copyright: Yann Libessart/MSF)

We admitted her and tried to put in an intravenous cannula but she was already so unwell that all her veins had shrunk down and it took us about one hour. This child endured us poking her with needles about five times before we were finally successful. We gave her antibiotics and placed her on oxygen and for a short time her breathing settled.


The other doctor and I retired to our tents for the evening knowing that this little girl wouldn’t sleep at all and probably wouldn’t survive. The next day her chest was full of crackly noises and the pneumonia was throughout the left side of her chest. Her mother had lost the girl’s twin brother two weeks before with a similar illness and she was rightfully distraught at the thought of loosing another baby. We tried everything we could think of to make this child better but without the ability to place this child on life support her hope of surviving was limited. I stayed up through the night holding her chin in the right position and using a bag mask to deliver oxygen into her little lungs. I knew it was futile but I couldn’t give up.

I couldn’t conceive this mother’s grief, having lost one child only a short time before that and now this. Her oxygen dropped and when the brain is starved of oxygen it can cause seizures. The child convulsed and I knew the battle was lost. I made her as comfortable as I could and apologised to the mother. I could hear her wail back in my tent, as I tried desperately to find sleep and forget the face of that child.

She didn’t need to die. Pneumonia is a vaccine preventable disease. But sadly it is unaffordable to many countries despite huge profits made by pharmaceutical companies.

We have had many successes and it’s important to remember these faces too. I often look at the photo of one child, whom came in with pneumonia and looked like death warmed up. He spent seven days on oxygen, but he made a full recovery and I’m lucky enough to see his gorgeous smiling face from time to time around the camp.

Pneumonia Vaccination Campaign in Yida Camp, South Sudan. (Copyright: Yann Libessart/MSF)

In Australia, my generation has known few children die of diseases like tetanus, measles and pneumonia. Here in South Sudan mothers know and don’t hesitate to vaccinate their children. For them it is a very real and tangible threat. However, the difficulty for them is that they might not have access to the vaccines that they need.

For every one of us who are privileged enough to live in Australia and have access to vaccines, there are countless numbers of mothers desperate to offer their child the same basic protections, and who can’t. We owe it to them to make the pneumonia vaccine more available.

A child dies of pneumonia every 35 seconds. Pharmaceutical giants Pfizer and GSK make an effective vaccine to prevent pneumonia but still 75% of children around the world remain unprotected against the disease. One key barrier is the high price. Pfizer and GSK have already reported more than US$28 billion in global sales from the pneumonia vaccine alone. This World Pnuemonia Day MSF is calling on Pfizer and GSK to lower the price to $5 per child for all developing countries and humanitarian organisations. It’s time to give all countries a fair shot at protecting the lives of their children.

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