STEVE INSKEEP, HOST:
In Liberia the indirect effects of Ebola may prove to be more deadly than the virus itself. Since the outbreak began six months ago, childhood vaccination rates have plummeted - inoculations for diseases such as measles, whooping cough and yellow fever. NPR'S Jon Hamilton reports from Monrovia that this has left thousands of Liberian children vulnerable.
JON HAMILTON, BYLINE: When Ebola began killing people in the Monrovia suburb of Clara Town several months ago, some residents blamed vaccines. Che Che Richardson, a vaccinator at the Clara Town Health Center, says mothers didn't want her near their babies.
CHE CHE RICHARDSON: They were all afraid of this Ebola because they had a notion that when the people come to the hospital, we would inject them and kill them because it was the hospital that giving the people Ebola.
HAMILTON: Since then Richardson and other health care workers have been waging a campaign against misinformation as well as disease. She says vaccinators have gone out into the community with a simple message for moms.
RICHARDSON: So we encourage them to bring their babies because we told them, the longer they stay away, it will not be good for the child. Let them bring their babies so that they can be able to fight against these sicknesses.
HAMILTON: There are lot of those sicknesses in Liberia. Even before Ebola, more than 7 percent of children here died before reaching their fifth birthday. Adolphus Clarke, who helps manage the government's immunization program, says many of these deaths have been from preventable diseases.
ADOLPHUS CLARKE: It hurt me most if I saw a child coming down with measles, when I know that I can do something to advert that child from getting measles. So indeed it hurts me. It pains me.
HAMILTON: The numbers tell a tragic story. Before Ebola, 97 percent of babies were getting their routine vaccinations. Now the figure is 27 percent. Clarke says that almost certainly means more children will die.
CLARKE: I wouldn't be surprised if we see that we have a hepatitis outbreak because we know that they are susceptible. The number is huge. So we're trying to act as fast as we can.
HAMILTON: It may not be fast enough. Sheldon Yett, the UNICEF country representative for Liberia, says he's hearing ominous reports from places hit hard by Ebola.
SHELDON YETT: We already have cases of measles in Lofa County, which was the original epicenter of the disease in Liberia. So that's already happening.
HAMILTON: Yett says before Ebola arrived, Liberia was making huge progress in reducing childhood diseases.
YETT: And now that progress of course is in tremendous risk of reversing. That is, to me, one of the biggest tragedies of this. The great momentum we had going in one direction is at risk of going in exactly in the opposite direction.
HAMILTON: There are a lot of reasons vaccination rates have fallen. Clinics have been closed, education programs have been suspended and health care workers are in very short supply.
YETT: We're all focusing on Ebola. That's important. We all need to focus on Ebola, but there's another storm cloud on the horizon here right now, and that's the storm cloud over the collapse in the health system itself.
HAMILTON: There are some hopeful signs. At the community clinic in Louisiana Township, about 15 miles from Monrovia, vaccination is getting back on track. Clatus Sheriff has been the vaccinator here since 2007. He shows me the solar-powered refrigerator where he keeps vaccines.
CLATUS SHERIFF: I have all the vaccines here and my routine vaccines. This is my yellow fever vaccine - yellow fever. I have some measles here - measles vaccine is here.
HAMILTON: He even has a new vaccine for pneumonia, which kills about 7,000 Liberian children each year. It was introduced just weeks before Ebola struck. Sheriff lives in the community and says people here trust him, and he knows exactly how many babies he needs to vaccinate by the end of the year.
HAMILTON: You know to the number?
He says business is picking up after a lull and that he's now vaccinating eight or 10 children each day. In the clinic's waiting room are several mothers with their children. I asked one of them her name.
YATAH ZIL: My name is Yatah Zil.
HAMILTON: And do you have children?
HAMILTON: How many?
ZIL: I have four.
HAMILTON: And have they been vaccinated?
HAMILTON: For everything?
HAMILTON: They all come here?
HAMILTON: Two other moms say their children also have been vaccinated and the mother of a newborn says the clinic did a good job delivering her baby, so she will trust them to vaccinate her child. John Hamilton, NPR News, Monrovia, Liberia.
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