Shielding residential school children from measles

Residential schools are a lifeline for communities living in scattered villages in the dense forests of Bastar district in Chhattisgarh, where access is often shaped by terrain and security challenges. For many tribal families, residential schools—ashram schools—offer children not just learning, but stability and opportunity. In 2024, however, these same close-knit environments revealed a hidden vulnerability.

In settings where students live, study, and share daily routines in close quarters, infectious diseases can spread quickly—especially when immunity gaps build over time. Between January and October 2024, 18 measles outbreaks were identified across residential schools in four districts, raising urgent concerns.

What followed was a swift and coordinated public health response led by the state government. District health authorities strengthened fever-rash surveillance systems with the assistance of World Health Organization (WHO). WHO’s National Public Health Support Network works with local authorities for early detection. Investigation teams moved quickly, working alongside district officials to identify high-risk groups, assess the extent of the spread, and guide the interventions on the ground.

WHO field teams supported the monitoring of the outbreak response immunization campaign in Mavlibhata Girls’ Residential School in Badekilepal, Bastar (©WHO India / Suresh Tanti)

The turning point came through a tightly coordinated, cross-departmental joint response. Under state government leadership, the Health, Tribal Welfare and Education departments aligned efforts to ensure every child received a dose of measles rubella (MR) vaccine. Instead of bringing children to immunization centres—often miles away from where they lived—vaccination teams went directly to them. Schools and hostels became vaccination sites, ensuring that no child was missed because of distance or other circumstantial challenges.

From February to October 2024, a targeted Outbreak Response Immunization campaign was rolled out in phases, across eight of the most affected administrative blocks in Sukma, Dantewada, Bijapur and Bastar districts. The campaign delivered an additional dose of the MR vaccine to children in all residential schools in these areas.

The impact was immediate and far-reaching. More than 51 000 school-aged children living in residential institutions received protection through the campaign. By rapidly increasing immunity levels, the intervention prevented further transmission risks—not only within schools but also in surrounding communities. Just as importantly, it strengthened trust. “When vaccination teams came directly to the school, it reassured us and the children’s families that the children staying here were protected,” said a residential-school teacher.

Measles-rubella vaccines being given to students at Cherpal Boy’s Residential School in Bijapur (©WHO India/ M. Nageshwar Rao)

“With the district authorities of Bastar, we have learned together that strong surveillance and rapid, targeted action can address the toughest challenges and bring vaccines directly to children where they live, so that they are protected when an outbreak hits,” said Dr Yvan J.-F. Hutin, WHO Representative to India.

These visible, proactive actions in Chhattisgarh demonstrated that even in complex, conflict-affected settings, health systems can adapt and respond effectively. This approach has helped safeguard not just health—but the promise of a safer future for every child.