Case Study

Salim Khan

In rural Uttar Pradesh, India, children often don’t get routine shots for measles and whooping cough — many develop pneumonia as a complication and risk death.

3-year old Salim is a bundle of charm and energy. He is playful and mischievous – spoiled by his grandmother, taking his brother’s toys, fed sweets by his mom. When reminded of Salim’s recent bout with pneumonia, his grandmother becomes tearful.

Salim fell sick with measles and then he caught pneumonia. He wouldn’t eat or drink for days, and he became like skin and bones. His chest was drawing in and out, an important sign of pneumonia. His temperature shot up and down. His grandmother prayed and kept him by a lit fire to keep warm. She implored not only Allah but all the local Hindu deities to keep her son alive. Salim’s family lives in a village in Uttar Pradesh, a state in India’s impoverished north. There is one doctor the family trusts, but he was traveling when Salim fell ill. Finally he returned. His grandmother remembers, “This kid was practically dead.” The doctor chided the parents for waiting to treat their son. The family had been petrified about the cost of treatment. His grandmother pawned all the family’s jewelry to borrow money for his treatment, which came to about $300.

Three days after the doctor admitted Salim to hospital, the boy became so healthy that he took off his own oxygen mask. The doctor explained that pneumonia had threatened the boy’s life and that they should be vigilant about watching for symptoms like fast breathing and the movement of a child’s chest drawing in and out. In fact, Salim’s older brother Shokeen had a very serious pneumonia case a year ago. A cousin who became sick at the same time died. The family members still are not sure how to prevent pneumonia, and blame the series of pneumonia cases on a new stone floor they purchased with money Salim’s dad earned recycling car parts. The stone is colder than their old sand floor, they point out. They believe the cold causes children to suffer from pneumonia.

His grandmother is intent on ensuring that Salim becomes educated. When asked what he wants to become, the boy replies that he wants to work in a hospital some day.