A measles outbreak has killed 12 children in one of Pakistan's lawless tribal districts and is spreading as fighting, power cuts and curfews cause a vaccine shortage, doctors said Monday.
North Waziristan, a restive and deeply poor area bordering Afghanistan, is Pakistan's most notorious Taliban and Al-Qaeda stronghold, hit frequently by US drone strikes targeting Islamist militants.
"For the past three weeks we are daily receiving five to 10 children suffering from measles," said doctor Mohammad Ali Shah, chief of the main hospital in Miranshah, the area's biggest town.
He would normally see only one or two deaths a year from the disease, he said.
But another doctor, Mohammad Sadiq, said 12 children and a man had died from measles in the last three weeks, and that there were up to 70 confirmed cases in hospital.
The UN children's agency UNICEF said there had been 143 measles alerts this year in Pakistan's seven-district, semi-autonomous tribal belt.
The measles virus is highly contagious and can be fatal, but can easily be prevented by proper immunisation.
However Shah said: "We do not have proper storage for measles vaccination because of long power outages and curfews and most of our stock expires due to these reasons."
Poverty and poor transport facilities mean villagers in the rugged, mountainous areas cannot come to hospitals for treatment, he added, while military operations and unrest mean vaccination teams cannot reach them.
"There is accumulation of significant number of unvaccinated children in different parts of this region which are revealing as outbreaks or alerts over time to time," said doctor Quamrul Hasan of the World Health Organization (WHO).
WHO and local health officials are to carry out a supplementary campaign in the tribal areas aimed at vaccinating more than a million children aged under 10 by the end of June, he said.
Polio vaccination campaigns in tribal areas have in the past suffered because of rumours -- sometimes spread by radio stations or from mosque loudspeakers -- they were a Western conspiracy to sterilise children to reduce the Muslim population.
But UNICEF said work had been done to tackle misconceptions and there was less suspicion of the measles vaccine, administered by injection, than of the orally-administered polio dose.
Nearly 140,000 people died of measles worldwide in 2010, according to the World Health Organisation -- 95 percent in low income countries with poor health infrastructure.