In 2010, Mothapo looked around her community in Soshanguve’s Block M and saw working mothers struggling to find good, affordable day care. In its absence, some children were left to loiter in the streets. Wanting to help mums and keep kids safe, Mothapo opened the Moraka Day Care Centre.

In late 2013, what started as one child’s rash quickly became a small measles outbreak among the 24 children enrolled at the day care. She remembers the day she found the tell-tale rash on the youngster

“One of the babies was having brown rush on the face and in the mouth,” she told OurHealth. “I immediately summoned the child’s mother to take her to the doctor where it was confirmed to be measles.”

Caused by a virus, measles symptoms include a fever, runny nose and most markedly – a blotchy skin rash. Although many children recover from it, it can be fatal and is highly contagious. National immunisation guidelines recommend that children are vaccinated at nine and 18 months against the virus.

However, about a quarter of children in Tshwane never receive the measles booster shot at 18 months that helps increase the vaccine’s effectiveness.

Nurses from the local clinic came to the centre to vaccinate children who had missed their measles immunisations and Mothapo closed the clinic to prevent further infections. The nurses’ visit likely came too late – after many children had already contracted the virus – and many parents reported that children later developed measles’ symptoms.

With no specific treatment for measles, parents like Dineo Tsotetsi said nurses at the nearby Maria Rantho Clinic provided children with vitamins and advised that they stay home until they got better.

No vaccine is 100 percent effective but if at least 95 percent of people living in South Africa were vaccinated against measles, the country would virtually eliminate the disease.

New cases mean South Africa is not hitting this target, despite government statistics that say 100 percent of children were immunised against measles in 2012. A recent Health-e investigation in Gauteng, the Eastern Cape and Limpopo found that vaccine stock outs and storage problems are helping fuel poor vaccination rates.

Mothapo says after the outbreak at her crèche, she has learned a valuable lesson.

“My lesson learnt is that I should check the health chart of every child I register in my crèche,” said Mothapo, who added that she has spoken to nurses from the local Maria Rantho to arrange annual visits from nurses to vaccinate children who may have missed their immunisations.

Read more from Health-e’s investigation into vaccination in South Africa “Shots in the dark?” as part of the African Story Challenge:

• Shots in the dark? Vaccines in South Africa
• Shots in the dark? Snapshots of Health-e investigation 
• Film: Shots in the Dark? A look at vaccines in the Eastern Cape
• Missing babies, missing booster shots in the Eastern Cape
• Stock-outs, low awareness stymie immunisations
• What is measles?