Two months ago, giggles floated through the home of fisherman Dada as his four-year-old son played ball outside with his two younger cousins on one of Madagascar's famed sun soaked beaches.
A few weeks later, all three children were dead, victims of the worst measles outbreak on the Indian Ocean island in decades.
Measles cases are on the rise globally, including in wealthy nations such as the United States and Germany, where some parents shun life-saving vaccines due to false theories suggesting links between childhood immunizations and autism.
In Madagascar, one of the world’s poorest countries, parents are desperate to vaccinate their children, many trudging for miles to get to clinics for shots. But there are not enough vaccines, the health ministry says, and many people are too poor to afford them.
Fisherman Dada – like many Malagasy, he only uses one name – had taken his son Limberaza to be vaccinated once already in their home in the southern district of Fort Dauphin.
But a second-dose booster shot cost $15 at a clinic - and the whole family survives on less than $2 a day - so he took the boy to a back-street doctor instead.
"I could not afford to take him to the hospital," Dada said quietly as his young wife silently held Limberaza's two-year-old brother.
In January, Limberaza began to cough. A rash followed. After a week, he died, his body afire with fever.
By then Dada's niece, three-year-old Martina, was also sick. Her weeping mother Martine stroked her face as her fever spiked.
She died eight days later.
That evening, his other sister Pela's three-year-old son Mario died as she clutched his hands.
"They were so full of life," Dada said, his voice breaking.
The three cousins are among the almost 1,000 people, mostly children, who have died from measles in Madagascar since October.
Their deaths show the grim reality for those left unprotected from one of the world's most contagious diseases. The virus, which can cause blindness, pneumonia, brain swelling and death, is able to survive for up to two hours in the air after a cough or sneeze, where it can easily infect people nearby.
Even though there is a highly effective vaccine, globally, around 110,000 people died from measles in 2017, according to the World Health Organization (WHO). Most, like Limberaza and his cousins, were children under the age of five.