Pakistan had looked to be winning its battle against polio until 2007 when 32 new cases were detected. Since then, things have deteriorated, with the president declaring a national emergency in January 2011, and describing the failure to eradicate the disease as “criminal negligence”.
The discovery of the polio virus in water samples obtained from five cities in February is believed to be just one of the reasons why the disease is spreading so rapidly in the country.
Pakistan had more polio infections in 2010 (144 cases confirmed) than any other country. Fifteen new cases have been recorded this year.
Whether or not negligence is involved is debatable. But there are many dimensions to what is a complex problem; lack of access for polio vaccination teams to certain areas of the country due to the activities of armed militant groups is one key factor.
According to media reports earlier this year, a worker for Pakistan’s Expanded Programme for Immunization (EPI) was kidnapped and later killed in the North Waziristan tribal agency on the Pakistan-Afghan border.
“The militants, and other orthodox elements, oppose vaccination for children. They say Allah alone decides about sickness or health and no one should interfere,” Jamila Bibi, a mother of three, told IRIN from the Khyber Agency, also along the western frontier. She said she and her husband had their children immunized “in secret” to avoid reprisals.
EPI deputy director Janbaz Afridi in the northwestern province of Khyber Pakhtoonkhwa told IRIN that for the latest campaign earlier this month “more supervisors” had been put in place to oversee the activities of field staff, and that the issue of “refusals… was also being addressed”. “Refusals” refer to parents who decline their children to be vaccinated, usually on religious grounds.
The National Research and Development Foundation NGO is working on tackling this issue, and has said the services of 1,700 clerics, prayer leaders and religious scholars had been enlisted to help build opinion in favour of vaccination.
|We are afraid of kidnappings or other violence. So many times children outside big urban centres do not get immunized at all|
“We believe children should be vaccinated so they can grow up healthy and strong,” Muhammad Siddique, a prayer leader, told IRIN.
Other problems stem from the militancy issue. Due to security concerns in many tribal areas, female health workers in particular are reluctant to venture beyond main towns.
“We are afraid of kidnappings or other violence. So many times children outside big urban centres do not get immunized at all,” said a health worker who asked not to be named. She suggested villagers be trained to immunize children themselves.
Aziz Memon, chairman of the Pakistan Polio Plus Committee of Rotary International, told IRIN: “The problem of more cases in Pakistan really came up after the floods from July to September 2010. It was only after August that we had more cases reported from Sindh and the Punjab, mainly due to poor sanitation and unhygienic conditions from floodwater. Before then, new cases were being reported only from Khyber Pakhtoonkhwa and Balochistan, mainly due to inaccessibility issues.”
He said Pakistan planned to use the new bivalent vaccine in future to tackle the different strains of polio simultaneously and that the vaccine had proved highly successful in India.
“We are determined to reach every child,” the EPI’s Afridi said. But given the scale of the problem, this is still a tall order and it is still not certain the plan launched by President Zardari to quickly eradicate polio will work.