It is necessary to conduct more ethnographic, multi-disciplinary research on infectious diseases, particularly polio.
UNIVERSITY OF VIENNA, AUSTRIA: In order to understand the causes and identify grey areas beyond the prevalence of polio in Pakistan, Svea Closser, an anthropologist, conducted a multisited ethnographic research on polio during 2006-07 collecting data from a village in Punjab.
Based on that research, her book — Chasing Polio in Pakistan: why the world’s largest public health initiative may fail (2010) — argues that the failure of this global initiative is related to social, political and management-related factors.
Some of her major observations are that local people and other stakeholders in Pakistan take polio as somewhat less problematic because of the presence of many other life-threatening diseases. Polio is also seen to be tied to politics at the district level, and her book claims that “district employees resisted the directives of their superiors in a number of ways, including refusal to work, falsification, corruption, false compliance, and direct confrontation”. Furthermore, most local vaccinators are paid around two dollars a day while the WHO consultants are paid around $10,000 a month and given additional perks such as housing and so on.
The important aspect, however, that the book did not talk about, was the refusal of local people from vaccinating their children. Many people, especially in Fata and Khyber-Pakhtunkhwa (K-P), see the polio vaccination as a ‘Western plot’ to sterilise Muslims. So far, K-P has seen the highest number of polio cases — around 40 — and refusal by over 28,000 families.
This creates a critical situation for Pakistan because polio is a highly contagious disease that spreads rapidly. At the external level, there is a foreign policy challenge. For example, during November, polio cases identified in Syria were confirmed as being of Pakistani origin. This recent polio-outbreak puts millions of children at risk in the country itself in addition to the Middle East and other countries. Some European scientists have already speculated on the possibility of Syrian refugees bringing the diseases to European countries, especially since children there are usually given a polio vaccine only once at the time of birth and not repeatedly. Because of this, it is likely that other countries may put a ban on Pakistanis travelling to their shores. India has already done this, requiring all Pakistani travellers to show proof of vaccination from January 2014 onwards.
It is necessary to conduct more ethnographic and multi-disciplinary research focusing on infectious diseases in general and on polio in particular in order to study it in Pakistan in a more holistic manner. For instance, the perception about polio and its vaccination across Pakistan needs to be explored since Pakistan is a country with diverse sub-cultures. In this regard, the much-needed decision by Imran Khan to spearhead the anti-polio programme in K-P is an admirable step, because his personal participation could make a significant impact on those who refuse the vaccination.
Inayat Ali Gopang
PhD Fellow
Department of Social & Cultural Anthropology
Published in The Express Tribune, December 26th, 2013.
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