Lurking in shadows: Polio elimination goal still remains a distant dream

Peshawar leads with refusal and missing children apart from consistent presence of virus in environment

PESHAWAR: Despite the fact that no case for polio has been reported in the province since August last year, the detection of the virus in environmental samples apart from the presence of an estimated 31,434 unvaccinated children have been casting a long and ominous shadow on anti-polio efforts in the province.

Environment samples collected from Shaheen Muslim Town in the provincial capital had tested positive for the virus in July sparking fear that the crippling virus could manifest as an infection in a child in any of the 18 union councils of the town. Health officials are now waiting with bated breath for results of the latest environmental sample collected in August and are hoping that it does not test positive for an eighth straight month.

According to health officials involved in the anti-polio campaigns, this [environmental samples testing positive] suggested that the virus is still circulating in the area. This, officials say, is alarming even if no infection was reported in any child in the area, noting that environmental samples mean a heightened chance of infection.

"Peshawar samples collected from Shaheen Muslim Town was positive from January to July 2018 where Larama area samples tested positive for March and June 2018," read an official document.

"Kohat's [environmental samples] tested positive in March and June whereas samples collected from Bannu tested positive for March only," the documents added.

The presence of polio in the environment, though, is not the gravest concern which health officials have been dealing with in the province. A grave concern has been expressed at the hundreds of children who have been missed in successive inoculation campaigns including those were "not available" at home during a visit by polio teams.

But the highest form of alarm is reserved for the stubborn block of parents who continuously turn vaccinators away and refuse to vaccinate their children.

"These 'unavailable children' may be available somewhere else, may be at the homes of their grandparents or uncles, hence they are not an issue but what is alarming is these refusal cases and these children have been putting the entire exercise at risk," a senior official involved in anti-polio drives across K-P said.

The official explained that over 90 per cent of the vaccination refusal cases is restricted to small geographic locations centred in Peshawar district.

"Just imagine, everything is happening under your nose and this happens after every campaign," the official told The Express Tribune even as he asked not to be named since he was not entitled to speak to the media.

According to a report for the anti-polio drive conducted in the province in August, a whopping 31,434 children could not be inoculated against the crippling virus. Parents and guardians of around 8,394 children had refused to vaccinate their kids with the Peshawar accounting for 6,909 of those cases.

Peshawar is followed by Charsadda where parents of 639 children refused drops to their children. In Nowshera, 329 refusals were recorded, 209 in Lakki Marwat, 125 in Dera Ismail Khan, 74 in Mardan, 66 in Bannu, 22 in Tank and Swabi was last with one refusal case.

Similarly, 23,040 of the 3.7million children supposed to be inoculated were not available at their respective homes. Peshawar again was in the lead with 9,952 children missed.

In DI Khan 3,245 kids were missed, 1,582 in Nowshera, 1,159 in Lower Dir, 1,138 in Kohat, 992 in Tank, 905 in Charsadda, 869 in Swat, 696 in Hangu, 494 in Upper Dir, 469 in Bannu, 388 in Karak, 331 in Lakki Marwat, 315 in Swabi and 186 children were not available in Batagram.

On the other hand, around 3.5 million children of the 3.72 million targeted kids were vaccinated.

Published in The Express Tribune, September 5^th, 2018.