PESHAWAR: Despite the advancements made in medicine, Pakistan remains one of the last three countries in the world where the transmission of polio continues to haunt the nation.
Even while the global drive to eliminate the crippling disease has made significant gains, a recent surge in polio cases in Khyber Pakhtunkhwa (K-P) has forced the World Health Organisation (WHO) and other agencies to reconfigure their approach to eradicate the ailment.
According to experts, the challenges against the viral illness, that in its most severe form causes nerve injury leading to paralysis, have been compounded due to loopholes in the campaign, lack of training, false rumours associating the vaccine to fainting spells — or even that it killed dozens of children, families denying access to children, and above all fake markings on the fingers of children to dodge vaccinators.
As a result, new polio cases continue to surface every week from the south and eastern districts of K-P. The situation is particularly bleak in tribal areas, where displaced families, routinely refuse to cooperate with vaccinators.
According to the Polio Emergency Operation Center (PEOC), a total of 62 polio cases surfaced from across the country in 2019. Out of those, 46 cases came from K-P and merged districts, five from Punjab, four from Balochistan and six from Sindh. The highest number of cases came from K-P’s Bannu district, where 22 children have reportedly fallen prey to the virus.
Derailing the campaign
In April this year, triggered by rumours on social media that vaccinations had poisoned children, angry mobs rioted in K-P and killed three polio workers.
According to Dr Imtiaz, the technical focal person for the polio eradication program, the fake video circulated from the Mashokhel area continues to harm the drive to eliminate the disease. “In that video, children can be seen suffering from reactions after they receive polio vaccines,” he explained.
“The incident left an indelible mark on the campaign. Parents are reluctant to administer vaccine since then,” claimed Dr Imtiaz.
Since then, an increasing number of parents have refused polio vaccination for their children. In January 2019, 60,959 families refused polio vaccination in the province. Likewise, in February 32,311, in March 78,961, in April 908,381 and in June 69,920 families denied access to their children. To pacify protesters, the provincial government conducted an inquiry. But that was too little, too late to rescue the campaign that had been maligned by the spread of misinformation.
The news spread like wildfire in Peshawar, forcing panicked parents to rush their children to hospitals. Irked by the visuals, protesters even torched a Basic Health Unit (BHU) in the Mashokhel village.
Dr Imtiaz claimed the K-P government has spent over Rs.7 billion over the ongoing eradication campaign so far.
The war against a disease that threatens Pakistan’s future faces many challenges. Hindered by attacks on health workers and resistance from parents in some parts of the country to have their children vaccinated against the disease, continue to impede progress Pakistan could have made in defeating polio.
“We face threats and abusive language from the community,” said Qazi Mussarat, a Lady Health supervisor from Peshawar. “They refuse to open their door for us,” Mussarat added.
Amid those challenges, Mussarat, and her team vow to continue their crusade against polio.
Earlier this year, a nationwide vaccine drive came to a grinding halt after members of the polio-eradication team were gunned down in two separate attacks.
“Every morning when I leave for the drive, I’m not sure about returning home,” said Mussarat with a quiver in her voice.
For decades the campaign to eradicate polio remains a source of deep-seated suspicions in much of Pakistan. Hard-line clerics believe the vaccination drive is part of a Western effort to sterilize the Muslim community.
The first victim of their wrath is usually the workers of the polio team, who are on the frontlines to fight Pakistan’s long battle against the debilitating disease.
The long battle against the crippling virus may never end without the support of the millions of parents who block access to their children.
“Initially the video on social media scared me, but after talking to
the lady health worker I feel the vaccine will protect my children against many diseases,” said Toheed Bibi, a mother of two.
Over the past few years, successive governments have introduced awareness campaigns to allay concerns of parents and counter anti-vaccination propaganda. Most of them end up refusing the polio vaccine due to the negative narrative about it.
Cases of non-compliance often go unreported as health workers face difficult choices in remote areas where kinship can often place them under severe pressure.
“After the Mashokhel incident, the numbers of parents who denied access to their children has increased by many folds,” said a vaccinator, speaking on condition of anonymity.
Efforts so far
The Polio Emergency Operation Center (PEOC), together with students from the University of Peshawar, launched an investigating into the rise in polio cases in Bannu, where children’s fingers had been marked with the same indelible ink used by vaccinators. Over 20 new cases of the crippling disease surfaced in the area this year alone.
“The study will reveal who is behind the fake polio vaccination marking in district Bannu,” said Dr Ibrar Khan, who heads the criminology department at the University of Peshawar.
Students from the district, who are well-versed in local traditions and norms, will be sent to their communities to convince residents to allow polio vaccinators to administer the vaccine to their children.
“As part of our campaign, focus group discussion will be conducted to disseminate information about the disease and its eradication,” said Dr Khan, adding that he had plans to extend the campaign to other parts of the province.
Published in The Express Tribune, September 12th, 2019.