Crippling statistics: All 8 of Karachi’s polio cases from Pakhtun families

Neighbourhood imams and informed husbands can make all the difference.

KARACHI: Experts are alarmed that all eight of Karachi’s polio cases have surfaced from Pashto-speaking families. Indeed, the numbers indicate that Pakhtun children are five times more likely to contract the crippling virus than children from other backgrounds.

The national extended immunisation programme (EPI), which targets about 33 million children under the age of five years, boasts high coverage rates but the rising number of cases tells a different story. Polio continues to haunt young Pakistanis - the number of reported cases in the country stands at 136. The disease persists despite aggressive national immunisation campaigns which run every six weeks. With the worst coverage and highest number of cases, Balochistan has reported 55 cases this year. Of these, nearly 80% are from the ‘Quetta block’ which comprises Quetta city with 14 cases, Pishin with 12 and 14 from Qilla Abdullah. So far this year, Sindh has reported 28 cases of which seven were from Thatta and eight from Karachi. From the city there was one child each reported from Orangi, Gulshan-e-Iqbal, Baldia and Saddar and two each from Gadap and Site. While the cases are spread across six towns, officials say all are from the Pakhtun community.

It has been an uphill struggle to persuade people to allow their children to be immunised. But there has been some measure of success. Some Pashto-speaking people of Katti Pahari in Karachi, for example, have been strict about their children being given the polio drops. “I was four years old when my father insisted I should take the drops,” says Shahnaz, 10, a resident. Ironically it was Shahnaz’s mother who was against her daughter being immunised. “Women in the neighbourhood would say the vaccine makes women barren and men infertile,” says her mother Hanifa. “But my husband insisted. He said it was very good for the children and warned if we did not give it they may become crippled.” Hanifa dared not argue further with her husband who she says, “Obviously knows more about worldly affairs.”

Hanifa’s husband Shaukat passed away last year but Shahnaz recalls her father telling her he had learnt about the polio drops through the imam. “He told me that the mosque’s imam had announced it during Friday prayers,” she says. Following that announcement, many men from the neighbourhood implemented the learning in their homes.

It was this kind of intervention that can make all the difference and the people working on these projects know it. “We have tried overcoming the obstacles with refusals from the Pakhtun community - from hiring local lady healthcare providers to getting the [neighbourhood] imams on board,” acknowledges an official with the Sindh EPI, who spoke on condition of anonymity.

A manager for the national EPI, Dr Altaf Bosan, adds, “Pakhtun communities are known to be very insular and while efforts have been made to increase coverage in the highly populated Pakhtun areas there are still many refusals.”

These health workers still find themselves defending the vaccine. “There is no problem with the vaccines being administered to children,” stresses Bosan. “It is the same vaccine which is used worldwide. There is no question that the vaccine works.”

Another Katti Pahari resident, Nasira, ensured her five children are given the drops each time the teams come around. “There were rumours of polio drops harming children instead of helping but in the last three years I have thankfully not experienced any such issues,” she says. Shahnaz’s mother Hanifa agrees that time is a factor. When she is told that all of Karachi’s cases are from Pakhtun families, she replies: “I was against it too but we need to learn and see things for ourselves. If the vaccine is going to keep children from falling prey to this disease then I don’t understand why mothers are not giving it to them.”

Published in The Express Tribune, November 10^th,  2011.