Polio killings — assaulting health workers and our future

It was absolutely shocking to read that nine polio vaccination workers, most of them female, have been fatally shot in Pakistan in the past few days, in what seems like a coordinated plan. This gruesome start to the latest three-day nationwide anti-polio campaign, which had aimed to target 5.2 million polio drops, has put the whole effort into disarray and shocked to the core the healthcare authorities, both national and international.

I had written in these very pages some time back about how the war against polio is currently in its final stages, that Pakistan remains one of the last strongholds, and that what was needed was perseverance and a continuum of strategy of which vaccination lies at the crux. Indeed, there was a sense of great pessimism after the surge in polio cases in Pakistan, but the financial boast from the Gates Foundation had restored some sense of optimism and perseverance.

From the looks of it, although it is a bit premature to judge right now, this attack seems to be the handiwork of militants who deem polio vaccination as a Western-hatched conspiracy. Armed with fatwas, there have been abductions and killings of healthcare workers in the past, but this is the first time the militants have struck multiple polio vaccinators in Karachi, in a planned fashion.

A lot has been done and is still going on to counter these conspiracy-laden perspectives. To just give a brief example, almost 160 ulema in the Swat region had issued a fatwa in favour of polio vaccination almost two years back. What I fail to comprehend is how come these sane voices are drained down and only militant perspectives continue to rebound and propagate? Perhaps it would be wise to have the ulema and community leaders on the same page all the time to stem the tide of militants exploiting the polio conspiracies.

No doubt, the CIA botched up the trust that had been instituted in vaccinators in the aftermath of the Abbottabad raid. Health agencies across the board including Medicines San Frontiers were in shock as to the ruse that had been employed and had warned of serious consequences. Deep within our hearts, we knew that the healthcare workers would come under the knife sometime, and we were hoping against hope that the vaccination workers would never be harmed.

Alas, time ran out for these vaccination workers, just like it is running out for eliminating the menace of polio once and for all. The vaccinators do not have an easy job — knocking door to door, braving harsh weather and other conditions, they are the most effective and important arm of the Global Polio Eradication Initiative. There are roughly 80,000-odd field workers spread across Pakistan and they are paid around ten dollars for a three-day vaccination campaign. No doubt, after this spate of killings, they will all be wondering if the money is really worth their lives, even though money goes a long way, especially in impoverished Pakistan.

The immediate action in the aftermath of the killings was that vaccination efforts in Karachi were called off. It is very possible that there could have been more killings planned and further loss of life has been averted. However, the most important step right now should be a speedy and conclusive investigation of the whole affair. The killers need to be caught immediately and brought to justice swiftly. Simultaneously, the government needs to launch a campaign to purge the society of polio conspiracy theories — notable ulema would be happy to get on board with this. There is an advertisement campaign underway and it makes sense to have religious personnel as part of this effort to dispel any talks of Western-hatched conspiracies.

Polio should not be in the headlines only when tainted in blood. Undoubtedly, it is a huge challenge but remarkable progress has been made. Experts agree that the battle against polio is going to end with Pakistan, and what is needed is that last, heavy push. We need to clean up our act right away and assure adequate security for our vaccinators since without them, one cannot even imagine a fight against polio.

Published in The Express Tribune, December 22^nd, 2012.