Polio and IDPs

We hope that the operation is concluded swiftly & IDPs are repatriated well before they put down roots of permanence.

Turning the IDP ‘threat’ in terms of the proliferation of the polio virus into an opportunity, as in a chance, to reach otherwise unreachable children is proving difficult. Four new cases have been reported by the Khyber-Pakhtunkhwa (K-P) health directorate. One of them is the first-ever wild type-1 case reported from Mardan. Other cases are from Miramshah tehsil, Peshawar and Mitha Khel. The worrying aspect of these reports in their geographical spread, indicating that carriers of the polio virus are widely dispersed among the existing population, a circumstance that is to be expected given that few IDPs have opted to use the facilities provided by the government. Of equal concern is the case discovered in Peshawar, as the Peshawar water supply was recently declared free of polio virus for two months by the WHO. Its reappearance will be linked to poor sanitary provision for the IDP influx, who could infect otherwise clean water supplies everywhere they settle. The number of cases reported this year has now risen to 88, most of them originating in K-P.



Yet another new anti-polio drive has now been announced for the children of families of IDPs. The new drive is funded by the United Arab Emirates. It is set to continue for three months, covering the summer months that are the height of the polio infection cycle. Parts of K-P lead in terms of the number of refusals, and this category is greater than those missed for other reasons. Polio is not the only threat brought to sharp focus by the decanting of IDPs. The majority of children who have fled with their families have had no immunisation — not only for polio, but for any of the childhood diseases that are routinely vaccinated against. There has been no vaccination campaign of any sort in North Waziristan since 2012. An estimated 0.7 million children (a number which includes local children as well as IDPs) will be vaccinated on consecutive Sundays for the duration of the campaign.

The campaign is clearly a considerable and unforeseen opportunity and it is perhaps, encouraging that thus far there have been no attacks on the teams carrying out this latest attempt to eradicate polio from Pakistan. We hope that their protection is of the highest priority for the local administration.

Adding to the discomfort of the migrants is Ramazan. They have all come from mountain areas that, in relative terms, are cooler than the plains to which they now find themselves, where temperatures regularly reach 40 degrees centigrade or more. Not only are they short of potable water but many of them are short of food as well. This does not bode well for a population that was already far from being healthy overall. There are reports that the displaced people have questioned the timing of the operation coinciding as it does with Ramazan, and they have reportedly commented that the militants had been there for years, so why start to fight them now? This question is doubtless not far from the minds of many and not only IDPs.

Questions of timing apart, the forced migration of communities that have been resolutely vaccination-resistant does present a unique opportunity to get to grips with a problem that has international dimensions for Pakistan. Bitterly sad as it is, the only way this population was ever going to get vaccinated under the prevailing conditions where they were heavily influenced by local clerics, as well as being under threat by the Taliban if they vaccinated their children, was by an assertive intervention. The ground operation has now commenced according to reports on June 30 and have been predicted — probably unreliably — to last only two weeks and to be finished by the middle of Ramazan. It is much to be hoped that the ground operation is concluded swiftly, and that on conclusion, the IDPs are repatriated to their native lands with all speed and well before they put down roots of permanence.

Published in The Express Tribune, July 1^st, 2014.

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