Polio in Balochistan

The elimination of polio is extremely difficult given the fact that 25% of families overall are refusing vaccination.

There is a grim inevitability about the report of a case of polio in Balochistan, which has not recorded a case in two and a half years. An 18-month old girl from Qila Abdullah district has recently been diagnosed, bringing the total number of cases in Pakistan this year to 102. Bibi Nazu Bibi had come to Qila Abdullah from Karachi in March 2014, and the area shares a border with Afghanistan. Her family reportedly had lived in Karachi for four or five years, and the origins of the Wild Polio Virus (WPV1) have yet to be determined. It could come from Afghanistan, Karachi or anywhere along the route from Karachi to Qila Abdullah. There have been two instances of WPV1 being detected in the sewage systems in Quetta this year, so the deadly virus is already lurking in the province.

Officials have said that it is possible that the child missed being vaccinated in Karachi on religious grounds, but others assert that she was just ‘missed’ during one of the many vaccination campaigns that would have been conducted during her lifetime. A doctor of the World Health Organisation said that the family had refused to administer polio drops, though it is not clear whether the refusal was at either of the two transit points near Karachi and Lasbela, or the six or seven points where drops are administered to children close to Quetta. Further confusion is added by yet another official who said that the child was missing because no organisation has a record of her. According to Unicef, more than 20,000 families have refused vaccination on religious grounds during recent campaigns. Amidst this welter of conflicting statements. it is clear that record keeping is at best poor and at worst absent, and that the sharing of records agency-to-agency is in urgent need of an overhaul. Alongside this is the fact that 25 per cent of families overall are refusing vaccination and against that backdrop elimination of polio is extremely difficult. Emergency meetings are being held to devise strategies to address the matter, but the reality is that Pakistan may be years away from the eradication of the polio virus.

Published in The Express Tribune, July 26^th, 2014.

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