Polio: The case of an explosive outbreak

Health officials say refusals, cultural norms and security issues responsible for increasing polio cases.

PESHAWAR:
As the world struggled to deal with a massive Ebola outbreak in 2014, the fight closer to home was with the crippling poliovirus which had by December 31 infected 295 children in Pakistan — a whopping 217% increase from 2013’s count of 93 cases.

A majority of the year’s 295 cases were reported from the Federally Administered Tribal Areas (Fata) and its adjacent Khyber-Pakhtunkhwa, 174 and 67, respectively.

Although, the K-P government made efforts for the eradication of the virus from the province, the number of reported cases has continued to soar over the past few months. Despite the much-publicised Sehat ka Insaf drive and several vaccination campaigns, the virus still runs amok with more than 800 samples sent to the National Institute of Health for testing in the first ten months of 2014.

Left out

According to health experts, a majority of this year’s cases are from Pukhtun families and several factors including refusals, cultural norms, deteriorating security and ineffective vaccination drives have contributed to the rising figures.

“Over 75% of the infected children below the age of two had not received even a single dose of the vaccine,” said a senior official associated with the polio campaign in K-P.

Requesting anonymity as he was not authorised to speak to the media, the official said polio eradication cells have failed to achieve their objective and the soaring cases are a clear indication of their ineffectiveness.




“Keeping in view the fact that the largest number of cases belong to Pukhtun families in tribal areas across the country, the federal government must focus more on eradication to not just save the children from disability but to also prevent travel restrictions on the country,” said the official.

According to him, vaccinators who go house to house have complained that in many localities women refuse to open the door saying no men are at home and telling the vaccinators to “go away.”

Contributing factors

“Polio cases are bound to increase when there are children have not received vaccine doses, parents refuse the drops and some children are missed by vaccinators,” said another health official, adding deteriorating law and order also affects polio drives.

“There are some areas on the outskirts of Peshawar where health workers are hesitant to go,” he said. “This is a typical example of the failure of the polio campaign. If you cannot conduct a successful vaccination drive in the provincial capital, how can you conduct successful ones in far-flung areas?” he questioned.

According to him, the only way to curb the circulation of the virus is to ensure that no child is left unvaccinated. “The government should direct all its resources towards the eradication of the virus from Pakistan. If possible, it should divert resources from other projects.”

Expanded Programme on Immunisation Deputy Director Tahir Nadeem said if polio cases continue to increase despite extensive vaccination campaigns, it clearly indicates something is amiss in the eradication efforts. Terming monitoring and supervision as “weak areas”, Nadeem said many plans are made for eradicating polio but they are not implemented.

“There are problems in coordination but the government has planned to formulate an Emergency Operating Centre which will coordinate and plan activities under one roof, and that way all problems will be dealt with individually,” Nadeem said.

Published in The Express Tribune, January 1st, 2014.
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