The polio challenge

In September this year, the World Health Organisation (WHO) announced that polio is no longer endemic in Nigeria. This is the first time that Nigeria has interrupted transmission of wild poliovirus, bringing the country and the African region much closer to being certified polio-free.

It is a big achievement for a country where, like Pakistan, a section of the population still believes that polio drops are a conspiracy of the West to curtail the population of Muslims across the world.

Granted the situation in Pakistan is also getting better. The total number of poliovirus cases reported in our country this year stands at 34, which is considerably lower than the 214 cases reported in the first nine months of last year.

But anti-polio drives continue to be marred by instances of terrorism, as health workers have been attacked and killed on numerous occasions. In one of the deadliest such attacks, four health workers – one man and three women – were shot dead by assailants near Quetta in November 2014.

The challenge does not end here. Salaries for anti-polio workers are low and those too are much delayed. Take for example the province of Balochistan where the government has declared a polio emergency to root out the crippling virus from the region, which has reported six cases this year.

The next anti-polio drive in Quetta has been planned for October 10 and in 10 other districts on October 13. But a successful campaign with maximum coverage might be a problem if the vaccinators remain unpaid for the previous campaign.

Our reporter Sameer Mandhro reports that the same is the case in Sindh. There are 22,576 lady health workers who form the backbone of the anti-polio drive in the province. They approach each house in their allocated area and do whatever work is assigned to them by their higher-ups, which mostly involves participation in polio campaigns.

For a lady health worker, the minimum qualification is a ‘middle pass’, which is equivalent to grade eight. The LHW programme aimed at reaching rural communities using female workers was launched in 1994. What is interesting is that the starting salary of a lady health worker is Rs1,200 per month. As hard as she works, her ceiling is Rs7,000.

These are women who work day and night, no matter if it is raining or there is a flood or any serious threat to female workers in no-go areas. They care for mothers and their newborns but lament that their own children are always starving.

Their basic work is to educate women and children on health issues and to take care of pregnant women and advise them even after the birth of their children.

A lady health worker is capable of counting on her fingertips how many expecting mothers live in her area as she keeps every bit of data and she visits every house. But for the past several months, many of these lady health worker have been protesting outside the Sindh secretariat in scorching heat to protest delay in their salaries as well as the low wages that they are paid. So far the government has not responded.

The same is the situation in Khyber-Pakhtunkhwa where Expanded Programme on Immunisation (EPI) workers announced a sit-in outside the provincial assembly last week to press for the payment of their salaries, saying they will not budge until their demands are met. A protest in May earlier had ended after promises to clear their dues were made by the provincial government. Seven months later, EPI employees are yet to be paid.

The anti-polio campaign in Pakistan or for that matter the basic health infrastructure in our country cannot move ahead without the excellent work done by these health workers.

Let us learn from Nigeria. The country has not reported a case of wild poliovirus since 24 July 2014, and all laboratory data have confirmed a full 12 months have passed without any new cases.

A concerted effort at all levels of government, civil society, religious leaders and tens of thousands of dedicated health workers resulted in Nigeria successfully stopping polio. It took more than 200,000 volunteers repeatedly immunising more than 45 million children under the age of 5 years, to ensure that no child would suffer from this paralysing disease.

Let us pay our health workers that what they deserve. Only then can we move forward.

Published in The Express Tribune, October 5^th, 2015.

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