Moving ahead with polio vaccination in Pakistan

By Yasmeen Ali

Nine anti-polio workers have been killed in a wave of assault that spread across Pakistan in December 2012. A crippling disease, polio, increased to a 15 year record high of 198 in 2011. As a result of the recent attacks on polio teams, 3.5 million children are left unvaccinated.

About 75 percent of Pakistan's polio cases can be traced back to certain areas, primarily FATA, the Federally Administered Tribal Areas, and neighboring Khyber Pakhtunkhwa. Quetta, in Baluchistan, is also difficult to enter, says Pakistan's point person for polio, Shahnaz Wazir Ali (npr:'How Taliban are Thwarting the War on Polio' by Jackie Northam on October 17^th 2012).

Using Shakeel Afridi to gather information on the whereabouts of Osama Bin Laden has obviously had huge negative fallout. Dr Shakil Afridi was accused of running a phony vaccination campaign, in which he collected DNA samples, that helped the American spy agency hunt down Bin Laden in May last year.

The people are afraid. They do not know who the people employed by WHO are. Are they genuinely trying to help eradicate polio? Are they fake; snooping and gathering information on them? After the expose on Shakil Afridi, the rumor of the vaccine having AIDS virus, resulting in making the children sterile and the vaccine administrators really being CIA agents has again reared its ugly head.

The current lawlessness does not help. Who knows what the cold box supposed to be containing vaccines really contains.  A gun? Can I let anyone unknown in my house with the same ease as I could a few years ago? I remember, probably an odd 5 years or so ago, three members of anti-polio vaccination team had visited my house in Lahore. Though not having children the age to be administered the vaccine, I had gladly allowed them the use of my lawns for offering prayers. Tea and refreshments were served before they could go on with their duty.  Can I be so open-hearted today?

Whereas I feel sorry for the fear of the uneducated, poor and deprived sections of the society, I cannot but be deeply grieved for the loss of lives of those who go house to house, looking for children and delivering extra doses of the polio vaccines. More often than not, there is filth, squalor and no sense of sanitation.

UNICEF and WHO suspended their anti-polio operations in Pakistan, recalling their staff owing to security threats reported The News of 20^th December 2012 after the killing of two more of their people in Charsadda district.

Those who died had worked selflessly for eradication of this disease, going from house to house, talking to groups of people and individual parents to convince them to vaccinate their children.

According to Reuters on 20^th December 2012, the Pakistani Clerics called for protests against polio workers killings. The report states that Tahir Ashrafi, who heads the moderate Pakistan Ulema Council, said that 24,000 mosques associated with his organization would preach against the killings of health workers during Friday prayers.

But is condemnation enough?

How do we go about the job of vaccination while protecting the lives of anti-polio workers? Will going house to house be safe for them? Can so many be provided personal security on one-to-one basis spread all over the country? Probably not.

Does this mean we shelve the anti-polio scheme? Leave our children to be crippled? Or is there a way whereby both the continuation of the anti-polio drive and the security of the workers can be ensured? Maybe there is!

Instead of going door to door, thus making security arrangements for the workers next to impossible- camps should be set up in local mosques. Each locality has one. Announcements for the camp being set up in the courtyard of the mosque can be made five times a day at least from two days prior to setting up the camps.

This will serve both objectives. First, with the strength of the mosque supporting the camps for anti-polio drive, confidence of the people; mostly uneducated will stand restored and second; with the workers going to and staying in one specified place, their security will be relatively easy.

An argument may be put forth here that by merely housing the camp in a mosque may not be enough to restore the confidence of the people in the anti-polio drive workers. The lack of confidence may persevere. WHO may like to enlist support of local pharmacies, doctors, hakeems and medicine men by providing exact prescribed dosage to them. This may be purchased or procured free of cost by the parents and administered to the children themselves.

In unstructured societies like Pakistan, the fallout of ill thought out schemes like using of Shakil Afridi, the costs can be high! In this case, 9 dead bodies and 3.5 million children unvaccinated!

But it is time to look objectively at the question posed-and move ahead!

Yasmeen Ali

The writer is author of,"A Comparative Analysis of Media & Media Laws in Pakistan." She is an established writer having written in many national & international publications. This is her first article since her book came out in October 2012.