As the globe observed World Polio Day, looking back at a story of human ingenuity and willpower overcoming nature’s vagaries, Pakistan looked ahead, at a task still not done. Pakistan produces 80% of the world’s polio cases, and along with Afghanistan and Nigeria remains one of only three countries in the world where the crippling disease is rampant; a sad commentary for a nation with global ambitions. The stigma is much more shameful, once you consider that a simple vaccination costing Rs.60 will protect a child for life against a disease that would otherwise leave him paralysed. Yet Pakistan’s quandary is not for want of initiative; the hurdles that it faces are unique to it, the solution must be unique too.
The disease is concentrated in the tribal regions, where structured propaganda, ignorance, insurgency, and the absence of state presence has led families to believe the rumours that the vaccine is a western attempt to sterilise Muslims or that it is made from pork, which is forbidden to Muslims. A 2011 CIA operation to locate Osama bin Laden using a staged hepatitis vaccine programme didn’t help matters either. Since then, at least 30 vaccinators and 30 security personnel have been killed in attacks by the Taliban, while on duty. The obvious solution: beefed up security and awareness drives, still haven’t managed to break through the phobias of the tribal belt. How do you combat a conspiracy theory when your attempts are viewed as proof of it? On Friday, tribal elders from South Waziristan, in a packed jirga, asked the agency’s political agent to administer polio drops to them. The symbolic act of a revered and trusted tribal elder asking the state’s representative to vaccinate them is much more powerful than words and guns could ever have been. The state cannot break this phobia from the outside, but from the inside. Previous state campaigners were outsiders or bit players in the local hierarchy. Involving local influential players can break the barriers. Religious leaders, sporting celebrities and doctors, all have a part to play. Now is the time, with Zarb-e-Azb clearing vast swathes of previously inaccessible land, and driving the Taliban underground, a concentrated push against polio is urgent and has the potential of getting rid of this disease once and for all.
Challenges still remain; cases of polio are also present in the area of greater Karachi and Balochistan. Recent studies have repeatedly found the virus in sewer samples, especially in Lahore, Peshawar, Chakwal and Ghakkar. Furthermore, the mass migration of unvaccinated children due to the military operation in the tribal belt has led to the threat of further spread into areas where the refugees reside. The efforts must not be restricted to FATA; only a nationwide campaign can cover all bases.
Winter is when the disease is least threatening; a revamped awareness campaign, a robust vaccination drive, a thoughtful local connection, and the security afforded by the military operation can allow Pakistan to wipe this blight off the face of its map, if the will to do so truly exists.
Sunday, October 26, 2014
Pakistan: Polio’s Last Stronghold
As the globe observed World Polio Day, looking back at a story of human ingenuity and willpower overcoming nature’s vagaries, Pakistan looked ahead, at a task still not done. Pakistan produces 80% of the world’s polio cases, and along with Afghanistan and Nigeria remains one of only three countries in the world where the crippling disease is rampant; a sad commentary for a nation with global ambitions. The stigma is much more shameful, once you consider that a simple vaccination costing Rs.60 will protect a child for life against a disease that would otherwise leave him paralysed. Yet Pakistan’s quandary is not for want of initiative; the hurdles that it faces are unique to it, the solution must be unique too.
The disease is concentrated in the tribal regions, where structured propaganda, ignorance, insurgency, and the absence of state presence has led families to believe the rumours that the vaccine is a western attempt to sterilise Muslims or that it is made from pork, which is forbidden to Muslims. A 2011 CIA operation to locate Osama bin Laden using a staged hepatitis vaccine programme didn’t help matters either. Since then, at least 30 vaccinators and 30 security personnel have been killed in attacks by the Taliban, while on duty. The obvious solution: beefed up security and awareness drives, still haven’t managed to break through the phobias of the tribal belt. How do you combat a conspiracy theory when your attempts are viewed as proof of it? On Friday, tribal elders from South Waziristan, in a packed jirga, asked the agency’s political agent to administer polio drops to them. The symbolic act of a revered and trusted tribal elder asking the state’s representative to vaccinate them is much more powerful than words and guns could ever have been. The state cannot break this phobia from the outside, but from the inside. Previous state campaigners were outsiders or bit players in the local hierarchy. Involving local influential players can break the barriers. Religious leaders, sporting celebrities and doctors, all have a part to play. Now is the time, with Zarb-e-Azb clearing vast swathes of previously inaccessible land, and driving the Taliban underground, a concentrated push against polio is urgent and has the potential of getting rid of this disease once and for all.
Challenges still remain; cases of polio are also present in the area of greater Karachi and Balochistan. Recent studies have repeatedly found the virus in sewer samples, especially in Lahore, Peshawar, Chakwal and Ghakkar. Furthermore, the mass migration of unvaccinated children due to the military operation in the tribal belt has led to the threat of further spread into areas where the refugees reside. The efforts must not be restricted to FATA; only a nationwide campaign can cover all bases.
Winter is when the disease is least threatening; a revamped awareness campaign, a robust vaccination drive, a thoughtful local connection, and the security afforded by the military operation can allow Pakistan to wipe this blight off the face of its map, if the will to do so truly exists.
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