News
Sunday, November 18, 2012
Pakistan polio fighters struggle against myths and realities
* Intractability of social ills, including insurgency, poverty, illiteracy, inadequate sanitation, conspire to ensure country remains years from meeting optimistic goal of polio eradication by 2013
* Five cases of ‘vaccine-derived polio’ in Balochistan, first in Pakistan, may give sceptical parents another reason to refuse vaccination to their childrenDaily Times Monitor
LAHORE: They gathered in a small room in one of the city’s worst slums, a dozen mothers sitting cross-legged with toddlers and newborns on their laps, listening to advice about polio prevention, according to the Washington Post.
“Keep your children from playing in garbage cans and sewer drains,” said Saddaf Malik, a brightly dressed young woman from UNICEF.
Simple enough, but then came the questions, spiked with suspicion and indicative of why Pakistan remains one of three countries in the world where the paralysing disease still thrives despite constant campaigns in recent years to defeat it.
Why, some mothers wondered, were the vaccination teams coming back once a month, instead of every three months like they used to? Were the repeated doses of the red drops meant to induce sterility in Muslims?
The Post reports the polio fighters looked crest-fallen. They thought this dangerous myth was dead in Lahore. “This is really alarming,” the district’s chief health officer, Saeed Akhtar Ghumman, said in his office later when a UNICEF staffer reported the women’s concerns to him.
Troubling, too, was the confirmation of the poliovirus in 16 of 28 sewage samples taken so far this year in Lahore, a marked increase over 2011. And three successive positive samples – in July, August and September – have raised worries about the virus’s “silent circulation”, as World Health Organisation officials call it, according to the newspaper. Last year’s cases numbered 198 nationwide. This year’s tally is 54.
But, the WP states, the intractability of other social ills, including insurgency, poverty, illiteracy and inadequate sanitation, have conspired to ensure the country remains years away from meeting its optimistic goal of polio eradication by the dawn of 2013.
Last week, a new setback emerged in Balochistan, where doctors reported five cases of polio-crippled children in the restive province, which had seen only four cases this year.
The new cases are significant because they resulted from the vaccine itself. WHO officials called this extremely rare, but it can happen in places where the level of immunisation is exceedingly low and the sanitation poor. The five cases of “vaccine-derived polio” – the first seen in Pakistan – could give sceptical parents another reason to refuse to vaccinate their children, some officials fear according to the newspaper report.
While refusals have been dropping nationwide, rumours abound the drops contain religiously proscribed (“non-halal”) ingredients or are part of a Western plot to spread infertility and limit Muslim population growth.
Polio has risen in Khyber Pakhtunkhwa. In North Waziristan and South Waziristan, the inoculation teams have no access to 210,000 children. Another 40,000 in risky frontier zones near the Afghan border also are out of reach.
One key to reducing outbreaks, UN health workers say, is to educate parents such as those at the session in Lahore this month. Those attending were ethnic Pashtuns, the descendents of Afghan refugees who came to Lahore in the 1980s along with millions of others who swarmed across the border after the Soviets invaded Afghanistan.
The Washington Post says Pashto speakers have accounted for 85 percent of the nation’s polio cases in the past three years, officials report. These include transients from the tribal region who relocate to enclaves here – and in other cities, such as Karachi – bringing the virus with them. (Afghanistan and Nigeria are the other two countries where polio is endemic.)
In Lahore, UNICEF dispatches so-called “social mobilisers” to comb flyblown streets and refugee hovels over and over, trying to account for what they term “missed children” – the still-unvaccinated ones who are potential polio time bombs.
To help find them, Mayor Noorul Amin Mengal hired 34 Pashto-speaking college students to bridge communication gaps in a recent inoculation campaign. He said he also recruited 30 religious leaders to support the effort. Is it working?
“Parents do not object to the drops,” said Amir Khan, 20, a teacher leading class for Afghan children in a three-walled brick structure. He said all 40 of his under-five pupils had been vaccinated, report the newspaper.
Nearby, a frail, thin mother peeked from behind a worn tarp and nervously greeted the vaccinating team. They were checking on the 11 children under the age of three who lived in the refugee compound and would need follow-up doses. The five children weren’t to be found.
Courtesy www.dailytimes.com.pk