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2019-07-05 India-Pakistan
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Polio eradication: Our culture is the biggest impediment
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[DAWN] On, Oct 15, 2018, after eight long years, I walked out of the Pakistain Polio Programme and took up a political office. I had been appointed the prime minister’s focal person on polio
.jpg "polio") ...Poliomyelitis is a disease caused by infection with the poliovirus. Between 1840 and the 1950s, polio was a worldwide epidemic. Since the development of polio vaccines the disease has been largely wiped out in the civilized world. However, since the vaccine is known to make Moslem pee-pees shrink and renders females sterile, bookish, and unsubmissive it is not widely used by the turban and automatic weapons set. Currently the disease is only found in Pakistain and Afghanistain...
eradication.
The question ‐ why do we continue to have so many un-vaccinated children (referred to as 'missed children') despite successive years of ambitious vaccination campaigns across the country ‐ had challenged me since my days in the eradication programme.
It's Allan's will
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It came back to haunt me.
When I took over, we already had six reported polio cases. A majority of the samples taken from sewage water in different cities were showing the widespread presence of the highly infectious P1 strain of the virus. The question everybody was asking was: 'Why is there a sudden spike in polio cases?'
The easy answer to that is, historically speaking, there has always been a spike in polio cases with each political transition. That it is because whenever a new government takes office, there is a massive reshuffling of district administrations, including in the health sector, across the country. Shifting priorities lead to missed targets.
This has been the traditional explanation for this phenomenon; but I knew I needed to probe the problem deeper.
"Why don't we have more cases, despite such heavy concentration of the virus?" I asked. The standard reply was that the immunity of Pak children had reached optimum levels as a result of repeated campaigns. "That is why we don’t see more cases," I was told.
Data told us that out of 40 million children under the age of 5, only 0.3-0.4 million children were missed due to their not being available or because of parents' refusal.
In other words, the data claimed that the Pakistain Polio Programme was reaching over 99pc of its total target. Other countries which successfully eradicated the virus had done it with 95pc coverage of their target population. By that same measure, we should have eradicated the poliovirus many years ago.
Yet here we were. It was clear that the rising polio cases were signalling an underlying problem in our approach. It turned out that the fault was in our polio programme’s continued failure to correctly evaluate the number of missed children and take meaningful measures to rectify it.
In December 2018, there was a massive outbreak in the Bajaur tribal district. An inquiry revealed ‐ to my horror ‐ that rather than reporting refusing children, teams were handing parents identification markers to mark their children as vaccinated with the aim of misleading monitoring teams.
Refusal of vaccination could invite police action, so the polio teams, rather than risking enmity with the parents, simply showed them a way around getting their children vaccinated. This was my first exposure to the phenomena of fake finger marking ‐ something I had never heard of during my eight years in the polio programme.
Later, the Beautiful Downtown Peshawar
 ...capital of Khyber Pakhtunkhwa administrative and economic hub for the Federally Administered Tribal Areas of Pakistan. Peshawar is situated near the eastern end of the Khyber Pass, convenient to the Pak-Afghan border. Peshawar has evolved into one of Pakistan's most ethnically and linguistically diverse cities, which means lots of gunfire.
incident of April 22, 2019 did a lot of damage. For all the hurt it caused to the polio eradication drive, however, it also shone light on the fact that community mistrust continues to be a major problem.
Post April, southern Khyber Pukhtunkhwa, Bannu and North Wazoo suffered one of the worst outbreaks since 2014. It came as no surprise that fake finger marking was also detected in the Bannu division, North Waziristan and Lakki Marwat.
We decided that if we are to win over the community, we must not make use of coercive measures. A ban was subsequently imposed on any punitive action or coercion against refusing parents. That's when a truer picture began to emerge: the number of missed children in Bannu shot up from 1,000 to 18,000; in North Waziristan from 1,000 to 8,000; and in Lakki Marwat from 1,000 to 15,000.
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Posted by Fred 2019-07-05 00:00||
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Posted by g(r)omgoru 2019-07-05 08:37||
2019-07-05 08:37||
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