Militants and rumors undermine Pakistan polio fight

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December 21, 2012

Pakistan is one of the three countries in the world where polio is still prevalent. But Pakistan's efforts to rid itself of polio are being hampered by a toxic mix of conspiracy theories about plots to sterilize Muslims and hostility from militants.

December 21, 2012

Pakistan is one of the three countries in the world where polio is still prevalent. But Pakistan's efforts to rid itself of polio are being hampered by a toxic mix of conspiracy theories about plots to sterilize Muslims and hostility from militants.

The Muslim-majority nation of 180 million people is one of only three in the world where the highly infectious, crippling disease remains endemic and infections shot up from a low of 28 in 2005 to almost 200 last year.

This week nine people working on a UN-backed polio immunisation program were shot dead in Karachi and the northwest, murdered for trying to protect children from a cruel disease that can leave limbs flaccid and useless in a matter of hours.

The Pakistani Taliban have denied responsibility, though they have threatened polio workers in the past and in June they banned vaccinations in the northwestern tribal area of Waziristan, condemning it as a cover for espionage.

Concerted vaccination efforts have seen infections in Pakistan fall to 56 this year, 45 of which were in the tribal districts, which are strongholds for Taliban and other militants, and neighborhing Khyber Pakhtunkhwa province.

"Certain elements we refer to as Taliban, though it's a very general term, feel threatened by the presence of people going round vaccinating children in their areas," Guido Sabatinelli, the top World Health Organisation (WHO) official in Pakistan, said.

In Afghanistan, Sabatinelli said, the Taliban are "absolutely in favor" of vaccination, but in Pakistan suspicion of immunization programs intensified after the jailing of a doctor who helped the CIA find Osama bin Laden in 2011 using a hepatitis campaign as cover.

Resistance also comes from parents, often poorly educated and impressionable, who believe wild conspiracy theories about the vaccine.

"They think polio drops contain pig fats, some said it will make the children infertile and they will not be able to become father and mother in future," said Janbaz Afridi, a senior doctor working on the polio campaign in Khyber Pakhtunkhwa.

Sabatinelli said WHO and its local health partners had made strenuous efforts to work with religious leaders to dispel these myths — often spread by imams.

The chief of Pakistan's council of religious scholars told AFP that prayer leaders at thousands of mosques across the country will condemn the killing of polio workers at Friday prayers.

"There is no room for criticism against polio immunization campaign, as top scholars at major Islamic institutions like Al-Azhar in Egypt, Deoband in India and Binouri Town in Karachi, have already issued fatwa (religious decree) in favour of the campaign," Maulana Tahir Ashrafi told AFP.

This week's campaign was aimed at reaching a million children who missed vaccination in a drive in the autumn, most in the northwest and Karachi.

Polio in Pakistan is concentrated among Pashtuns, the dominant ethnic group of the northwest who also have a large migrant population in Karachi.

WHO says Pashtuns account for three quarters of polio cases nationally but only 15 percent of the population, and in Karachi the figure rises to 90 percent.

Whether fleeing insecurity or searching for a better life, Pashtuns frequently migrate from the northwest across the border to Afghanistan, where polio is also endemic, or south to Karachi, Pakistan's economic boiler room.

Access to the lawless and impoverished tribal areas is difficult and extremely dangerous, and health infrastructure there is limited, making the region a fertile breeding ground for polio.

"They are the source of infection which is carried from FATA (the tribal areas) and moves around to Karachi and Afghanistan," Sabatinelli said.

Last year the disease reached China, which shares a border with Pakistan, for the first time in a decade, he said.

The attacks this week prompted WHO and UNICEF to suspend their field work against polio and Afridi said it was unclear when vaccination might start again.

"For three days we have suspended all our activities and will sit together on fourth day, Sunday or Monday, to take a decision on re-launching the campaign," he said.

The next drive may see a change of strategy and focus on specific districts, he said, but it will be low profile and not publicized in the media.

Prime Minister Raja Pervez Ashraf has vowed to "stay the course until polio is wiped out" in Pakistan, and Sabatinelli said vaccination would go on despite this week's violence.

"We have almost achieved eradication. We are going into a season of weak transmission and it's the ideal time to wipe out the virus," he said.


Courtesy: AFP