polio immunisation
A polio vaccination worker marks the finger of a child after administering with anti-polio drops during a door-to-door polio immunisation campaign on the outskirts of Islamabad. Image Credit: AFP

Islamabad: Pakistani officials had been hopeful that 2019 would be the year they would succeed in their campaign against polio and declare Pakistan polio free. But a complete victory has proved elusive.

Instead, the country’s anti-polio campaign has been hobbled by recent deadly attacks on health workers and resistance from parents in some parts of the country to having their children vaccinated against the disease. Amid those challenges, new polio cases continue to surface, with eight new ones reported this year.

The polio virus has also been found in sewage samples in several cities, including Rawalpindi, adjacent to Islamabad, the capital, a worrisome sign to health officials.

Last week, a nationwide vaccine drive had to be temporarily suspended after two separate attacks that killed a female health worker and two police officers guarding a polio-eradication team.

In the vaccination drive that ended Saturday, Pakistan managed to vaccinate more than 37 million children, nearing its target of 39 million. But in the cities of Karachi, Peshawar and Quetta, the active search for unvaccinated children has been suspended given the security fears. There are now doubts about whether the next vaccination drive, scheduled to start in June, will start on time.

Babar Bin Atta, Prime Minister Imran Khan’s point person on polio eradication, acknowledged in an interview that the situation remains challenging. Apart from the eight new reported polio cases, environmental sampling shows that the virus is still being transmitted in 12 major cities and many remote regions of the country.

“This poses a serious threat to children all over the country,” Atta said.

Pakistan is one of only three countries, along with neighbouring Afghanistan and Nigeria, where polio still exists.

The local campaign to eradicate polio remains a source of deep-seated suspicions and fears. Many believe the vaccination drive is part of a Western effort to sterilise Muslims. The fact that the CIA used a vaccination team to track down Osama bin Laden in a Pakistani town in 2011 has helped fuel the resistance to vaccination campaigns in the country. Militants have frequently attacked health workers, accusing them of being spies, and police have been deployed to provide security to anti-polio teams.

Poor immunisation services, malnutrition, unsafe water and poor sanitation have allowed the virus to survive and paralyse vulnerable children with low immunity levels, officials say. And anti-vaccine propaganda on social media has compounded the problem.

“As a result, we continue missing children during immunisation campaigns,” Atta said.

Successive governments have introduced awareness campaigns and repeatedly enlisted religious scholars to allay concerns of parents and counter anti-vaccination propaganda. Still, attacks on polio workers have continued.

On April 22, an angry mob set fire to a government health facility in Peshawar, the provincial capital of the northwestern province of Khyber-Pakhtunkhwa, after rumours spread that expired vaccination drops were being administered to children. Dozens of children complained of nausea and vomiting after getting the polio drops. Within hours, thousands of parents thronged local hospitals and demanded their children be examined.

As panic spread and an emergency was declared in local hospitals, officials clarified that the vaccine was neither expired nor dangerous.

Atta said he had lived in Peshawar for 18 years but had never witnessed such mass hysteria and panic.

A day after the burning of the health facility, a police officer providing security to health workers was killed, also in Khyber-Pakhtunkhwa. Another police officer was killed the next day in a different part of province. At least 700,000 families refused polio vaccination in the province because of rumours and panic, local news media reported.

And Thursday, unidentified gunmen shot and killed a female health worker while another female worker was critically injured in an attack in southwestern Pakistan.

Even big cities, including Islamabad, have seen resistance to polio immunisation campaigns.

“The biggest challenge in cities like Islamabad is the refusal by parents,” Mohammad Hamza Shafqaat, deputy commissioner of Islamabad, said in an interview. “Even if 1 per cent of the children don’t get the polio drops, the polio sample remains alive in the environment and we have to work harder in the next campaign.”

The government is focusing on addressing the misconceptions in communities, and building trust and demand for polio vaccinations, officials said.

On Sunday, Noor Ul Haq Qadri, minister for religious affairs, sought the help of clerics and religious scholars in Peshawar, warning them about those spreading negative propaganda against polio vaccination.

“Religious scholars across the country agree that children need to be vaccinated against polio,” the minister was quoted as saying.