Lack of clean drinking water major cause of polio: study

ISLAMABAD: More than 42,000 of 124284 primary schools in Pakistan are deprived of clean drinking water facility, 90 per cent of these schools are located in FATA, Balochistan, Khyber Pakhtunkhwa, AJK and Sindh which are considered high-risk polio areas, official data shows.
According to Pakistan Education Statistics 2014 published by ministry of federal education and professional training, Balochistan province, most parts of which are considered high-risk polio areas, has no clean drinking or even water facility in more than 80 per cent of its schools.
As per data, 4,766 schools in the province have no such facility whereas only 1021 schools have water or clean drinking water facility. Federally Administered Tribal Areas (FATA), where the highest number of polio cases were reported last year, has no water or clean drinking water in almost 60 per cent of its schools - 2099 schools lack this facility whereas just 1437 schools have the water facility.
Khyber-Pakhtunkhwa has no drinking facility in almost 34 per cent of its schools as 7680 schools have no such facility whereas 14982 schools had the water facility in 2014. Similarly Sindh, the second largest province in terms of population, has no drinking water or clean drinking water facility in 51.43 per cent of its schools - 21,771 primary schools have no such facility whereas 20,560 have the facility of water or clean drinking water.
Majority of the polio cases have been reported in the said provinces or territories in the past. According to the official data of ‘End Polio Pakistan’ which is the official website for polio partners in Pakistan - Government of Pakistan, UNICEF, World Health Organization (WHO) and Rotary, a total of 306 polio cases were reported in 2014. Of these 306 cases were reported in FATA, 68 in KPK, 30 in Sindh and 25 in Balochistan whereas only 4 cases were reported in Punjab.
Professor Dr. Azmat Talat, head of Hayatabad Medical Complex Peads department, says majority of the pediatrics who visit his hospital have infectious diseases like Hepatitis A, E, worm infectious diseases, gastro and diarrhea, and most of them belonged to a background where sewerage system was very poor or they had no clean drinking water facility. Even polio could spread from one person to another if the water is contaminated and it carries poliovirus.
“When a child is infected with wild poliovirus, the virus enters the body through the mouth and multiplies in the intestine. It is then shed into the environment through the faeces where it can spread rapidly through a community, especially in situations of poor hygiene and sanitation. Because of the poor sewerage system in the urban as well as rural areas, majority of the population is drinking contaminated water and this could be one of the reasons for the spread of poliovirus,” commented Dr. Azmat.
He said majority of the patients who receive waterborne infectious diseases are reported from rural areas, FATA or the urban areas where the sewerage and sanitation system is very poor.
Ayesha Raza Farooq, prime minister’s focal person on polio, when approached, said there could be risk of poliovirus spread where the sewerage system is poor but this doesn’t mean this is the cause of polio spread.
There are many other segments of poliovirus spread and challenges to control polio disease including low routine immunization performance, building trust and demand for OPV, limited availability of OPV, insecurity resulting in compromised access to children, gaps in adequately implementation of transit and migrant strategies, persistent pockets of refusals and failure to track and reach missed children after every SIA, she commented.
“In our Polio plus Strategy, we recommended and encourage the provincial governments for providing pure and clean drinking water facility, clean environment so that the poliovirus could not spread,” commented Miss Ayesha Raza.
Dr. Riffat Ayesha Anees, senior scientific officer in National Institute of Health while talking to The News said poliovirus could be transmitted or spread through fecal-oral route. She said many diseases including diarrhea, typhoid, Hepatitis A and E and cholera could spread through unclean or contaminated water. Similarly contaminated water could also cause polio if water contains poliovirus via sewerage system.
“Clean water is a basic right of human being and it is very important for a healthy kid. Primary school-going kids are the softest target of poliovirus and they need clean and pure drinking water and also the environment of the schools needed to be kept clean,” commented Dr Riffat.
Dr Amir Safdar, a public health expert, while talking to The News said the environment factor matters a lot in an endemic country like Pakistan. Normally poliovirus remains alive from 3 to 35 days and during this period if the virus is not eradicated then there are chances of its spread from one person to another through oral-fecal route. Those children whose immunity level is low can fall easy prey to this virus.