Concerted efforts, IPV introduction reduce polio cases in Fata

Refusal ratio brought down to 0.015 percent

PESHAWAR: Gaining access to inaccessible areas and introducing inactivated polio vaccine (IPV) has drastically reduced the number of polio cases in the Federally Administered Tribal Areas (Fata).

In 2014, around 359 polio cases were reported worldwide and 306 of them were diagnosed in Pakistan. Some 179 of the 306 cases were reported from Fata alone. Some of the polio cases reported from the settled districts had links with Fata that was unofficially declared as ‘no-go’ area for polio workers.

The vaccinators performing duty in Fata were unable to conduct door-to-door campaign and vaccinate children against the crippling disease.The polio workers did their job under unfavourable circumstances due to poor law and order situation as the militants were opposed to polio vaccination in certain areas.

Pakistan faced criticism in 2014 from the international community and the World Health Organisation (WHO), the public health arm of the United Nations (UN), recommended strict travel restrictions against it due to the unprecedented rise in polio cases. The international community felt that Pakistan might infect other countries by spreading the virus.

Pakistanis were required to present polio certificates for travelling abroad and the aim was to make Pakistan take steps to curb the crippling disease.The focus was on Fata as the militants in South Waziristan and North Waziristan had banned polio vaccination in 2009 as a mark of protest over the US drone strikes.

Between 2009 and 2014, majority of the children in the two troubled tribal regions remained unvaccinated. In 2014, according to senior government officials, 33 percent area in Fata and the Frontier Regions (FRs) was inaccessible for polio teams due to insecurity.

When all efforts proved fruitless in overcoming polio in the tribal areas, the then Additional Chief Secretary (ACS), Mohammad Azam Khan assigned the task to Secretary Security Fata Shakil Qadir Khan.

Senior officials of WHO and Unicef said they had given up hope of reaching children in Fata due to the deteriorating security situation and inaccessibility to the target population.

However, they said that after the responsibility was handed to Shakil Qadir, he took it as a challenge and developed strong liaison with the armed forces in Fata for reaching out to the children.

Talking to The News, Shakil Qadir gave the credit to the Pakistan Army and paramilitary Frontier Corps (FC) for their active participation in providing access to polio teams in Fata.

“When I was given the task, I observed within a few days that polio was not a health issue but purely a security and an administrative matter,” Shakil Qadir said.He said being head of security affairs in Fata helped him understand security concerns.

He said there was a huge burden on him when he was handed over the task as polio was the biggest crisis in Pakistan owing to international pressure in 2014.

“The main problem was access to children and the armed forces helped us a lot. It took us six months to get access to children as 1/3 of the area was out of access. We brought 98 percent area under direct coverage. Then we removed fear of the polio teams and enabled them to reach to the children in areas where polio teams had never been in recent years,” the Fata security chief said.

He said that 2015 was comparatively better than 2014 as only two percent area remained inaccessible in Fata and FRs.

In September 2015 the health authorities launched door-to-door anti-polio campaign in Fata. “Instead of hujra vaccination, we launched door-to-door anti-polio drive to reach out to the missed children,” Shakil Qadir recalled.

He said the health authorities in Fata used IPV instead of the oral polio vaccine (OPV) to vaccinate the children. “IPV is very successful in terms of overcoming polio. It boosts the immunity of children and reduces the chances of reoccurrence of the virus among them,” he observed.

He added that no polio case had been reported in a year from FR Bannu, Bara and Jamrud subdivisions in Khyber Agency that were previously called notorious in terms of limited access to children.

Shakil Qadir said that 15 polio cases were reported in Fata In 2015. He said around 2,80,374 children were targeted for IPV in Fata and FRs out of which 2,57,901 were inoculated.

Shakil Qadir said that no polio case had been reported from the tribal areas in 2016. He stressed that no effort would be spared to make Fata polio free.

He pointed out that the number of parents refusing vaccination was higher in the four provinces than in Fata.

The year 2016 was encouraging for the government and those dealing with polio in Fata.In 2016, 9,49,873 of 9,65,632 children were vaccinated against polio. The vaccination coverage was almost 98 percent. According to officials, 6,465 children were missed in the drive.

The parents of around 142 of the 6,465 children refused to get them vaccinated while the remaining ones were not available at home when the anti-polio campaign was carried out.The refusal ratio in Fata has been brought down to 0.015 percent.