KP govt losing commitment damaging anti-polio efforts

By Mushtaq Yusufzai
May 21, 2022

PESHAWAR: The fast-losing commitment of the Khyber Pakhtunkhwa government has started causing serious damage to efforts previously undertaken to eradicate polio from the province.

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Pakistan after a 14-month gap reported the first polio case recently, followed by another case and now a third child was diagnosed with the crippling disease.

All the three polio cases were reported from the North Waziristan tribal district, where Pakistan armed forces had conducted a massive military offensive, Zaib-e-Azb, in 2014 against the local and foreign militants.

The operation had caused a huge displacement of the local population that continued for a long time.

The government then announced that the tribal district had been cleared of militants and allowed the displaced families to return to their villages and towns, though most of the buildings were damaged either in the military operation or seasonal changes.

Until Zarb-e-Azb was launched, the government had lost writ in the tribal district and thus not a single child was vaccinated as local militants led by Hafiz Gul Bahadar had banned the polio vaccination there.

And thus Pakistan immediately started reporting a high number of polio cases in 2014 when the entire population, except for the Dattakhel subdivision, also a stronghold of militants, came out of their inaccessible villages and towns.

Pakistan and Afghanistan remain the only two countries in the world where poliovirus still exists. The world has long got rid of the disease.

Even Afghanistan is in a better position where despite security and economic challenges only one polio case was reported this year.

Interestingly, in both Pakistan and Afghanistan, the polio victims belong to the Pakhtun families.

In Afghanistan, the Afghan Taliban had extended all-out support to the national and international health workers involved in efforts to eradicate polio in the war-torn country.

The Taliban took a keen interest and arrested the killers of eight polio workers within a few days after they were gunned down by armed people during the anti-polio campaign. It sent a strong message of the Taliban’s commitment to the polio cause in the country.

Unlike in Pakistan, polio workers aren’t escorted by police or any other security guards in Afghanistan. Also, Afghans have their own issues that are affecting the immunisation drive as the Taliban are reluctant to allow women's health workers to contribute to this great cause.

And in many places, mothers don’t take their children to male polio workers during campaigns due to traditions and strict purdah customs.

Since polio is primarily an administrative issue in Pakistan as the majority of parents, either influenced or pressured by clerics, refused the polio vaccine to children.

Apart from North Waziristan and South Waziristan tribal districts, known for the violence and militancy from 2001 onward, the health workers faced serious hardships in reaching out to children in southern districts of Khyber Pakhtunkhwa.

The districts included Bannu, Karak, Lakki Marwat, and Dera Ismail Khan.

There was a time when the polio workers were not able to conduct door-to-door campaigns in some of the districts, particularly Bannu, Lakki Marwat and Tank.

Former Chief Secretary of Khyber Pakhtunkhwa Dr Kazim Niaz took it as a personal challenge and personally visited the troubled districts and ensured vaccination there.

He selected his team and appointed Basit Khan as its head and gave him the task of utilising all the available resources for the purpose.

Dr Kazim would keep himself updated on each and every development related to the polio vaccination.

Refusals were a major issue during his tenure.

He led the team from the front and reduced refusals to a negligible amount of level as he made the deputy commissioners and other administrative officers accountable.

And it worked as first the commissioners and deputy commissioners were practically involved in the polio programme and then they were made accountable.

Dr Kazim was replaced by Dr Shahzad Khan Bangash last year. Both are medical doctors.

Dr Shahzad Bangash also took a keen interest in the polio programme when he took charge.

However, it is widely believed that he didn’t show the same commitment that his predecessor had shown and yielded results.

According to officials involved in the polio programme, 95 per cent of refusals were handled by Dr Kazim Niaz during his tenure.

“Refusals based on religion or misconception are no longer an issue. It is now purely an administrative issue as the polio teams can’t reach the children living in remote villages of the troubled areas, particularly in North Waziristan,” a senior official of the polio programme told The News on condition of anonymity.

He said it would not stop here, saying the number of polio cases this year is likely to reach 20 or even more.

The recent polio cases also revealed deficiencies in the polio programme, particularly on the part of national and international health organisations.

The polio workers knew that children were not vaccinated, either due to refusals or inaccessibility, but they neither informed their own officials nor the local administration.

And to evade any punitive action, the health workers reported them to have received the polio vaccines and reportedly marked their fingers.

It was later revealed that none of the three children diagnosed with poliovirus had ever received the vaccine.

Fake finger marking is now stated to be a serious challenge to the national and international health organisations as their staff is involved in this heinous crime.

Bannu Division Commissioner Arshad Khan avoided comment. He is an officer of the secretariat group and was recently appointed Bannu commissioner.

Dr Shahzad, Unicef polio programme chief in Pakistan, admitted to The News that they were facing problems within the programme but said they had better plans to overcome these issues.

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