To eradicate the longstanding infectious disease polio from the province, Khyber-Pakhtunkhwa government came up with a plan, ‘Sehat Ka Insaf’ programme. The government took Peshawar as a model district for the programme. The PTI-led government took this initiative after Peshawar was declared world polio virus reservoir by the World Health Organisation.
There were two hurdles in the way; one, security and two, people eyeing the vaccines with suspicion. To ensure security, the KP government, apart from providing foolproof security to the team, has banned motorcycle ride in the area where Sehat ka Insaf programme is running. The campaign runs on Sundays only to ensure all children get immunised.
To foil negative propaganda by some clerics and remove misconception of parents regarding polio drops, the provincial government replaced the polio campaigns specifically called ‘polio drive’ with Sehat ka Insaf which, apart from administering polio drops to children, is immunising children against eight other preventable diseases. Distribution of public health messages at people’s doorsteps is besides this.
The Health Department, with the assistance of World Health Organisation (WHO) and Unicef, initiated Sehat ka Insaf campaign on February 2. Each Sunday, thousands of health workers and PTI Razakars (volunteers) run the campaign in their respective union councils which will end on April 21.
Attacks on anti-polio teams also severely disrupted the efforts in the Khyber-Pakhtunkhwa and tribal areas. Since December 2012, a total of 32 people have been killed nationwide in attacks on polio workers. Of these victims, 22 were from KP.
Under the programme, the Health Department is holding free medical camps where vouchers for free checkups and free medicines are being provided to people. Each child is receiving vitamin A drops. Each family is also receiving hygiene kit, including soap, toothpaste, toothbrushes, towel, water container, etc.
For this campaign, a sum of Rs20 billion has so far been allocated, under which more than 12,500 free kits would be distributed among 350,000 families that would protect them from the nine diseases. The target is to reach out to more than 754,000 people.
The programme seeks to replace the polio campaigns that were run in collaboration with the Prime Minister Polio Monitoring Cell throughout the country, including Khyber-Pakhtunkhwa. Now, there is no role left for the federal government after the passage of 18th Amendment which authorised the provinces to have their own programmes for health. Khyber-Pakhtunkhwa became the first province to implement its own immunisation programme.
So far, the provincial Health Department has run the campaign in three phases.
In the first phase of the programme, children in 43 union councils of Peshawar were immunised. According to the Expanded Programme on Immunisation in Khyber-Pakhtunkhwa (EPI) data, 402,730 children were the target of the campaign in 45 union councils while 365,625 received polio drops with 2,865 cases of refusals and 19,462 could not be accessed.
In the second round of the drive conducted on February 9, children of 60 union councils including 45 of the first phase were immunised. The total number of children targeted was 449,559 while 446,136 children were accessed and vaccinated. There were 3,955 refusals while 23,119 children could not be reached.
In the third phase of the drive, the health officials said they would vaccinate 635,675 children against polio and ‘other diseases’ in 77 union councils of Peshawar. They succeeded in vaccinating 547,093 children while 30,062 children were missed. A total of 210,000 coupons were distributed for ‘free’ routine immunisation of children.
In the fourth round of the drive, the official data revealed that almost 551,000 out of the total target of 635,000 children were immunised in six hours in 77 union councils of Peshawar. According to the data sheet, only 22,327 remained unvaccinated due to non-availability of the target children at their residences when the vaccination teams visited the locality. These children were marked as ‘absent’.
The officials claimed that the number of absent and refusal cases has dropped drastically and the drive is running successfully. According to the provincial health department, 20,000 hygiene kits were distributed in various towns of the city.
The Sehat Ka Insaf initiative of the ruling Pakistan Tehreek-i-Insaf has widely been acclaimed by the UN agencies.
Younas Zaheer Mohmand, the focal person of the programme, told TNS that Insaf Change Force was playing a leading role in materialisation of the PTI’s plan to save children from diseases. He also appreciated the PTI’s Tabdeeli Razakar Force for its support. "The immunisation programme is being run by local people in accordance with local traditions. The programme has received social acceptability because people realise that it is totally owned by the government to safeguard our children from diseases," said the focal person of the programme.
Peshawar had recorded five of the 10 polio cases registered in Khyber Pakhtunkhwa last year. In all, 14 cases were reported countrywide in 2014 before the launch of Sehat Ka Insaf programme.
The Khyber-Pakhtunkhwa Health Minister, Shaukat Yousafzai, said that Sehat ka Insaf campaign was the need of the hour. "It will not only eradicate polio but control child mortality rate in the province as well," he said. He condemned attacks on police personnel and polio workers.
According to Dr Jan Baz Afridi, who heads the Expanded Programme on Immunisation in Khyber Pakhtunkhwa, the initiative taken by Imran Khan will prove effective. Immunisation for all preventable diseases is vital and it is good that they are being administered.
Pakistan began the anti-polio campaign in 1994 when the World Health Organisation declared global emergency against the vaccine-preventable childhood ailment. Due to aggressive drop administration, the disease was eradicated from the entire world, but the virus still exists in three countries -- Pakistan, Nigeria and Afghanistan.
The Swat-based cleric Maulana Fazlullah, who is now Tehreek-i-Taliban Pakistan chief, started delivering sermons from the FM radio in 2005, asking people that vaccine was haram (forbidden) in Islam and those using it were infidels. He also argued that it was a ploy by the Western countries to render the recipients sterile and impotent. But even before that, the situation with regard to polio vaccination had never been satisfactory. Fazlullah’s argument found receptive ears and Swat recorded 40 cases in 2007.
The UN and other donor agencies have reportedly spent over $1 billion since the launch of the campaign, but the situation never saw any improvement and the crippling disease continue to haunt the children. For example, these agencies were required to play second fiddle to the government, acted on their own and didn’t take into account the government’s proposals and ground realities in the country, especially Khyber Pakhtunkhwa and Federally Administered Tribal Areas where the disease affected most of the children.