It may be too early to call Lahore polio-free
The midday sun blares in the summer sky as temperatures in the city soar high. It’s that time of the day when many inside the Walled City of Lahore prefer to stay indoors, the streets are deserted and the bustling neighbourhoods go silent.
Seeking a reprieve from the summer heat, Hafiza Ayesha Anwar and her team move inside the massive labyrinth of streets, checking every door for markings they made last month. They are preparing for another round of polio vaccination drive, which begins next week. For that, they are making sure that no child under the age of five is left unvaccinated in the neighbourhood assigned to her. She’s among the many locally-trained frontline workers who will spread out into the nooks and crannies of the city and conduct a door-to-door polio vaccination drive.
Recently, the local administration announced that Lahore was free of wild polio virus, as the latest environmental samples showed no trace of the virus in any locality of the city. Almost all officials, including the deputy commissioner (DC) of Lahore, termed it a success and congratulated the polio teams working in the city for their untiring efforts. But, this is just the beginning.
For the past couple of years, Lahore has been one of the worst affected districts in terms of the spread of the wild polio virus, and was even declared the “epicentre of polio transmission” by the Independent Monitoring Board (IMB), the apex global body for monitoring the efforts against the polio virus. The city was previously declared polio-free for two consecutive years in 2017 and 2018 until all hell broke loose. Many still think that the authorities let their guard down when they were busy receiving accolades for the achievement and that’s when the virus bounced back.
The worst was in 2019, when five cases of children being infected by the virus were reported from Lahore. This, when compared to 12 in Lakki Marwat, was still considered high. Experts believe that Lakki Marwat, having a weak local administration and authority, cannot be compared to a developed metropolitan like Lahore. But in the same breath they blame the developed metropolitan for acting as a magnet, attracting people from far-flung areas where the wild polio virus is still active.
Sundas Irshad, head of Polio Programme, Punjab, agrees that the environmental samples coming out positive for the past couple of years were a serious concern, not only for the local authorities but also for the international community. “The IMB was concerned when the wild poliovirus was not being interrupted in the province and the provincial capital. But since October last, through a coordinated effort we have been successful in curbing the polio virus from spreading,” she tells TNS.
Crediting the polio workers as their frontline workforce, Irshad lauds their services but cautions that it is still quite early to declare the city polio-free. “It’s a positive sign that for the past two months environmental samples collected from the sewers of Lahore have showed no trace of the virus, but we still have to proceed with caution. For a country or a place to be declared polio-free it takes at least three years without confirmed cases and a vigorous surveillance.
The city was previously declared polio-free for two consecutive years in 2017 and 2018 until all hell broke loose. Many still think that the authorities let their guard down when they were busy receiving accolades for the achievement and that’s when the virus bounced back.
“What should be encouraging for us and the people of Lahore is that we are on the right path,” she adds.
With only two cases reported in 2020 and none after October last year, Anwar and many other women vaccinators are tasked to take the lead in all upcoming vaccination drives.
A mother of a four-year-old, Anwar says that women have the capacity to encourage parents to immunise their children, build community trust, and reach out to children who might otherwise be missed. “Being a mother myself I am able to connect with the mothers who often are more comfortable discussing immunisation with us than with our male colleagues.”
Having an MSc in social work, Anwar believes that she can put her education to the test in the field when convincing mothers who might be reluctant to open their doors to polio vaccinators. “We have to win their trust,” she says. “I totally understand why many parents are reluctant to get their children vaccinated.
“Misinformation remains an issue among parents living in these areas, but as a vaccinator I have the training to dispel these rumours.”
Typically, vaccine hesitancy is attributed to low-income neighbourhoods. In the case of Lahore, it’s the posh neighbourhoods that top the list. Dr Ujala, from the Surveillance Office of the Emergency Operation Centre (EOC), identifies Lahore’s urban slums, katchi abadis and congested areas as being high-risk areas for any virus but terms the residents of posh areas as more vaccine hesitant. “It may be because they get their children vaccinated at private facilities or they don’t have the time to come to the door. Whatever the reason, we can only request them to be more welcoming and cooperative towards our staff,” she says.
Experts are of the opinion that the response within the city as well as the entire country, to the ongoing Covid-19 pandemic, can act as a silver lining for the polio vaccination drive. During the pandemic, the government authorities went into a war-room-like situation which resulted in the dissolution of many organisational and professional boundaries. This, in turn, made way for a smooth, hurdle-free system and a rapid mobilisation strategy that was found lacking in previous immunisation drives in the country.
The eradication of polio requires the kind of commitment shown by the authorities in dealing with Covid-19. As for Lahore becoming polio-free, the authorities have shown the resolve not to be found lacking in eradicating the wild polio virus. People can only hope that this resolve will translate into a greatly improved performance in the weeks and months to come.
The writer is a freelance contributor based in Lahore