This radio feature report reveal key Challenges to Polio Eradication in Pakistan…!
Polio eradication is at a critical juncture in Pakistan as it is now at a risk of becoming the last and the only home of the poliovirus in the world, and the last hurdle in achieving global polio eradication.
Pakistan’s polio crisis represents one of the last big hurdles in a 23-year campaign run by the World Health Organization. The fact that Pakistan has the highest rate of prevalence of polio in the world today despite receiving huge foreign funding and carrying out more than a dozen nation-wide campaigns for countering polio over the years points to the hard fact that there have been some serious lapses in state’s efforts in addressing the issue. Pakistan`s persistent failure in eradicating polio reflects the acute lack of commitment and obligation on part of the government and society towards saving children from the scourge of this devastating disease, more interestingly this radio report describes that how Taliban factor effect and threaten polio campaign in Pakistan….how 2 may 2011 Abbottabad operation for hunting most wanted person in the history put the polio eradication continued progress at risk…!
This radio feature has been broadcast different FM, AM radio channel across pakistan.
Full Transcription of Radio program on Polio in Pakistan- the deadly disease – challenges and way forward..! What Happens….After dark zero thirty
Year-2011, Month- May, city - Abbottabad- the northern city of Pakistan, American military operation, result…? The most wanted person of criminal history- usama bin laden(UBL)- killed, climaxes of 10 years American’s war on terror… Celebrations…Greetings
Hollywood made an excellent action movie on this historical hunting operation of UBL, ZERO DARK THIRTY (the name is based on a military term)
But, listener..! There is always some difference in man-made depiction of story and facts behind the story..!
Most of the people watch film ZERO DARK THIRTY- but listeners..! today , I would like to present real ZERO DARK THIRTY…! What happened after ZERO DARK THIRTY-2 may military operation? What are the consequences of the operation?
Next thirty month, will reviles those bitter truth that how 2 may Abbottabad operation impact and put deadly effect on 23 years polio eradication campaign in Pakistan…!
How Pakistan’s polio eradicate campaign becomes at high risk after this operation…!
So let’s get to know some bitter truth and ground realities…!
Let’s come to know… what happens... After ZERO DARK THIRTY
Year-2013, Month-May, City-Karachi- the largest city of Pakistan, extremist militant attack on school which is located in thick populated urban area, result- school’s principal killed.. Taliban except the responsibility, the killed person was an educationist, a reformer a social worker, who helps medical teams to carry out polio vaccination campaign in the area. ..!
Listener..! Have u suppose any co-relation between 2 May 2010 & May 2013 incident…? Yes, there is a relation... During last 2 years, public health worker of polio eradication campaign is under attack..!& he number, diameter and frequency of these attacks are increasing day by day..!
Initially only public health visitor targeted, then national & international NGOs and then the supporters of the polio eradication campaign…!
This matter is very sensitive and demand to pay attention on serious note, because Pakistan facing high pressure from international community to eradicate polio as Pakistan amongst in last three countries where polio virus still exist…! In Nigeria- Afghanistan- Pakistan.
Pakistan is last country of type three, where polio virus WPV3 exists... Pakistan is major and critical last hurdle to eradicate polio virus in the world.in this time, major polio cases being reported in Pakistan as compare all over the world, also Pakistan is most of effected and highly vulnerable country around the globe..
Polio eradication campaign is now in critical juncture and sensitive stage..!
Is this a big question that why Taliban anti towards polio eradication campaign? What’s wrong in this public health campaign that Taliban dislike? And appearance of larger polio cases in 2011 only in Pakistan causes anti-Taliban factor or there are other aspects and reasons that effect on polio eradication campaign pushing in failure.
What are the reasons behinds that this deadly disease that paralyze children’s for life time?
In decade of 1990, 20000 cases have been reported per year in Pakistan, however that resulting reduced only 30 case per year in year 2005.this was tremendous achievement that only few couple of years, Pakistan get ride on this disease that become as epidemic.
Then suddenly, in 2010, 144 record cases had been registered that were highest number in decade of 2000…! Then this situation getting worse in 2011 as per registration of polio cases becomes 198.
The major reason of rising polio cases were security concerns and constant attacks on field worker of vaccination campaign that resulting millions of children are deprived to get vaccinated.
These security threats coming from Taliban, who declared ban on vaccination campaign and warned authorities that do not carry out any vaccination campaign.
Actually that is the result of 2 may military operation…! Before the operation, in Abbottabad, Bilal town a fake vaccination campaign carried out to conform presence of UBL by getting DNA samples of children’s living in the big suspicious house. This fake vaccination campaign run by the support of Pakistani Dr. (Shekel Afraid),
Pakistan 23 years polio eradication campaign getting irreparable loses by CIA’s adventure of running fake campaign, as common people trust diluted. According to a reputed medical journal, after this incident, the year ahead, 200 children’s paralyzed due to polio various. Only in tribal areas, FATA 2.5 million children have deprived being vaccinated. Taliban used these lapses to propagate that this door +to door campaign being used for detective networking. Innocent people believe and trust has been shaking.
After Abbottabad incident Taliban imposed ban on vaccination campaign and warn to carry out any of these activities otherwise prepare to any loose. According to one of Taliban leader stated that “it’s now proved that western forces are using education, health and development sector as a weapon to destroy Muslims”
And since then, a purely public health campaign becomes controversial, unreliable to the masses and specifically Taliban suppose it as offensive for Muslims.
To get comment on the security threat, we talked to a government functionary, deputy director public health education Dr. Abdul Khalique... he says:
Q: About security concerns, as we saw in Karachi whose vehicle had been attacked many peoples killed, public health staff who has to go door to door, would they have some serious reservation because of law and order situation? What is your strategy to address these kinds of issues? How you motivate your staff?
A: In such circumstances we ask district administration to provide us security. Since ABBOTTABAD operation TAL+IBAN’s threats are our serious concerns death and live are in the hands of GOD and in meeting with district administration, every district officer reports about their staff’s concerns mainly related with security and government provide us security where there are concerns.
Q: As u discuss ABBOTABAD operation that was on 2nd of May and a fake polio campaign was run and after that incident TALIBAN factor has gotten more strength and attacked man civilians so do you think this is only factor and main reason that affects polio campaign?
A: yes absolutely some peoples have been arrested in Karachi and polio vaccination doesn’t harm. Polio vaccination has no enmity with anyone. Infect it is beneficial for the child.
Q: Has government of PAKISTAN taken any action against that fake polio campaign and did government record any protest in front of global organizations?
+A: the one who has committed has been arrested and in initial court proceedings he has been punished and he is in jail.
Q: We have also seen in rural areas people are unaware of polio vaccination campaigns and thinks that polio vaccination affects fertility of child, so what measures have you taken to address such issues to aware rural based population?
Al: To increase awareness level in people, we use print media, television, Radio, pamphlet, other means of communication. Our staff also organize sessions for people’s awareness and is anyone has any doubt about vaccines, can take e samples could be tested by any renown international lab.
People attitude and conduct in term of their social responsibilities he says:
Polio full vaccination is necessary for health of child but people are unaware and don’t take their Childs to clinics for vaccination and when our staff went to their most of the people deny for vaccination in spite of the fact that it is free of any cost to them our health ministry and who spent billions of dollars to prevent our Childs from such harm full disease but if parents don’t want it we cannot perform best of our job and we have also decided to take legal actions against those parents who deny for vaccination.
Its dilemma that before 2 may, extremist raise objection on vaccination campaign, according to the news reports Taliban used to say that these vaccination is being used to unfertile or damage children reproductive system to control Muslim population.
Innocent and simple heart people getting suspects on HILLAL components in vaccination, Taliban propagate that the vaccination is un-Islamic or non-Hillel (prohibited to Muslims)
Although theses stance prove false when after peace agreement with government that withdraw self- imposed ban on vaccination, if Taliban were right, whatever they claim on vaccination(un Hillel, hazardous reproduction etc)….so it proves that there is no truth, whatever Taliban says to misguide masses. But, unfortunately, INGOs supported these vaccination campaign loose it credibility and trust worthy in most of the masses specially in far flung, deprived, backward areas.
Here, we are taking an opinion of a lady belongs to poor labor class….
Talked with Akhtari Bagam (House mad: my name is Akhtari, I have been working since 15 years as house mad,
in our community, whenever Polio teams come, I always cooperate them, but some of my community members having some concerns on vaccination they says, this vaccination is harm for reproduction & because of the vaccination the family will have only 2 kids. I, myself don’t agree on this stance, if it so, it’s better to have only 2 kinds in this time of inflation…however, I suppose, its good thing the free medical has been giving to our children to prevent this diseases, in our community, there are 5-6 persons living with polio, a girl have polio, could not get married even, because nobody would take the Burdon.
Question: how serious people are to have such concerns? And what do you think there is any reality that polio vaccination hazardous for reproduction health?
Answer: no.no, I strongly believe that this not truth, in my family, a woman, she had polio drops, having 2 children’s and now expecting another. So this only myth. I encourage people to get their children being vaccinated, so that no kid paralyzed for life time.
Polio vaccination campaign received huge refusals across the country that is resulting of propaganda generated by Taliban. This propaganda become easy to believe for innocent common people after the fake vaccination campaign by CIA’s paid Pakistani doctor and now achieving people’s trust is basic element for success of this campaign.
Listeners, do you think that this security threat is only reason of failure this campaign in Pakistan? We find many other reasons that rooted in the issue. There is a need of juncture to pay head towards strategies adopted by government, review mechanism, implementation strategy, and social behaviors and so on. We should review out of the box, all elements that may course +hurdle of polio vaccination campaign.
Listeners, for back ground information; I would like to inform you that in the year of 1978, polio eradication campaign commence first time at global level
The Polio eradication programmer started in 1978. In 1988, the World Health organization (WHO), together with Rotary International, UNICEF, and the US Centers for Disease Control and Prevention passed the Global Polio Eradication Initiative, with the goal of eradicating polio by the year 2000. The initiative raised $120 million toward immunizing all of the world’s children against the disease.
The annual cases of polio in Pakistan, which were estimated to be more than 20,000 cases a year in early 1990’s, decreased to around 30 cases in 2005. It is hard to believe today but just a few years ago Pakistan was on the verge of polio eradication. Unfortunately, the number of cases increased to a 15 year record high of 198 in 2011-2012. It is an increase of nearly 40% as compared to 2010. It is now 2012, and Pakistan is one of three countries in the world, the other being Afghanistan and Nigeria, that are on the World Health Organization’s list of countries where the disease is endemic. The key challenges to polio eradication are limited oversight and accountability at the district and union council levels; access problems due to insecurity particularly in KPK and FATA; failure to identify and focus on underserved population and mobile groups; operational and planning challenges to deliver vaccination door-to-door to more than 38 million children several times a year and achieving high coverage at UC level; and overall campaign fatigue in public domain, rumors and negative perception of oral polio vaccine in some communities.
In this scenario, we talk about government efforts and strategy, with additional director public health Mr. Wali Mohammed lagari:
Dr. Wali Muhammad Lagari – Additional Director Public Health, D.G Office
Actually our office supervises of monitoring i.e. actual operational things, DHO of concerned districts, they plan everything like trainings, pre campaigns, campaigns & post campaigns. A micro plan is scheduled before every campaign. It gets updated with areas, district teams (staff), contact numbers, zonal supervisor, contact number, day 1 areas, and day 2 areas, number of required vaccines & POL.
If there are few security issues, DHO intimates administration for providing of security. DC and police get advice at SP level and they provide us security for three days campaign. It is our target to cover all the children making sure that no children is missed out.
Q. Security concerns were not there before 2005, now-a-days polio teams are getting attacks, what are the reasons behind it?
Ans. We have no security issues in Sindh, few incidents occurred in Karachi and upper Sindh but in rare cases, these issues have occurred in northern areas/KPK. For this purpose DHO is already conscious and he informs administration, they provide their cooperation in this regard. At the end a comprehensive report is being prepared which is given to DG Health.
Q. Why people kill the polio teams? Though they know that these teams are working for a noble cause?
Ans. I think that there is a misconception in Taliban that Americans are working anti-Taliban in the shape of polio workers and they are against WHO & UNICEF. This could be a main factor.
Q. You are supervising the monitoring work, what is monitoring mechanism? And how you will ensure that all the children have been covered in through the polio campaign by door to door?
Ans. To monitor these teams, district offices have assigned their supervisors and D.O and ADO monitors are being monitored from D.G office, all the process is monitored that whether the process is going in a smooth way or not? And district gets feedback from supervisors.
Q. Every house has no door like beggars are living in shelters. What the system to reach over there to cover these kinds of areas to ensure all children’s vaccination?
Ans. Areas are being divided amongst the teams and they have cover all areas which their target to cover every child. They know the areas very well. In our village, formers working in the fields with their families and mothers take their children with them in morning time. In this connection our teams revisit in evening to vaccinate the children.
Q. Why polio cases are increasing day by day?
Ans. The population is in continuous migration (movement) like someone’s relatives from other province (which are not vaccinated); they bring the wild virus along with them. You know very well that this virus will spread more. And there are few religious misconceptions that polio drops are used for family planning etc. That’s why the polio is increasing.
Q. What is your strategy on refusal?
Ans. Refusal from polio vaccination is a crime. Some strong steps have been taking against it and teams are advised to inform local administration in case of refusal. District administration will involve itself to ensure vaccination. Administration is taking serious interest on this core issue and administration is also advised at chief secretary level to ensure the polio vaccination and drops and on any refusal they have to visit the spot.
To know the field worker issues and concerns on +ground level while administrating polio vaccination campaign, we talk with few health visitors and workers….
Talked with Health visitors:
My name is Ms. Naseem Akhter, I have been working in Vaccination campaign since 5-6 years, as far as people response is concerns, we do not have regard from community, we are treating like baggers, as people called door-to – door health visitors, the shouted, says that “why are you people coming frequently to kill our time? “we are visiting communities, there are many challenges we faced, like severe weather, no security, some time being a women, people treated us so badly, because in our society, door to door job not suppose good for woman. In well-off families, they don’t like to get their children’s being vaccinated from us, they say, “we can get our children’s vaccinated privately”.
In this job, instead we are serving people by knocking door to door, we as women, treating wearied, we don’t have respect, sometimes we are facing harassment or sexual harassment, sometime an alone male open the gate, we feel unsecure because we have to listing remarks as “ come inside…,will you have tea or something with me....?, come inside. Have fun…, there is no kid inside, let’s give me drop...”
In last remarks, Naseem Akhter says: “This is Pakistan, everything possible...”
Another health worker field in charge Mr. Nader Ali says:
we as a field health workers, have no regards and rights, many sever problems we are facing, security threats, law and order situation, community refusals, community aggressiveness, but we are forced to work in critical conditions and meet our targets, our officers suppose us a labor, we have no respect.
While describing on security concerns, he says: there is no any security arrangement for us, security available for those who have higher positions, donors, INGOs worker but not for us.
Question: but when I asked security arrangement provision, officers says that, they provided police deployment or security with polio workers field teams.
Answer: no, no. we never have any security arrangements by administration at field level, as I told you, the arrangement may be for higher officers, not field workers, who have actually need it. We are working just believe & trust on god that he will protect us.
Health visitors Ms. Naseem Akhter says: we found major refusal in community from Madrasas (Islamic education schools), they people says that, this medical is un-Islamic and western, they quoted from holy book Quran that” Allah prevent 700000 disease cure just by recitation of Quran”
We motivated them, give logics, sometimes community doctor support us and try to make them realized and motivation to get children’s vaccinated.
Health worker in change Mr. Nader Ali says: One thing, I would like to mention, that this polio campaign is majorly depends on local administration, I can give many examples that if officer pay attention, going with us in field, community always cooperate, one of our officer used to make an announcement from mosque, now , last two years, this campaign gradually less attention by administration and higher authorities due to uncertainty, security threats and bad governance , whenever we faced refusals from community, all admiration and field workers pay much attention to cover refusals by constant visits and support of administration and community, now, things are changes, refusal remain refusals…!
To support and enhance awareness and remove misconception about polio vaccination campaign, a mass media awareness campaign is carry out by using every means of communications. For getting popularity among the masses, polio vaccination campaign was initiated by prime minister Benazir Bhutto (Late) by given vaccination to her daughter Asifa Bhutto, now she is goodwill ambassador of polio eradication in paitsan.in 2010,president Asif Ali zardari appealed to nation, that get their children to vaccinated, all citizen must perform their responsibility in this regard.
To address the misconception on religious prospective, ammay kabay(Muslims holy leader) appealed to masses specially people of Pakistan that there is no hazard in polio drop, and for the humanity, life and health of children’s every person should get their children to be vaccinated.
Celebrities and public figures also taking part of polio eradication campaign, polio victims themselves become part of the campaign to create awareness by depicts their life miseries after polio.
As we talk those brave people, who are living with polio with such a courage and optimism by creating awareness about this disease…….
My name is Qayyoum khan, I feel myself a normal person, but other people treat me as a handicap, as I become victim of polio in just three years old age. And from that time, I never stand up by my own feet, now I am 20 years young boy, but useless... I like plying cricket but I can’t ever, I don’t blame anybody… it’s now my fate, but, one thing , I would mention that my grant father who had some backward approaches, didn’t allow me to be vaccinated, he said “This is western medical, its harmful for Muslims, we don’t need it” and that is how it is.. All my whole life upset…I would not be a normal person ever..!
My name is Shazia balouch, my age is 35 years, when I was 6 years old my right feet start banding, I become victim of polio, on that time, no vaccination was available like this, if I could had been vaccinated, as this time vaccination available door by door for free, I never be paralyzed.my whole life destroyed because of did it take polio vaccine on right time. I appeal to all listeners that please must vaccinate their childes, so that we can defeat polio…
Polio mission in Pakistan is at the verge of high risk these days. There is danger of getting handicapped of millions of Pakistan children. This critical situation is not only in Pakistan but also at worldwide level to see polio mission failure. The achievement of Millennium Development looks difficult.
However, World Millennium Organization, UNICEF and other international health providing agencies along with Pakistan are making their efforts to curb the polio in Pakistan. Pakistan is facing a lot of pressure at international level.
According to WHO, international Brotherhood has expressed deep concern over the protection of health. If Pakistan fails to control the polio virus, the visa and the movement of Pakistanis at national and international level would be banned.
The internal issues of Pakistan international criticism have link somewhere with international security.
Polio is a very serious problem at national and international level. If effective efforts are not taken to form a good strategy or planning, then the days are not far away when Pakistani student will require Polio Immunization Certificate for studying abroad.
In 1994, 1500 children died due to polio. Hence forth, 30 lack children under 5 years of age are provided with polio drops every year.
There are threats at community level as well regarding to polio vaccination mission. If polio drops are provided after every three months, the why polio team comes every month? This fears to Muslim community that through polio vaccination Muslim race might be eliminated.
These fears and threats by the community cannot be ignored. It is of vital importance that a well-planned strategy be organized so that the misconceptions regarding the polio might be irradiated.
In any community, the polio virus is diagnosed through sewerage water test, and after the test of hundreds of samples if polio virus is found in anyone case that means the polio virus is present in that community.
This virus is brought by the migrants settled in Pakhtunkhuwa areas and other areas of the country. So the migrants’ camps, slum areas, the poor and the beggars are of worth attention regarding the polio vaccination.
Social welfare organizations with religious leaders should provide awareness to the masses and to get them in confidence, so that the fears and threats regarding the polio vaccination must be eliminated.
The polio vaccination mission has been disturbed by the flood of 2010-2011 by Taliban and by CIA, and by the fake polio vaccination mission.
However, CIA has accepted that at the end of this fake mission neither the children could be given polio vaccination nor the DNA sample of Osama Bin Laden could be achieved.
America has been playing very important role in providing the health facilities. In general and special attention towards the health of children it is expected that the country which is helped America should not encourage anything against the polio mission.
Like other countries of the world which are free from polio, Pakistanis also dreamed a country free from polio diseases because they cannot see their children being handicapped. So there is dire need to promote polio mission in Pakistan.
In security risk areas, with the help of media, social organizations, religious leaders, the vaccination of polio should be promoted. Regarding this the Taliban leaders are of the view that if their fears are satisfied them they have no objection against polio mission.
The climate of Pakistan, the hygienic situation of Pakistan, the diet to disturbances to Pakistan is the main causes of the growth of polio virus in Pakistan.
The disease of polio is caused by a virus found in the stomach of children, makes them disable.
The desired results are not achieved due to weak planning and strategies by the government to curb the polio.
Moreover, our social attitudes, civil society and media are not seen serious to this problem. Besides this the critical situation of peace, religious clashes and social and regional problems are great obstacles in the spread of polio mission.
The public should give importance to polio vaccination mission and take positive part in it.
The positive thinking, attitudes and behaviors of people towards polio mission can save the life of millions of children.
And the Pakistanis public and nation have such abilities and capabilities to face the music of come out with flying colors.
Me, Samreen Ghauri, radio Pakistan, Hyderabad…standing in public health hospital for children EPI vaccination, seeing this 2 month baby crying...he is being injected or vaccinated ….so that he could be cure of deadly disease that can paralyze him for life ..I could imagine those children, who have been vaccinated to cure for sufferings of pain …for life time……!!
This radio program is produce & presented by Samreen Ghauri- Radio Pakistan
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