Daily Times

The government of Khyber Pakhtunkhwa launched the Sehat ka Insaaf’ (justice for health) immunisation campaign in Peshawar last week amid tight security and the minister for health announced that during the initial phase of the drive, 480,000 children would be administered polio drops. The campaign was launched when last month the World Health Organisation (WHO) warned that Peshawar had the world’s largest reservoir of the polio virus and that 90 percent of Pakistan’s polio cases last year were linked to a strain of the disease found in Peshawar’s sewers. WHO’s researchers say that unless transmissions are curbed in Peshawar, the virus could spread, threatening global eradication efforts.

According to WHO statistics, 91 cases of polio were reported in Peshawar in 2013, up from 58 in 2012. Pakistan is one of the three countries around the globe that have failed to eradicate polio. Polio drops imply everything ranging from infertility drops to a western conspiracy against Muslims in Pakistan from the viewpoint of a common Pashtun or Punjabi, far away from the city lights and illusion of awareness created by an influx of private television channels.

In the past few months, I had the opportunity of going through some diverse research-based data on issues of immunisation, including polio vaccination, and catching some real life stories from Khyber Pakhtunkhwa, known in the world for terrorism rather than its beautiful landscapes, culture of hospitality and rare gemstones.

Four major issues came up during my interactions with the community and parents to understand their concerns in regard to vaccinations. Parents were sceptical about polio vaccinations as they think they cause infertility. They want to know why the government focuses only on polio when people are dying of hepatitis. Parents believe that their children when not given any drops are still fine physically. As if the above reasons were not enough, the way the case of Dr Shakil Afridi was presented in the media made every polio drops provider a suspect spy. Dr Shakil Afridi had been accused of launching a fake vaccination campaign to help the US Central Intelligence Agency (CIA) hunt down Osama bin Laden in Pakistan.

However, there is another side to the story: in some cases, even the vaccination does not help and there are reports of children affected by polio despite being given drops. What could be the possible explanation, if not justification — malnourished children, inadequacy of dosage or problems with the vaccine, including flawed storage mechanisms and the culture of greed? While exploring the truth it was noted that mostly those who are associated with the expanded programme on immunisation directly or indirectly refrain from sharing any personal opinion. Only a local doctor, on the condition of anonymity, divulged that since “Pakistan is among the three countries in the world that are not free of polio, in panic we give drops in excess, which has counter-effects and there are cases where children get infected despite having been given polio drops.”

A quick literature review-cum-analysis on the issue of polio immunisation, followed by field observations, revealed that since Pakistan is among the countries with the lowest national spending on health, it is not a priority issue for political parties and media. The ‘magic recipe’ for most donor agencies and technical aid agencies in Pakistan (including UN agencies and NGOs) is producing a documentary or some television advertisement by outsourcing to corporate media agencies or well-connected individual consultants, who too often do not have any expertise in health-related issues. This is all executed as a time-bound activity too hastily with the non-realisation of certain facts, e.g. in the remote mountainous areas, very few people have access to television and, more importantly, how credible is the source?

Interpersonal communication matters a lot in such cases. We also have this fatalistic approach in our television advertisements showing a crippled child and his father is shown regretting not immunising his child. While witnessing real life tragedies in Khyber Pakhtunkhwa, I happened to meet Marjaan (coral), a prized gem. Marjaan is a common name among Pashtun boys and girls. The word Marjaan has Hebrew origins and coral, as a precious gemstone, is known to be most effective as it radiates powerful emotions through the absorption of red radiation from the visible light spectrum.

The Marjaan I met was anything but hope. While sitting on her front porch, in despair she looked on at other children playing hide and seek in the street. Marjaan cannot run like other girls of her age and is not part of the game as neither team is willing to include her — she is a victim of polio. She is an 11-year-old displaced girl from Khyber Agency and lives in a small town, Chamkani, 20 miles to the north of Peshawar. Her father passed away a year before Marjaan was hit by polio. “I know it is too late and we regret what happened to Marjaan but then teams were not visiting each house like they do now nor were campaigns run in the media to create awareness about polio vaccination. There is a realisation now among even those who are not educated to make sure that their children get immunised,” Sajid, Marjaan’s brother said.

I am not a believer in the powers of the gem but, after witnessing the predicament and plight of real gems, I desperately wished for decision makers to prioritise basic healthcare and make it appear in their political agendas.

According to the rights holders, the billion dollar initiative by the world’s leading organisation to eradicate polio appears crippled in Pakistan and the most critical question of reasons behind the failure to reach those most in need, and the questionable efficacy of the vaccine, remain camouflaged — if not buried — by one simple phrase by those who are responsible for materialising the effective immunisation drive (the bearers) in the simple and short phrase: complex terrorism and the security situation in Pakistan.

The writer is a freelance journalist and can be reached at kaharzalmay@yahoo.com