Community dialogues in the security-compromised Kurram district helped reopen several areas that had remained cut off for years from public health activities, including routine immunisation of children against 12 vaccine-preventable diseases.
The approach of holding parleys with people and elders of different areas helped in achieving a highly difficult goal of initiating immunization, ensuring protection of hundreds of zero-dose children and women who missed essential vaccination and remained prone to different life threatening diseases.
The initiative was jointly carried out by Expanded Programme for Immunization (EPI), Medical Emergency Resilience Foundation (MERF) with the support of GAVI, a global public-private health partnership.
In Union Council Khujbarat, Yaseen Ahmad had to travel around 80 kilometres for reaching a nearest major health facility for availing basic healthcare and immunization of children.
For several years, the local Civil Dispensary was shut down due to years long land dispute between the Khuaidad Khel and Palosin Wazir tribes, restricting arrival of health teams due to security concerns, Yaseen informed.
Majority of the locals in Khujbarat UC, having a population of around 8000 people, had stopped vaccination of their children due to hardships in reaching to the nearest health facility, Yaseen added.
In Khujbarat, 14 villages had completely ceased vaccination while 642 children every year were missing out on life saving protection, growing as `zero-dose’, informed Nasib Seemab, Social Behaviour Change Communication S&BCC officer MERF.
“For five and a half months, MERF’s team, EPI Officer, vaccinators and outreach workers lived the values of community-centered engagement,” Seemab told APP.
We held meeting with religious leaders, teachers, and tribal elders (Malakan) in their homes, at corner shops, and through endless WhatsApp updates. During consultations the communities were apprised that children health is of prime importance than land dispute and due to persistent efforts the Khuaidad Khel tribe formally allowed health teams in vaccinating of children.
“The long-dormant Civil Dispensary was brought back to life, now staffed by a government dispenser and MERF’s dedicated vaccination team,”. Within just a couple of months, the Civil Dispensary in UC Khujbarat vaccinated hundreds of children and recorded 451 OPD consultations, Nasib Seemab added.
He said around 282 newly born babies have been administered BCG vaccine which is a very remarkable development as children were missing this basic prevention treatment in the area for years.
Like Khujbarat, UC Mundan Durrani was also among the high-risk union councils in Central Kurram, that remained cut off from basic health services for six years, shared Dr. Junaid Khan of MERF.
Families had to travel up to 42 km to Tehsil Headquarte Sadda or 15 km to BHU Manatoo for vaccination, an impossible journey for most due to insecurity and financial hardship. As a result, hundreds of zero-dose children and women were left unvaccinated. Fear of militant groups, coupled with misinformation, further deepened resistance and isolation.
When MERF team first visited UC Mundan Durrani in July 2025, they faced strong community resistance. No household was willing to host or support vaccination activities, he recalled. The community had deep mistrust toward immunization efforts, fuelled by rumours and years of neglect.
Determined to restore health services, MERF team conducted repeated visits and community dialogues under the EPI KP framework.
Through consultative sessions, they discussed key topics such as 12 EPI-preventable diseases, vaccination schedules, and target groups, children under five and women of reproductive age.
They highlighted the importance of vaccination in protecting against life-threatening diseases like measles, polio, diphtheria, and tetanus, emphasizing that vaccines are safe, free, and essential for a healthy future. The turning point came when elders offered a Hujra (community guest house) as a permanent vaccination site where children were vaccinated.
With official approval from district health authorities, an Ice Lined Refrigerator (ILR) was installed at the site to safely store vaccines, the first in UC Mundan Durrani in over six years.
The establishment of the first EPI site in UC Mundan Durrani marks a historic milestone for immunization access in Central Kurram, Dr Junaid remarked. Through persistent social mobilization, trust-building and community consensus, EPI with support from MERF and Gavi, successfully transformed a zero-dose, high-risk union council into an active immunization hub.
This reflects how community engagement and health system strengthening can overcome barriers and protect vulnerable populations.