Polio is among the deadly preventable diseases. Although the world is celebrating the success of its elimination, the virus still prevails in Pakistan and Afghanistan. Both countries have reported during this year 52 and 12 cases, respectively.
Despite the success, the advocates of polio initiative are worried and admitting that the aim to eradicate polio worldwide is still far away. They are debating how to unravel this perplexing problem and change the state of stalemate. All eyes are on the said two countries now.
Why? Because polio is such a contagious virus that spreads so stealthily. Leslie Roberts writes, in a reputable Journal called Science, polio’s prevalence anywhere poses a danger to the whole world. If the polio programme fails in Pakistan, that means 24-year old polio initiative that coasted around $10 billion is nothing but a failure.
The question is, what are the underlying factors polio’s existence in our country despite immense efforts at the national and the global level?
According to Mushtaq and colleagues’ review of 2015, the reasons are multiple: religious, political, awareness-related, insecurity, inequity of resources, governance and social responsibility. Svea Closser, an anthropologist, who followed the trajectory of polio in Pakistan during 2006-07, also hints at the multidimensionality of the causes. One among them to her is the ‘office politics’ that occurs at a district level.
Since polio is a highly contagious disease that spreads rapidly, the problems will be socio-cultural, economic and political. Globally, such cases can compel other countries to put us on the radar to travel abroad, because of the fear and the risks of bringing the virus there
That means the engaged stakeholders negotiate polio to meet specific ends. The politics occur at all levels, but just different in terms of type and scale. For instance, the media recently reported about a leader of a traders’ body in the Bannu region, who announced to boycott the vaccination drive if the government opts not to withdraw specific taxes.
Moreover, the researchers and journalists have highlighted another vital aspect that is the local perception in which people label the vaccination as ‘western plot’ to sterilise Muslims and see some ‘hidden interests’ beyond it. The perception strengthened its roots further after a reported ‘fake’ vaccination drive in Abbottabad in 2011.
This narrative is rather predominant in Khyber Pakhtunkhwa (KPK). That shows how our immunisation programme is engulfed with conspiracy theories and rumours. As in April 2019 newspapers reported, a man in Peshawar spread misinformation about the polio vaccine, asserting that it caused children to faint and die. After the rumour, a mob attacked a government health facility and murdered a woman polio worker in Chaman, Baluchistan. These assaults obligated the government to stop the scheduled polio-vaccination drive across the country due to safety concerns about 270,000 polio workers.
When this local perception, perhaps, reaches the extreme, the people that are extremists, abduct or attack the vaccination teams, including their escorting security officials. For instance, in November 2013, 11 teachers engaged in a polio vaccination were abducted while considering as ‘western spies’ to work for the plot of sterilising Muslims. According to media, since 2012, over 100 attacks have occurred in the country that killed more than ten dozen of vaccinators, escorting security and citizens.
I already described in the previous take on, how the rife of polio poses challenges for Pakistan, both domestically and internationally. Locally, since polio is a highly contagious disease that spreads rapidly, the problems will be socio-cultural, economic and political. Globally, such cases can compel other countries to put us on the radar to travel abroad, because of the fear and the risks of bringing the virus there. As at the beginning of this decade, several countries already showed an intention to put a travel ban or to prove the vaccination record.
Indeed, besides polio other contagious diseases, such as measles, hepatitis, and alarming rise of HIV/AIDS, can also play their part to determine such decisions.
Given that, everyone has to play a due role to eliminate the polio virus because it is not anymore, a national social obligation, but a global. For fulfilling this obligation, it is a principal obligation to revise the whole paradigm of eradicating polio at all levels: regional, national and global.
This revision needs detailed qualitative understanding related to polio that is solely possible to obtain through ethnographic and multi-disciplinary studies. The investigations should centre, in addition to recording the local perception about polio and vaccination, to explore the experiences of polio-contracted people and their families. These finding can also help to develop effective awareness campaigns.
Furthermore, at the national level, every change requires a political will and vision. Therefore, the much-needed decision of Prime Minister, Imran Khan, to choose himself a polio ambassador to spearhead the anti-polio programme is a laudable step. Such steps would improve the image of, the highly cited phrase in the global discourse about Pakistan, ‘the lack of political will’. These initiatives are indispensable and badly needed, especially of the concerned, influential and accountable stakeholders, irrespective of geographical scale, to own the issues and play their due role in making our homeland problem-free.
The author is a PhD Scholar at the University of Vienna, Austria