Polio cases have refused to disappear in Pakistan. According to the recent survey, one million children either could not be reached in the latest polio vaccination campaign or were held back from the campaign for fear of some western conspiracy to render Muslims infertile. Though terrorism has its role in marginalizing a vast majority of Pakistani citizens from leading a normal life, the skewed efforts of the government in generally providing health facilities to its people is to be blamed as well. Law and order and the abandoning of a primary healthcare system have collectively damaged the EPI programmes like polio vaccination. Three barriers have been identified that rendered one million children unreachable by polio vaccinators: unrest, floods, and terrorism. Balochistan, Sindh and FATA are considered highly risky areas both in terms of running the polio campaign and in producing new cases of polio. Why would Balochistan and Sindh remain in the ambit of risky areas? FATA, though unfortunately, still makes sense because of falling in the war zone area. The situation in the other two provinces reflects sheer negligence of the government.
The usual kill and dump activity being common in Balochistan and the thrust of kidnapping and killing being on doctors, Balochistan has virtually become a no go area for the health visitors. A polio vaccinator was killed in Quetta during the recent polio campaign and the same thing happened a few months ago in Karachi, when a doctor was killed before the campaign kicked off. Then the killing of foreign health doctors and campaigners is another case in point.
The Lady Health Worker’s (LHW’s) programme was initiated in Pakistan in 1994 to muster community participation by creating awareness and bringing about changes in attitude regarding basic health and family planning issues. This primary health care system for its ability to be embedded in local systems was considered more relevant to eradicate diseases such as polio from rural areas. But what we have done to this programme is that only in August were their salaries disbursed on the orders of the Supreme Court. They usually do not have medicines or medical kits. And they have to run from pillar to post to get these basic but important things to carry out their duties. A further setback to the programme was the 18th amendment because of lack of ownership by the provinces.
As far as Sindh is concerned, floods, the unhygienic living condition and the inability of LHWs to reach and sustain there is another reflection of government’s tardiness in controlling polio.
Since polio is contagious, any movement of people due to internal displacements because of flooding, terrorism and law and order could aggravate the problem. Therefore in order to make polio eradication a success story, the government has to revive the community participation phenomenon and tighten its belt to combat law and order.
RABBIYA GABA
Lahore
