The measles epidemic across the province has once again highlighted the failure of health officials in performing the mandatory routine immunisation against diseases among children, Pakistan Today has learnt.
The government spends millions of rupees on the Expanded Program of Immunisation (EPI) for children under five years. The programme includes vaccination against TB, Polio and pentavalent (whooping cough, tetanus, diphtheria, pneumonia and hepatitis), while two dozes against measles are carried out.
However, sources on good authority revealed that the data shows around 85 percent of the affected children did not receive the mandatory routine vaccination against measles. The other 15 percent missed one of the two mandatory dozes. Among those who received vaccination, the protection rate was only 70 percent, while the remaining 30 percent still remained vulnerable to the disease.
“In this case what is alarming is the fact that the district authorities failed to administer injections to an overwhelming majority of the reported cases. The question remains that where do all those millions of rupees of funds go if the health authorities fail to complete a routine procedure that is ongoing for the past many decades,” an official, on the condition of anonymity, told Pakistan Today.
The official further said a recent third party evaluation on Punjab’s EPI reported 60 percent coverage, showing clear gaps in the objectives.
“The vaccinators have become afsars and they are not interested in their work. A large network of lady health workers also provides support, but the objectives are not achieved because they don’t perform vaccination or a follow up as mentioned in the standard operating procedure,” he added.
According to details, Chief Secretary Nasir Khosa himself called a meeting of all DCOs to ensure implementation of the routine EPI in all districts. Similar meetings were held before for dengue and polio vaccination campaigns. The outbreak of this epidemic has however manifested the inefficiency and the indifference of the field formation in complying with the orders from the top authorities.
According to authorities, around 14 districts were affected and 1,476 measles cases were reported during the current year in Punjab. Around 30 cases had been reported in Lahore alone, while problem persisted in Gujranwala, Rawalpindi, Sialkot, MandiBahudin, Khushab, Layyah, Mianwali, Bhakkar, DG kahn, Rajanpur, Rahimyar Khan, Bahwalpur, Vehari.
A senior health expert said those children who were breast feeding develop natural immunity for nine months, while the “modern” child drinking bottled milk remains unsafe.
“Natural immunity is already low in malnourished children, who are far more vulnerable to the fatal disease,” he said. “The World Health Organisation (WHO) also provides technical support in achieving the EPI and conducts tests and compiles data and shares it with the government. However, despite so many levels of officers, the problem still persists.” EPI Director Dr Tanveer Shaiq revealed the root of the problem was “mismanagement”, as same resources were given to all districts, but some officials “just don’t perform”.
Nine EDOs were removed last year on the basis of poor EPI to send a message to others, he said.
To a question, he said that weaknesses were prevalent and the higher authorities had been focusing on fixing the same for the last six months.
To another question, he said the EPI coverage was 90 percent in the 1990s, but the momentum could not be built afterwards.
Punjab has always been a separate country and has been at loggerheads with the federal government for proving its own superiority. The recent example of the Punjab government declaring that they are not going to take foreign aid is a typical, one shot, reactive approach where the purpose is not self-reliance but the desire to encash anti-government feelings. The PML-N’s philosophy of banking on the mood of the hour rather than a solid principled stance has cost them a huge dent in their vote bank. With a history of doing these emotional big bang activities with little impact, they have added to the economic ruin of the country. The 30-billion-rupee sasti roti disaster is one of the many examples where projects made without any heed to cost and benefit have saddled more burden on the fluctuating cash flows of the provincial exchequer. Yet they remain consistently oblivious to the after-effects of such irrational decision-making and behavior.
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