- Sources say govt focused on advertisements in posh low-risk localities with communications strategy incompatible with high-risk suburban areas
With the persistent detection of poliovirus at a Lahore site in the last six months, Punjab’s capital has become a cause of serious concern for the authorities which have failed to penetrate in suburban high-risk areas of the metropolis for awareness campaigns.
In a detailed conversation with Pakistan Today, World Health Organization (WHO’s) polio expert Dr Zubair Mufti said that although Lahore has no polio case, yet it is highly disturbing that the virus has been persisting for six months at the outfall pumping station.
“Lahore has now become the hotspot of Punjab and that’s why a lot of intensified campaigns have also been launched. The Punjab government also recognises that some union councils (UCs) are inaccessible. However, the government has demonstrated recently that it has the ability to shield against poliovirus,” he added.
Until and unless the poliovirus reservoirs are not completely destroyed, the polio cases will persist. It is not possible to eradicate them, he added.
However Punjab is the safest of all provinces with only two polio cases reported so far, one each from Chakwal and Bhakkar. According to Dr Mufti, the study of the virus revealed that it was not local and came from the tribal areas.
Situation is worse in other parts of the country as Pakistan recently broke its own record, crossing the shameful figure of 200, standing at 202 cases reported so far. The Federally Administered Tribal Areas (FATA) tops the list with 135 cases followed by 40 in KPK, 19 in Sindh (16 in Karachi), six from Baluchistan and two in Punjab.
NO VACCINE MEANS POLIO:
As per the WHO record, Bannu, Laki Marwat, Peshawar, Mardan, Quetta, Pishin and Qilla Abdullah are places where there are “clusters of refusals”. Evidence shows that the 11 cases reported in Bannu are all from families who refused vaccination for their children.
The official data shows that more than 80 percent cases are those which did not even receive the vaccine. “A bulk of cases is from KP and FATA – majority of these areas are those where the campaign has not even started. This shows that where there is no campaign there will be virus,” Dr Mufti said.
An estimated 34 million children up to five years of age live in Pakistan and during any nationwide campaign, the number of refusal is less than one percent.
REFUSAL NOT THE ONLY CAUSE:
This clearly shows that refusal, although a major reason, is not the only cause. The two reported cases in Punjab, for example, were administered polio vaccination several times.
Punjab Health Secretary Jawad Rafique Malik said questions have been put to the WHO authorities about the incidence of polio cases in Punjab despite the administration of vaccine to those kids. “The authorities [WHO officials] say the poliovirus hit to the most vulnerable and weak before its decline,” he added.
CAMPAIGNS KEEP FLOWING, SOMETIMES USELESSLY:
The Islamic Development Bank has given a loan of US$ 200 million for the polio program in Pakistan to be implemented over a period of three years (till the end of 2015). However, the communication strategy adopted for the awareness programs has some placement issues.
A senior official privy to the development said that the government spent a major chunk of its advertisement revenue in putting up billboards on The Mall and Jail Road and other posh localities, which are the low-risk areas, leaving the high-risk suburban areas including Bund Road unattended.
WHO’s Dr Mufti said that he agreed that the communication strategy was mostly needed in the high-risk areas, where the government should involve local elders and clerics to make sure the vaccine is administered.
To a question on overdose in certain areas, he said polio vaccine is among the safest vaccines in the world and there is no risk at all how many times you may administer the dose to the kids up to the age of five years.
Dr Mufti further suggested that the government machinery such as the DCO should deal it as an emergency situation, because it has now global implications.
GOVT SAYS IT’S WORKING ON LAHORE:
Punjab Health Secretary Jawad Rafiq Malik told Pakistan Today that Lahore’s “environment sample” has been marked as high-risk. “We have also started specific coverage of these areas. Rawalpindi is also very sensitive because it has a lot of travelling from FATA and KP,” he said.
To a question, he said announcements were made in the mosques and clerics were also taken on board in high-risk thickly populated poor neighbourhoods. “The WHO and UNICEF will do a third party analysis and it will show how successful our efforts have been. However, we will try our utmost that the environment sample is negative,” he added.
State minister for Health Saira Afzal Tarrar told Pakistan Today that the cases are being reported from areas where there has been no vaccination taken place for the past two years. “Health is a devolved subject and its implementation is with the provincial governments. Here people are not only anti-government but anti-polio as well. Polio is no more a technical issue but a political and law and order issue,” she added.