Pol­i­tics of Polio

The polio vac­ci­na­tion drive should be re­shaped in such a man­ner that it comes across less as a for­eign ef­fort and more a lo­cal one.

Southasia - - CONTENTS - By Maria Ka­mal

Pak­istan’s in­abil­ity to curb polio could mean a rise in travel re­stric­tions for its cit­i­zens.

In Pak­istan, ad­min­is­ter­ing polio drops to chil­dren is per­ilous work. In the last few months, vol­un­teers and work­ers of the UN-backed anti-polio drive have been tar­geted and killed in Pe­shawar and Karachi. In Waziris­tan, the Tal­iban have gone so far as to ban im­mu­niza­tion al­to­gether.

Pak­istan is one of the three coun­tries in the world that still have a polio prob­lem. While neigh­bor­ing In­dia has been polio-free since 2011, Afghanistan, Nigeria and Pak­istan have yet to de­feat this in­fec­tious, po­ten­tially deadly dis­ease.

The sta­tis­tics are grim. Ac­cord­ing to the World Health Or­ga­ni­za­tion, 85 cases of polio were re­ported in Pak­istan in 2013; a sig­nif­i­cant rise from the 58 that were recorded in 2012.

It doesn’t help that de­feat­ing polio has be­come a deeply politi­cized is­sue in Pak­istan. The seem­ingly in­nocu­ous anti-polio cam­paign met with a mas­sive con­tro­versy when news broke that Dr. Shakil Afridi had run a fake vac­ci­na­tion pro­gram in Pak­istan to help the CIA close in on Osama bin Laden. This rev­e­la­tion, com­bined with the per­sis­tence of the mas­sively un­pop­u­lar U.S.-led drone strikes on Pak­istani ter­ri­tory, has led to a wide­spread dis­trust of polio vac­ci­na­tion ef­forts in the coun­try.

Deeply con­ser­va­tive el­e­ments view im­mu­niza­tion with sus­pi­cion, re­gard­ing it as a ploy to make the Pak­istani pop­u­la­tion ster­ile. The re­sult is that driven ei­ther by fear or dis­trust, par­ents in many parts of the coun­try refuse to get their chil­dren vac­ci­nated against polio.

Faced with in­tim­i­da­tion from mil­i­tants, health work­ers op­er­at­ing in var­i­ous ar­eas of the coun­try have halted work un­til se­cu­rity is stepped up or the ban re­scinded. The up­shot is that thou­sands of Pak­istani chil­dren re­main ex­posed to this dis­ease that can cause life­long paral­y­sis.

It is es­ti­mated that above 163,000 chil­dren in the re­gion, who are be­low five years of age, may be af­fected by the anti-polio ban. Ad­di­tion­ally, the coun­try’s in­abil­ity to curb polio could mean a rise in travel re­stric­tions for its cit­i­zens. Al­ready, In­dia re­quires visa ap­pli­cants from Pak­istan to pro­vide proof of polio vac­ci­na­tion. Other coun­tries are ex­pected to tighten poli­cies in this re­gard as well.

Nonethe­less, a com­bi­na­tion of lo­cal politi­cians, cler­ics, so­cial work­ers and celebri­ties has pushed for Pak­istan’s anti-polio cam­paign to con­tinue un­de­terred. Imran Khan, whose party con­trols the provin­cial govern­ment in Khy­ber Pakhtunkhwa, has pledged sup­port for the cam­paign. Lend­ing re­li­gious author­ity to these ef­forts, prom­i­nent cleric Maulana Samiul Haq has is­sued a fatwa urg­ing par­ents to im­mu­nize their chil­dren against polio. Govern­ment of­fi­cials have also stated their com­mit­ment to de­feat­ing the dis­ease.

These are im­por­tant steps to­wards re­vi­tal­iz­ing the drive against polio but they are not enough.

Pak­istan can­not af­ford to nur­ture polio. Its fail­ure to erad­i­cate the dis­ease deals an­other blow to child health in the coun­try and en­dan­gers the prospects of global erad­i­ca­tion of polio – re­in­forc­ing Pak­istan’s sta­tus as some­thing of an in­ter­na­tional pariah. Con­cerns have been raised about Pak­istan ex­port­ing polio and set­ting back hard-won progress made by other coun­tries.

To crush polio, Pak­istan must first beat the pro­pa­ganda sur­round­ing polio vac­ci­na­tion. What it needs now is to re­frame the polio de­bate, high­light med­i­cal truths and sep­a­rate them from ram­pant mis­in­for­ma­tion. It must also ad­dress le­git­i­mate con­cerns about the liv­ing con­di­tions that cul­ti­vate polio and other dis­eases – such as poor san­i­ta­tion, mal­nu­tri­tion and lack of health ser­vices in the poor­est parts of the coun­try.

The job will not be com­plete with the act of ad­min­is­ter­ing polio drops to ev­ery child in the coun­try – al­though this will in­dis­putably be an im­por­tant mile­stone. Ba­sic health ser­vices also need to be made avail­able to them, both as a con­fi­dence-build­ing mea­sure and as a sen­si­ble way to sus­tain gains in the area of health.

Polio can only be de­feated through a firm po­lit­i­cal will at the high­est level and strong lo­cal co­op­er­a­tion. It is im­por­tant to call on re­li­gious lead­ers with a huge fol­low­ing to rubbish the ar­gu­ment that seek­ing vac­ci­na­tion is an un­nat­u­ral act of de­fi­ance and that polio is some­thing good Mus­lims are des­tined to live with. Deny­ing chil­dren vac­ci­na­tion can­not be passed off as an act of re­li­gion in a coun­try where re­li­gion is taken quite se­ri­ously and in­forms many per­sonal de­ci­sions.

A pow­er­ful pub­lic in­for­ma­tion cam­paign must fo­cus in­stead on the ter­ri­ble con­se­quences of polio and the fact that the dis­ease can and should be pre­vented. It should be de­signed to build ac­cep­tance of polio vac­ci­na­tion among lo­cal com­mu­ni­ties.

Ad­di­tion­ally, the govern­ment must as­sert its writ and refuse to al­low the anti-polio cam­paign to be hi­jacked by mil­i­tants. This will mean tight­en­ing se­cu­rity pro­vi­sions for health work­ers and mak­ing it pos­si­ble for them to go about their work un­harmed.

Be­ing mind­ful of the neg­a­tive per­cep­tion of the U.S. and the UN in the re­mote parts of the coun­try, con­certed ef­forts should also be made to re­shape the cam­paign against polio in such a man­ner that it is seen as less of a for­eign ef­fort and more of a lo­cal one. It is im­por­tant to get lo­cal lead­ers

of ev­ery district to ex­tend their sup­port to the cam­paign against polio.

There is an­other facet of Pak­istan’s polio dilemma that un­der­pins a larger, very dis­turb­ing, so­cio-po­lit­i­cal trend in the coun­try – its fix­a­tion with bans. From Youtube to polio drops, any­thing that of­fends sen­si­bil­i­ties is out­lawed in Pak­istan.

Pro­hi­bi­tion is a quick so­lu­tion to quell di­ver­gence or any­thing re­motely prob­lem­atic. How­ever, the ab­sur­dity of this ap­proach is all too ap­par­ent when the same for­mula that is ap­plied to cur­tail­ing porno­graphic ma­te­rial is also ap­plied to life-sav­ing drops.

Pak­istan’s fail­ure to find ways to cope with dis­sent and con­tro­versy have given birth to a cul­ture of ban­ning that begs a re­think. How long can ex­clu­sion and eva­sion be the knee-jerk re­sponse to a de­bate? Is it vi­able to al­low crit­i­cal mat­ters of pub­lic health to be held cap­tive to the pol­i­tics of dis­trust and oth­er­ness?

This is the larger ques­tion that the govern­ment needs to ad­dress. When ef­forts to root out polio among our chil­dren can be sub­jected to bans, which crit­i­cal as­pect of health­care or na­tional wel­fare could be banned next?

The govern­ment can only es­tab­lish its le­git­i­macy by re­mov­ing all need­less bans that threaten the well-be­ing of our people.

Newspapers in English

Newspapers from Pakistan

© PressReader. All rights reserved.