How social media nearly stalled polio campaign
As health workers picked their way through the grimy lanes of one of Karachi’s poorest slums, the virtual world of social media would appear to pose little threat to their work. Five years ago, distributing vaccines door-to-door meant defying the real threat of motorbike-riding Taliban militants who would gun them down.
That has thankfully receded, but this year the campaign to wipe a crippling viral disease from one of its last haunts has instead had to confront a very 21st century challenge.
Community workers now worry that when they knock on a door, there is a chance the parents will refuse their child a life-saving jab because a bogus video shared online claims the drops are deadly.
Last week a network of 250,000 workers accompanied by tens of thousands of police swung into action across Pakistan, as it does every month in a regular five-day vaccination drive.
Pakistan’s struggle with social media comes as a decades-long battle to eradicate polio globally moves towards its endgame.
If successful, it will be only the second disease in human history to have been wiped out – the first was smallpox, which was declared eradicated in 1980, three years after the final recorded case.
Such is the power of social media that a video falsely claiming polio drops killed 16 children in March led to a spike of parents refusing the jab.
“Cell phones are so cheap now and they all use Facebook, Whatsapp and so on. People can sit at home, make their own video, and put it out and it goes viral,” explained Zakir Khan, a 29-year-old communications official working on the campaign in the Mustafabad neighbourhood.
“People would show us videos as soon as we enter the house and say ‘because of your vaccines, 16 people have died. Why are you coming?’”
May’s campaign saw the number of refusals in Karachi double to 70,000, with the fake video to blame. The damage was done by a simple phone clip shot in Nawabshah. The city had just seen three children die after a string of alleged medical blunders by a health worker trying to give them a measles vaccine.
But the man filming the mourning crowds instead blamed polio and said 16 children had died. Within days the clip had spread faster than any disease.
“We tried to tell people whatever social media says is not necessarily true,” said Seema Adel, a 21-year-old supervisor who with 42 colleagues is trying to vaccinate 8,900 children in Hijrat colony. “We had some serious refusals in my areas because of that video. Around 45 kids were refused because of that film.”
Days and sometimes weeks of patient persuasion eventually changed the minds of many and early signs suggested that the harmful video had begun to lose some of its power.
But misconceptions remain one of the campaign’s largest problems, said Fayaz Ahmed Jatoi, who coordinates the programme for Sindh province.
“Social media is one big phantom which we have never been able to be on top of,” he explained. Officials have considered using police cyber crime powers to rein in the viral media.
Mr Jatoi said: “This is a continuous challenge for the programme because we cannot trace their origins and we cannot fix the responsibility on people who spread this disinformation.”
Pakistan’s authorities are not the only ones grappling with the issue. Last week Indian authorities asked Whatsapp to stop a spate of village mob lynchings that had been inflamed by falsehoods on the platform.
Whatsapp offered a $50,000 (£37,800) reward to anyone who could help stop the spread of fake news on its platform following the lynchings. Meanwhile, the polio virus has been all but wiped out worldwide and remains only in Pakistan, Nigeria and Afghanistan. Those three countries have seen only 11 cases so far in 2018, compared to 22 last year. That marks an incredible fall from the 350,000 annual cases when the eradication drive began in 1988. Afghanistan and Pakistan are the likely setting of polio’s last stand.
Pakistan itself has made strides after seeing 306 polio cases as recently as 2014, when health workers faced a bloody Taliban campaign claiming vaccination was a Western plot to sterilise Muslim children. Suspicion was heightened by gossip that the vaccination campaign was actually a CIA plot to gather DNA samples in the hunt for Osama bin Laden.
Between 2012 and 2014 around 100 vaccinators and police are thought to have been killed on polio duty.
In 2015, Pakistan set up emergency operation centres and recruited only local women to be vaccinators.
With this new workforce accepted and trusted, much suspicion vanished. Each worker carries a book of decrees from senior clerics endorsing the campaign, which has greatly reduced religious objections.
Army efforts to clear the Taliban from the border regions have also given health workers access to areas they had not previously reached. Attacks on workers have declined, but they still occur. A mother and her daughter administering vaccinations in the south-western city of Quetta were shot dead in January.
The programme has other problems. To ensure the virus is completely wiped out, children under five are given monthly top-ups, leading to growing parental fatigue on the doorstep. The scale of the operation is vast. In Karachi alone 23,000 health workers are trying to vaccinate
2.4 million children in five days. But despite the obstacles, the vaccination rate hovers close to the 95 per cent level thought to be necessary to consign the disease to history.
“The country is making progress,” said Mr Jatoi. “We have the minimum number of human cases in the history of polio. But we know we have a continuous challenge – so we know we need to stay focused.”
‘People would show us videos and say because of your vaccines, 16 people have died. Why are you coming? ’