Panic and mistrust threaten push to wipe out polio
Burning of clinic is latest setback in Pakistan where mullahs stir up conspiracy theories against aid workers
The one-storey health clinic in Masho Khel had for more than three decades cared for the sickly children, expectant mothers and ailing elders who turned up at its gate each day. In a village of few amenities, the residents had at least been sure of basic care from the blue-and-white building.
That role in generations of village life was not enough, however, to save it from a mob of 350 people one day last month.
The clinic’s crime had been to be a base for local vaccination workers and a neighbourhood symbol of Pakistan’s part in the worldwide campaign to eradicate the crippling polio virus.
Enraged by false reports on social media that polio drops had made their children ill, the mob ransacked and then burnt the centre, leaving only a derelict shell.
The attack on April 22 came as long-festering suspicions and propaganda about the worldwide vaccination campaign boiled over across northern Pakistan in a heady mix of fear and wildfire rumour.
By the end of the day, 25,000 children had been checked into hospital in Peshawar alone by frantic parents wrongly convinced their children had been poisoned by polio drops. Amid the panic, the long-running campaign was temporarily suspended to protect staff.
The hysteria marked a worrying setback for a movement that had been on the cusp of eradicating what was once a worldwide scourge. Pakistan, Afghanistan and Nigeria are the only countries left harbouring the virus after a 30-year global push that had caused cases to fall from 350,000 in 1988 to 33 last year.
Yet after years of declining cases, the number increased last year and monitors admitted the final global push for eradication appeared to have stalled. The 13 cases detected in Pakistan this year have already
surpassed last year’s tally. Moreover, several polio workers have been shot dead in recent weeks.
Polio drops are safe and effective, the World Health Organisation says. Yet the scale of last month’s panic highlighted how divisive the programme remains to some, despite years of public education, and also how it continues to be used as a focus of extremist propaganda.
Anti-vaccine disinformation on social media has made the situation worse, officials say. They are particularly worried about how the suspicion appears to have spread from the illiterate rural poor to grip middle-class families.
“The mistrust in one segment of society, that refuses vaccinations due to religious beliefs, is translating into the rest of the country, which is something not seen in the past,” Babar Atta, the government’s senior coordinator in the drive against polio, has said.
Masho Khel, a short drive from Peshawar, had long had a small, but hard core of parents who refused to accept polio drops. Pernicious rumours, spread by religious hardliners, that the drops are a Western conspiracy to sterilise children and cut the Muslim birth rate had taken hold stubbornly, as they have across Pakistan.
After years of frustration, health officials earlier this year decided to step up pressure on those refusing the drops. The result was a reprisal aimed at sabotaging the campaign, said Dr Syed Farooq Jamil, health secretary for Khyber Pakhtunkhwa province.
“In retaliation, they started this whole drama,” he said. The flashpoint was the Dar-ul-qalam primary school only a few hundred yards from the health clinic. Teachers at the private religious school had previously resisted vaccination. When told they had no choice, they reluctantly accepted.
But soon after pupils had been given drops, the school reported children were suffering an adverse reaction and vomiting or falling unconscious.
Mobile phone footage found later purportedly shows a man telling pupils to pretend to faint. As ambulances arrived at the school, panic began to spread through the village. Mullahs at the mosques began
‘The mistrust in one segment of society is translating into the rest of the country’
‘In retaliation [for being pressured to accept vaccination], they started this whole drama’
to call people on to the street and demand that they protest outside the clinic. As the mob gathered, the health workers were abused and fled for their lives under the protection of other villagers.
By now the scare had reached beyond the village. Scores of children had died, according to rumours. Parents who had had their children vaccinated began to worry if they too would fall sick. At Peshawar’s hospitals a stream of children started to arrive. Vaccinators going door-to-door that day found an increasingly hostile reception, and not just in backward villages.
Most vaccine refusals are simply due to poor education, Dr Jamil believes. But some religious groups are using it as a political tool to undermine trust in the government and to rally a support base. Mistrust of modernity and outsiders provides fertile ground for their conspiracy theories.
As in the West, these theories now often travel online. Pakistani officials this week asked Facebook to take down anti-vaccination propaganda.
The polio campaign is now on hold for the fasting month of Ramadan and organisers have breathing space to decide how to proceed. A new public information campaign is being prepared. Eradication remains within sight and Dr Jamil is confident the events of last month are only a hiccup. Villagers in Masho Khel regret torching their clinic, but still refuse to believe their children suffered no adverse reaction to the drops.
Dr Jamil’s staff, along with those across Pakistan, now face the task of rebuilding trust among people who remain deeply suspicious of the authorities.