Pak­istan’s army of­fen­sive gives po­lio fight a boost

Se­cu­rity im­proves as Is­lamist mil­i­tants flee tribal ar­eas, al­low­ing vac­ci­na­tion work­ers to reach more peo­ple.

Los Angeles Times - - THE WORLD - By Zul­fiqar Ali and Shashank Ben­gali shashank.ben­gali @la­times.com Twit­ter: @SBen­gali Spe­cial cor­re­spon­dent Ali re­ported from Pe­shawar and Times staff writer Ben­gali from Mumbai, In­dia.

PE­SHAWAR, Pak­istan — The Pak­istani army’s nearly year­long cam­paign against Is­lamist mil­i­tants in the north­ern tribal belt has its skep­tics, but one area where ex­perts say its ef­fect has been un­mis­tak­able is in bat­tling po­lio.

Six cases have been re­ported this year in the Fed­er­ally Ad­min­is­tered Tribal Ar­eas, down from 56 in the same pe­riod last year. In Oc­to­ber, a quar­ter-mil­lion chil­dren could not be reached by vac­ci­na­tion teams; the num­ber dropped to 47,000 by May.

Health au­thor­i­ties and re­lief of­fi­cials credit im­proved se­cu­rity in the tribal ar­eas since an army of­fen­sive against the Pak­istani Tal­iban, which op­poses po­lio vac­ci­na­tions be­cause it al­leges they are a cover for West­ern es­pi­onage. In past years, mil­i­tants rou­tinely at­tacked health work­ers car­ry­ing out vac­ci­na­tion drives, along with their se­cu­rity teams, killing dozens.

The army pro­vided ad­vance warn­ing of the of­fen­sive, which be­gan last June, al­low­ing res­i­dents as well as mil­i­tants time to f lee the tribal belt. As peo­ple have re­turned to towns and vil­lages cleared by army op­er­a­tions, vac­ci­na­tion teams have re­sumed their work with greater ac­cess to ar­eas once seen as off-lim­its.

“Pak­istan has done re­mark­ably well this year be­cause the ar­eas are now be­ing cleared of mil­i­tants and ac­ces­si­bil­ity has be­come eas­ier,” said Aziz Me­mon, chair­man of Ro­tary In­ter­na­tional’s Po­lioPlus pro­gram in Pak­istan.

“There are ar­eas that are still not within reach, where fight­ing is go­ing on, where we hope to get to sooner or later,” Me­mon said. “But the qual­ity of the cam­paign has im­proved.”

A May re­port by the In­de­pen­dent Mon­i­tor­ing Board, which tracks progress in the Global Po­lio Erad­i­ca­tion Ini­tia­tive and had sharply crit­i­cized Pak­istan in the past, cited “a pos­i­tive dif­fer­ence” in the coun­try’s anti-po­lio ef­forts.

Pak­istan is one of only three coun­tries, along with Nige­ria and Afghanistan, where po­lio re­mains en­demic. Of the 24 cases re­ported this year, all but one have been in Pak­istan, ac­cord­ing to the Global Po­lio Erad­i­ca­tion Ini­tia­tive.

Although most of the coun­try is free of the deadly vi­ral dis­ease, which mostly af­fects chil­dren, it has been dif­fi­cult to erad­i­cate in sev- eral pock­ets, in­clud­ing the lightly gov­erned tribal belt, the neigh­bor­ing prov­ince of Khy­ber Pakhtunkhwa and the sea­side me­trop­o­lis of Karachi. The tribal belt had more than half of the 307 po­lio cases Pak­istan recorded in 2014.

U.S. of­fi­cials, who urged the Pak­istani mil­i­tary for years to take stronger ac­tion against mil­i­tants based on its soil, have of­fered qual­i­fied praise for the of­fen­sive, dubbed Zarb-eAzb, the name of a sword said to have been used by the prophet Muham­mad.

Although Pak­istani mil­i­tary lead­ers say they have killed hun­dreds of fighters, the claims have been dif­fi­cult to ver­ify be­cause the tribal re­gion is all but of­flim­its to jour­nal­ists, and many ex­perts be­lieve se­nior mil­i­tants f led be­fore the fight­ing.

In neigh­bor­ing Afghanistan, of­fi­cials at­tribute a rise in vi­o­lence over the last year in part to mil­i­tants who crossed over from Pak­istan.

The of­fen­sive fo­cused largely on the North Waziris­tan tribal area, home to sev­eral mil­i­tant groups in­clud­ing a Pak­istani Tal­iban fac­tion led by Hafiz Gul Ba­hadur, who banned the po­lio vac­cine in June 2012 and said he would al­low it only af­ter the United States ceased drone strikes.

More than 1 mil­lion Pak­ista­nis f led their homes in North Waziris­tan and other mil­i­tant-con­trolled ar­eas, many tak­ing shel­ter in dis­place­ment camps in Khy­ber Pakhtunkhwa. There, for the first time, health work­ers could reach fam­i­lies that had been in­ac­ces­si­ble.

As a re­sult, 86% of the tribal ar­eas are now cov­ered by the vac­cine, up from 47%, ac­cord­ing to health of­fi­cials.

Yet in­ter­na­tional of­fi­cials say se­ri­ous chal­lenges re­main. Many mil­i­tants have moved from the tribal ar­eas to Karachi, and although the most re­cent case there was re­ported in Sep- tem­ber, the in­ter­nal migration has in­creased fear that the virus could spread through the city of more than 20 mil­lion and to other parts of Pak­istan.

The In­de­pen­dent Mon­i­tor­ing Board has also crit­i­cized Pak­istan for prob­lems pay­ing salaries to its front­line health work­ers, whose morale has suf­fered be­cause of the vi­o­lence and ad­min­is­tra­tive ne­glect. A prime min­is­te­rial task force that was due to meet quar­terly to di­rect erad­i­ca­tion ef­forts has not con­vened in nine months.

“We need the top lead­er­ship to take the own­er­ship,” Me­mon said. “The re­sults are good, but the work is not yet done.”

K.M. Chaudary As­so­ci­ated Press

A HEALTH WORKER gives a po­lio vac­cine to a child in the eastern Pak­istani city of La­hore. In the north­ern tribal ar­eas, only six po­lio cases have been re­ported this year, com­pared with 56 in the same pe­riod a year ago.

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