Yesterday, we got the tremendous news that after having lead the world in the number of polio cases as recently as 2009, the World Health Organization announced that there have been zero polio cases in India for three consecutive years. In today’s Express Tribune, we see a discussion of whether and how Pakistan can now rise to the challenge of polio eradication. In the article, we learn that the US drone killing of Pakistan Taliban leader Hakimullah Mehsud not only disrupted the developing plans for peace talks between the Taliban and Pakistan’s government, but it also affected polio vaccinations in North and South Waziristan:
According to the State Minister for National Health Services, Regulations and Coordination Saira Afzal Tarrar, NWA and South Waziristan did not receive any immunisation in months, contrary to former North Waziristan Agency (NWA) surgeon Jan Mir Khan, who was part of recent polio efforts. “After the drone strike that killed Hakimullah, it all stopped. Not just the peace talks, but also our efforts,” she says.
The terrible impact of the CIA’s vaccination ruse employing Dr. Shakeel Afridi in the search for Osama bin Laden has been extensively documented here, but this is the first time I have seen a suggestion that backlash to a drone strike directly resulted in polio vaccines being denied to children. Tarrar is not ready to give up, however, and believes that Pakistan and the Taliban will eventually come to an agreement that will allow vaccinations to resume:
Saira Tarrar also emphasised that the people of the area need to be part of the solution. “Parents are now sick of the ban; this pressurises the Taliban.”
“There is an accessibility problem in Fata, but by 2014, we will get a bargain and get some access.” And access is key, as far as Elias Durray, the head of Polio Eradication at the World Health Organization in Pakistan is concerned. “Immunisation prevents circulation. The virus won’t vanish on its own.”
Let us hope that Pakistan can achieve full vaccine coverage and have polio disappear as quickly in Pakistan as it did in India. Of course, this will require the US actually letting peace negotiations between the Taliban and Pakistan come to fruition, so success is far from guaranteed.
While much attention is appropriately focused on the horrific and brutal attacks by Pakistan’s Taliban on secular political parties as the country approaches elections in its first-ever transition from one civilian government to another, we have news today of a sad triumph by the Taliban as a child in North Waziristan has been diagnosed with polio after the Taliban successfully shut down polio immunizations there last summer.
Health workers are on the cusp of making polio the second disease after smallpox to be completely eradicated from the planet. The latest plan forecasts eradication by 2018, but a huge barrier is that conservative Islamic groups view Western vaccination programs as attempts to sterilize Muslims. In addition, the participation by Dr. Shakeel Afridi in a bogus vaccination program set up by the CIA to obtain DNA samples from Osama bin Laden’s compound added fresh fuel to the belief that vaccination programs also are used to spy on Muslims. Just under a month ago, a policeman protecting workers administering polio vaccine was shot and killed:
The latest attack took place in the afternoon in the Par Hoti neighborhood of the Mardan district in Khyber-Pakhtunkhwa Province. The policemen, Raj Wali and Mohammad Ishfaq, were accompanying two female workers on the second day of a three-day anti-polio drive, said Wajid Ali, a local police official.
The policemen were standing guard in the street as the health workers administered drops inside a house when an unidentified gunman, who appeared to be in his early 20s, walked up to them and opened fire. Mr. Wali was killed and Mr. Ishfaq was wounded, Mr. Ali said in a telephone interview. The gunman escaped.
That killing followed the deaths of eight vaccine workers last December and the violence has led to a significant interruption in the distribution of the vaccine:
In December, at least eight people engaged in polio vaccinations were shot dead in Karachi and the north-west, and in January and February two police officers were killed in similar attacks.
The UN said last month that some 240,000 children have missed vaccinations since July in parts of Pakistan’s tribal region, the main sanctuary for Islamic militants, because of security concerns.
And it is from the tribal area of Waziristan where we have today’s sad news of a child being diagnosed with polio:
A child has contracted polio for the first time in Pakistan’s militant-infested tribal belt since the Taliban banned vaccinations a year ago, a UN official said Monday.
“The new case has been detected in North Waziristan where we had been denied access in June last year,” the World Health Organization’s (WHO) senior coordinator for polio eradication in Pakistan, Elias Durry, told AFP.
Durry fears that this case is not likely to be isolated:
“We are worried because this new case comes as an example of a bigger impending outbreak of disease in the region,” the WHO official said.
In addition to making vaccination drives shorter and lower profile while working closely with security, the executive summary (pdf) for the new polio eradication plan has a key step of outreach to religious groups:
4. Religious leaders’ advocacy: markedly step up advocacy by international, national and local Islamic leaders to build ownership and solidarity for polio eradication across the Islamic world, including for the protection ofchildren against polio, the sanctity of health workers and the neutrality of health services.
Unfortunately, I don’t see an open call in the plan for bringing about an end to intelligence agencies undertaking new vaccination ruses, although “the neutrality of health services” would seem to touch on it. Meanwhile, Afridi has started a hunger strike in a desperate attempt to keep his name in the headlines.
The day before the fateful attack in Benghazi that killed four Americans and gave the Republicans Mitt’s desired “Jimmy Carter moment“, Fox News published an interview purported to be with Dr. Shakil Afridi, who helped the CIA in its quest to locate Osama bin Laden by carrying out a bogus “immunization” program aimed at collecting DNA. At the time, it was entirely unclear whether the interview was genuine. Now, however, there is no doubt that the interview was real. In response to his actions, authorities at Peshawar’s Central Jail have beaten and tortured Afridi and put him into more restrictive solitary confinement with no family or attorney visits allowed. In response, Afridi has started a hunger strike in an apparent attempt to bring attention to his plight and to get back the amenities which were taken away from him.
Reuters gives us the bare bones of the solitary confinement and hunger strike:
The Pakistani doctor who helped the U.S. Central Intelligence Agency (CIA) hunt down Osama bin Laden started a hunger strike in his jail cell this week to protest against his living conditions, prison officials said on Thursday.
Prison officials in the northwestern city of Peshawar said they are keeping Afridi in solitary confinement and will not allow him to have visitors nor speak to anyone by telephone as punishment for a media interview he gave in September.
“After the interview in which Dr. Shakil Afridi levelled serious allegations against the country’s top spy agency, the prison authorities barred his family members and lawyers from meeting him,” said a prison official, who asked not to be identified because he was not authorized to speak to the media.
“In protest, Dr. Shakil has begun a hunger strike for an indefinite period.”
The “prison official, who asked not to be identified because he was not authorized to speak to the media” appears to have no appreciation of the irony of his making an unauthorized statement to the media describing Afridi’s punishment for making an unauthorized statement to the media.
It appears that Afridi made more telephone calls than just the one in which Fox News interviewed him:
An investigation following the September interview found that Afridi had bribed guards to use their cell phones to speak to journalists, family and friends, making a total of 58 calls, prison officials said. Six prison guards have been suspended.
As one of only three countries in the world where polio is still endemic, Pakistan launched a three day vaccination drive yesterday with a target of vaccinating the 318,000 children in North and South Waziristan who have not received their vaccinations. Across all of Pakistan, the goal is to vaccinate 34 million children under the age of five. The drive is being held despite a push by the Taliban to prevent vaccinations in tribal areas. The Taliban’s ban on vaccinations is aimed at stopping US drone strikes in the tribal areas and is in response to the vaccination ruse by the CIA. Dr. Shakeel Afridi pretended to be doling out hepatitis vaccines in a failed attempt to retrieve DNA samples for the CIA from the bin Laden compound when it was under surveillance prior to the attack that killed Osama bin Laden. Today, a UN doctor and his driver were wounded when a shooter opened fire on them in Karachi. The doctor was reported to be working on the vaccine program.
Dawn reported yesterday that a jirga was convened today in the tribal areas to try to find a solution to the Taliban’s vaccine ban. That article gives good background information on the ban:
Although a nationwide anti-polio campaign was launched on Monday, the authorities were yet to convince the Taliban shura on the importance of getting children of North and South Waziristan vaccinated against the debilitating disease.
Commander Hafiz Gul Bahadur, who leads the powerful Taliban Shura, had banned the anti-polio drive in North Waziristan on June 16 and said that children would not take polio drops unless the government stopped drone strikes in the area.
He was followed by Commander Mullah Nazir in South Waziristan and other militant commanders in FRs D.I. Khan and Kohat.
In South Waziristan, the ban is much stricter because it prohibits vaccination against all eight childhood diseases, including polio.
“We have asked health workers to be careful and don’t put their lives at risk,” the official said, adding that they were waiting for the government’s response.
However, the Taliban ban is not the only barrier to vaccines:
He [the official quoted above] said the military operation in Orakzai and Khyber agencies was one of the factors which deprived children of the much needed vaccines.
Just the two tribal agencies of North and South Waziristan account for a large number of unvaccinated children: Continue reading