During another week of extreme violence in Pakistan where bloody images of mutilated civilians, soldiers and militants dominate the media, one image stood out for me. It was of a man in a smart grey suit administering a polio vaccine drop to a baby. A fairly routine procedure you might think until you look beyond the photograph and learn that this simple act now carries a risk.
The man is politician Imran Khan, PTI (Pakistan Tehreek -e- Insaf) leading by example, an action that could save the lives of children at a time when polio vaccination workers such as Fehmida Shah (44) are being gunned down in Karachi by men on motorbikes http://uk.reuters.com/article/2012/12/23/uk-pakistan-polio-idUKBRE8BM00S20121223
The polio campaign has become another battleground with the Taliban who succeeded in putting a halt to the programme at one point declaring no vaccinations unless US drone strikes were ended in the tribal regions of Waziristan. It is still unclear though who is behind the latest shootings. Not long ago I received an indication that this important work could continue without interference and some media are reporting a TTP denial regarding this week’s murders.
I also condemn the use of drones to target kill which has obliterated families in the Tribal Areas but attacking a vaccination programme only harms more children.
Problems arose around vaccination programmes when the CIA took an extraordinary and unethical decision to launch a “fake” hepatitis vaccination programme. They acquired the services of Dr Shakil Afridi to access Osama Bin Laden’s compound using the programme as a cover and gather evidence that he was in residence. An act which would end in Bin Laden’s assassination by American navy seals and destroy trust in a vital health initiative http://www.gq.com/news-politics/newsmakers/201301/doctor-cia-blood-of-bin-laden-january-2013
There is also concern from some quarters that vaccines could lead to sterilization. It is easy to dismiss these concerns without addressing them but some community leaders point to a history of western pharmaceutical companies using those in the developing world as guinea pigs for medical research. That is a fact…it has happened on occasions. However in the case of the polio vaccine this has been widely used for many years now with a good safety record and eradicated the crippling disease of polio in some areas.
The United Nations have now estimated that 3.5 million children have missed out on the vaccine this week. Those unable to receive the polio drops could suffer from nerve damage, muscle wasting, paralysis of the arms and legs and breathing difficulties which could lead to death http://dawn.com/2012/12/21/more-than-3-5-million-pakistani-children-miss-polio-vaccine-who/
The polio issue has wider political implications too as highlighted by Tribal Area journalist Rasool Dawar. He drew my attention to the fact that Frontier Crimes Regulations (FCR) North Waziristan Agency political administration “has suspended all perks and privilege of Othmanzai Dawar and Wazir tribes for not cooperating with the authorities in the anti-polio drive in their areas” http://en.wikipedia.org/wiki/Frontier_Crimes_Regulations
Rasool feels this is very unfair. He points to the fact that “Political Agent Siraj Ahmed on Monday issued directives to heads of all government departments including Nadra, passport and Tehsildar office to stop issuing passports, national identity cards and domiciles certificates to members of Wazir and Dawar — two major tribes of North Waziristan”.
Rasool asserts that the ban on the polio campaign in the tribal agency was imposed by Hafiz Gul Bahadar group of Taliban and Maulvi Nazir group not by Othmanzai Dawar and Wazir tribes. He stated that “more children will die and health workers also trying to save children” and explained that “mostly local people of Waziristan are also not in favour of a ban on the polio campaign but people of waziristan are also not in any position to influence on local Taliban”.
Reuters reported last week that an “alliance of clerics” were to protest against the killings of polio workers and Tahir Ashrafi, who heads the moderate Ulema Council, said that “24,000 mosques associated with his organisation would preach against the killings of health workers during Friday prayers”. He also emphasised that “neither Pakistani customs nor Islam would allow or endorse this” adding that “far from doing something wrong, these girls are martyrs for Islam because they were doing a service to humanity and Islam.” http://uk.reuters.com/article/2012/12/20/uk-pakistan-polio-idUKBRE8BI08T20121220
As a nurse, I appeal to all sides to think. Polio does not discriminate, it can attack any child. Who is being punished here, it’s the children and health workers that are trying to protect communities from disease. Those who stop the programme may inadvertently harm their own children by doing so, could they live with that knowledge if their beautiful child could no longer walk or breathe freely! There are already reports of deaths.
As someone trained in health education it is my moral duty to consider the arguments for and against any health care intervention or treatment. When I qualified, I made an ethical commitment to present health information as honestly as possible. Local health workers are there in Pakistan to answer any concerns that might arise. I have had the polio vaccine myself as have my sister and son and have come to the conclusion that the benefits far outweigh the risks.
To conclude with the words of my sister in humanity, Amina Masood Janua, “death is dancing in every nook and corner of Pakistan. From drones in tribal areas to target killings in Karachi, everything signifies utter failure and lack of ability of the present government and all its departments.”
What is needed now is to ensure that alongside Imran Khan, other key figures take positive steps and support the country’s health workers to deliver their polio vaccines and help save lives.
Carol Anne Grayson is a qualified nurse and Executive Producer of the Oscar nominated, Incident in New Baghdad. She has been awarded the ESRC, Michael Young Prize 2009, and the COTT ‘Action = Life’ Human Rights Award’ for “upholding truth and justice”.