KARACHI: High-rises pose problems for anti-polio drive
By Zofeen T. Ebrahim
KARACHI, April 6: “After climbing several flights of stairs, sometimes our teams may be told brusquely that the child is asleep and they should come later,” says Seemi Fatema, one of many health workers in this city charged with administering polio vaccine drops to children under five.
Fatema, who has been with the anti-polio campaign since 1995 and monitors the house-to-house drive, often has to be physically present to support her team in convincing parents to get their children immunised. It is this indifferent attitude of “difficult” parents, she says, that is holding up eradication.
Gulshan Town, where she works, has a target population of 1.6 million under-fives. The target population in the whole of Karachi is 2.24 million children.
Manning each four-day polio campaign in Karachi are 5,053 teams, out of which 411 teams are combing Gulshan alone. Each worker is paid a meagre Rs150 per day. “And this amount was raised from Rs100 only this January,” says Syed Zohair Hasnain, 18, who has been with the campaign for the past three years.
The door-to-door drive to administer oral polio vaccine to children is part of the Health Ministry’s Expanded Programme on Immunisation. Pakistan’s Polio Eradication Initiative was launched in 1994 in collaboration with the Global Polio Eradication Initiative, begun six years earlier to that.
Employing a battalion of 60,000 field workers across Pakistan and targeting 6.5 million children, coverage remains unsatisfactory. Pakistan still remains on a list of four countries still battling the crippling paediatric disease, along with Afghanistan, India and Nigeria.
For workers like Hasnain and Fatema, each four-day campaign may extend to a total of six days. “We have to go back to those homes where children were missed. It is all the more gruelling because the town has over 4,000 high-rises (four floors and above).
“I’d say almost half of the high-rises in Karachi are located in Gulshan Town,” says Dr Shabbir Ahmed, district support officer, employed by the United Nations Children’s Fund (Unicef).
Climbing up steep stairs is not the only worry. “Porters may refuse to let us inside a building. Getting inside individual homes is another task. Many homemakers refuse to let us in saying their men are not around,” says Fatema.
Sometimes teams wait for over an hour before they are let in as many homemakers go back to bed after their husbands leave for work and do not want to be disturbed or wake their children.
For these reasons the teams have requested the government to reschedule the campaigns in such a manner as to cover the weekends and also change visit timings to afternoons and evenings. “Weekends would mean men would also be around and in the afternoons children would be home from schools,” said a worker.
Superstitions and customs abound. Some people will not allow strangers to cast eyes on a newborn until after it is 40 days old, following ancient ‘evil eye’ beliefs.
A majority of the workers are males, which makes it difficult for teams to enter a home. Some are not very well educated and lack interpersonal skills.
In March, during the latest round of National Immunisation Days, the area recorded 3,000 refusals. “We were refused for various reasons. While some are missed due to negligence of parents, increasingly negative propaganda against the polio vaccine is hampering our efforts. Most refusals are on religious grounds, with some people believing that the vaccine is made from pig fat. Others fear it causes infertility. Or that it comes from the United States,” says Unicef’s Ahmed.
Of late, some religious newspapers, published in Urdu, have begun campaigning against the polio drive, as have some of the 100-odd madressas in the area, said Ahmed. “But the government remains indifferent.” —Dawn/IPS
