PESHAWAR: Reluctance by vaccinators in Bannu district to take part in the immunisation campaigns due to non-payment for the previous 12 campaigns could pose a threat to the local children due to the arrival of thousands of unvaccinated children from North Waziristan Agency coupled with soaring trend of refusals against use of oral polio vaccine (OPV).

“The vaccinators have sent a letter to the executive district officer, health, Bannu on June 28, demanding immediate payment of their dues. In case of the government’s failure to accept their demand, they will not administer OPV to children,” officials at the Bannu DHO’s office told Dawn while quoting from the letter.

They said that the health workers wanted the government to pay them their dues for the past 12 anti-polio campaigns. The vaccinators had warned that in case otherwise it would be impossible for them to remain part of the vaccination efforts.

Arrival of unimmunised displaced children from Waziristan and soaring cases of refusal against use of OPV in Bannu could jeopardise polio eradication efforts.

Demand payment of dues for the past 12 campaigns

The officials fear that unwillingness by the health workers could snowball the situation into a major crisis because refusals against OPV have been increasing in the district and there is an urgent need for vaccination activities in view of the displacement of thousands of unvaccinated children due to military operation in North Waziristan Agency.

The letter signed by around 70 vaccinators also said that they had not been paid for the additional five days during which they covered refusals against OPV. “We also demand the government to postpone immunisation campaigns in Ramazan because it is difficult to carry out door-to-door campaigns in the scorching heat,” it said.

The vaccinators also asked the health department to ensure them payment of outstanding amount for the two-week anti-measles campaign in the district.

The health officials said that in the current year they had recorded 4,200 refusals during the three-day campaign from January 6-8, 4,463 from January 20-22, 5,883 from February 10-12, 6,076 from February 24-26, 8,238 from March 10-12, 9,611 from March 24-26, 8,589 from April 14-16, 8,767 from April 27-29, 9,344 from May 5-7, 11,005 from June 14-16 and 12,043 from June 23-25.

They said that Pakistan had detected 88 polio cases in 2014 so far, which included 66 from the Federally Administered Tribal Areas, 15 Khyber Pakhtunkhwa and seven Sindh. The main area of concern is unvaccinated children from North Waziristan Agency now living in Bannu, Dera Ismail Khan, Karak and Lakki Marwat.

North Waziristan has registered 55 cases, highest by any district/agency in the country. “We have found poliovirus from North Waziristan in four of the nine polio-infected children in Bannu,” said the officials, citing a report.

The provincial health department has been asked to consider the demands of the health workers as any break in vaccination could expose children not only in Bannu, but in all the southern districts. The displaced children who remained unvaccinated for the past 22 months due to Taliban ban on immunisation now live with local children requiring immediate vaccination.

Vaccinators are paid Rs500 a day and each of them works for four days in every campaign, said the officials.

Published in Dawn, July 11th, 2014