Gadap is Karachi’s largest town, area-wise, occupying around two-thirds of the entire city. Parts of the terrain tend to resemble Afghanistan or Pakistan’s Federally Administered Tribal Areas (Fata), and a considerable number of Pashto speakers inhabit parts of the town.

Yet geographical and cultural similarities are not the only common denominators between this part of Karachi and Afghanistan and Fata. Like the latter two, Gadap is also one of the last major battlegrounds as far as the fight against polio is concerned.

Know more: Karachi’s 6pc areas contribute all polio cases

“Poliovirus is a small but a great ally of the militants,” said Ali Murad, a local volunteer, during a visit to Machhar Colony.

Gadap has contributed 10 of the 22 cases in Karachi and 25 cases overall in Sindh. The government and global healthcare regulators are particularly keeping an eye on the town, considering it as the ultimate place that holds the key to the total eradication of the crippling disease.

Pakistan which has reported 246 polio cases thus far this year — a 15-year high for the country — is currently busy trying to curb militancy in North Waziristan Agency through a military operation. It was in this agency that the outlawed Tehreek-i-Taliban Pakistan (TTP) had banned polio vaccination in June 2012. The fact that more than 150 cases were reported from Fata prompted the World Health Organisation’s (WHO) latest statement blaming Pakistan for exporting polio to Afghanistan.

The military operation has resulted in hundreds of thousands of Internally Displaced Persons (IDPs), who have gone as far afield as Karachi carrying thousands of unvaccinated children with them, and settled mostly in the Gadap and Baldia areas of the city where their kinsmen were already residing.

As the Sindh government frequently blames IDPs for the city’s highest yearly polio figures since 1999, it has zeroed in on 11 union councils (UCs) falling in eight out of the city’s 18 towns with around 250,000 children aged less than five years to root out polio. All 22 cases this year have been restricted to these 11 UCs out of 188 UCs in Karachi.

“Eradicating polio from Karachi has great significance,” said Dr Khalid Shaikh, Special Secretary in the Sindh Health Department. “It is an international city” and eliminating polio from the metropolis would send a positive message to the world, he observed.

‘Polio amplifier’

“Karachi serves as an amplifier, exporting wild poliovirus nationally and globally,” says a recent WHO data sheet. It adds that Karachi has the biggest Pashto-speaking population globally: five million people in 47 out of 188 UCs of the city.

“Has anyone noticed why polio does not affect militants?” asked Murad, who helped Dawn get access to neighbourhoods generally regarded as no-go areas for non-Pakhtuns. He answers his own question: “I know many of them [militants] who have vaccinated their children against polio here or in Fata.”

While a large portion of Gadap’s residents still depend on agriculture, many of the town’s villages and slums do not have water supply, electricity or gas even though all water conduits supplying water to Karachi from the Indus and Hub sources and pipelines bringing natural gas crisscross the town, while high-tension electricity wires that link the metropolis with the national grid pass through it. The Superhighway, which connects the city with upcountry areas, passes through Gadap but even in this age, it takes hours for residents in remote villages to travel across the town because of battered roads.

Dozens of water parks, resorts and farmhouses have been built in Gadap for the privileged, but the state of education and healthcare infrastructure in the town is dismal.

Visiting the town, one could see children playing in sewers and foraging through garbage. Murad pointed to a young child with fair complexion, striking European features and deep-blue eyes who moved slowly on crutches. “His family has lately arrived from North Waziristan. There are a few more like him.”

Determined volunteers

Five out of 10 cases in Gadap have been reported from UC-4, in which Machhar Colony also falls. Shumaila, 24, who was among 30 volunteers who had cheated death in an attack by six militants in Gadap’s Noor Mohammad Brohi Goth in August last year, said the incident failed to deter her.

“After all,” she smiled wryly, “I am also Pakhtun, not that easy to crack.”

She is among scores of Pakhtun women and teenagers who risk their lives to immunise children in the area against polio.

“They threaten us time and again of ‘consequences’ even though we have repeatedly shown them fatwas issued by religious scholars supporting polio immunisation. But that helps little,” said Shumaila.

An official in Sindh’s Expanded Programme on Immunisation (EPI) raised an interesting question that echoed Murad’s observation. “I wonder why the Taliban oppose polio vaccine here, while the Taliban in Afghanistan help volunteers save their children?”

Most people blame both Mullah Fazlullah of Swat, who now heads the TTP, and the American CIA for damage done to the anti-polio campaign; the former in his infamous radio sermons demonised polio vaccine as an American tool for causing sterility among Muslims, and the latter for engineering a fake polio drive to seek to collect Osama bin Laden’s DNA in its campaign to hunt down the now dead Al Qaeda chief.

“They [the militants] know the vaccine is not harmful, but they now consider every volunteer a spy,” said a senior official in the provincial health ministry who spent years in Gadap to oversee previous polio campaigns.

Published in Dawn, November 18th , 2014