Health officials told Ghulam Rasool, a mason from Bara tehsil of Khyber Agency, in March this year that his 18-month-old son had tested positive for polio and has been crippled for life by the virus. Angry over his decision to follow the ban that the Taliban had imposed on administering polio drops in the tribal areas, he cannot restrain himself from cursing the militants and their leaders.
“I accepted all their orders without any if and but [not knowing the consequences],” he says. “I was helpless against them.” His son was born in 2009 when the militancy was at its peak in Khyber Agency and the Taliban were so much in control that no one – neither the parents nor the health officials – could defy their orders and have the children vaccinated.
Ghulam Rasool is one of scores of parents across the non-descript towns and villages in the Federally Administered Tribal Areas (Fata) whose children have fallen victim to the ill-directed Taliban ban on polio vaccination, which had been termed as Western conspiracy to sterilise future generations of local Muslims. The trend in the number of children succumbing to the disease in fact reads like the story of the militancy’s ebb and rise in Fata, revealing an inexorable link between the rise in its incidence and the intensity of the Taliban’s control in the region. In 2010, of the 144 polio cases detected in Pakistan 95 were from Fata whereas of the 53 cases reported in the first six months of 2011, 18 have been reported from the tribal areas.
Swat is another region that categorically links an increase in polio cases to the rise in militancy but with a vastly different trend. The first polio case there was reported in 2007. Next year, the number went up to four and in 2009, when the militants were totally in control, Swat recorded 20 cases. Now that the Taliban have been driven out of the region and polio vaccination campaign has re-started in earnest after a hiatus of about two years, there has been only one polio case detected in Swat in 2010 and none so far in 2011.
That the situation in Fata is alarming seems like an understatement when seen in comparison to global statistics on polio. According to the World Health Organisation (WHO), only four countries – Nigeria, India, Afghanistan and Pakistan – are yet to be rid of the disease. But in the first five months of the ongoing year, only eight cases were reported from Nigeria and one each from India and Afghanistan. Put together, all these cases are four times less than the number of cases reported from Pakistan in the same time period.
Unfortunately, it looks likely that polio cases continue appearing in Fata because a large part of the region still remains inaccessible to the health officials, mainly because of the militancy. Officials say that they do not have access to 25 per cent (272,110 out of 1,086,682) children in Fata. Dr Jan Baz Afridi, deputy director of the vaccination programme in Khyber Pakhtunkhwa, provides an agency-wise breakdown (see table) which shows that in some agencies such as Khyber and Orakzai over 50 per cent of the children have missed out on vaccination campaigns.
Local government and other NGO officials cite a number of reasons for their inability to access these children in Fata — and all of these reasons are directly or indirectly linked to militancy. Take, for instance, Khyber Agency where many parts are virtual no-go areas for health staff since long and seven per cent children are inaccessible in villages that are under the militants’ control. Health officials are afraid of visiting such villages after four of their colleagues, including a doctor, were killed and four others abducted there in the last two years while administering polio drops.
Consequently, with the threat to life, there is also a fear factor that makes the health workers reluctant to join the ranks of vaccinators. Less than 500 vaccinators are available for entire Fata which means one vaccinator covers a big area spanning four square kilometres.
But perhaps the most important factor is the lack of local cooperation, again instigated by the Taliban. Misconceptions about the polio vaccines abound and parents refuse to give up their blind faith in the Taliban’s propaganda. In at least seven polio cases reported in 2011 from Fata, the refusal to administer vaccine had come from the parents. In all, 21,000 children have remained unvaccinated in Khyber Pakhtunkhwa and Fata owing to refusal by their parents.
Ten-month-old Mohammad Arif, son of Zulfiqar Shah of Hissara village in Khyber Agency’s Tirah Valley, is one of them. Going by his age, he should have received polio drops at least four times but did not get even a single dose because his parents had refused. In March this year when he tested positive for the polio virus, the militants never bothered to explain to his parents as to how the child had contracted the disease, let alone sympathise with them over an ailment that they hindered from being prevented and that has made Arif a handicapped person for life.