KARACHI: The provincial authorities are perturbed over a high number of refusals during anti-polio campaigns despite all-out efforts to raise awareness regarding vaccination, it emerged on Wednesday.

“Number of refusals remains high despite all efforts; yet we are doing our best to stem this stubborn obstacle,” said an official report submitted to the government by the authorities tasked with keeping Sindh free of the crippling disease.

Around 9,000 children in Karachi and over 4,000 in other parts of Sindh were either not found at home or school or whose parents refused to let their wards be inoculated against polio, official figures show.

In the early months of last year, the number of such children was around 2,000 in the city and over 2,000 in other districts of the province. But the number of such cases increased to around 12,000 in Karachi and more than 7,000 in other districts of Sindh in August. Their number declined to around 15,000 in December and further dropped to 13,000 in the past five months.

Around 13,000 children missed in Sindh over past five months

The official figures show the number of refusals by parents is quite high in Karachi while other districts of Sindh show an overwhelming majority of those children whom the teams could not locate at homes, schools or elsewhere. This could be because of the nomadic populations who remained on the move, thus denying, unwillingly though, their children a chance of being inoculated against the crippling disease, officials believed.

At present, the officials said, almost half of around 9,000 children who had been missed during the past campaigns were those whose parents or guardians had refused. In the rest of Sindh, such parents were less than a couple of hundred.

It is learnt that such situation persisted at a time when the international community is still considering Karachi a ‘ticking time bomb’ vis-a-vis its potential for polio outbreak because of various reasons.

“All this is happening when the government is in the driving seat by continuing strong oversight and accountability through the city administration and the law enforcement agencies are maximally supportive,” said a senior official.

He said sustained strong performance in areas with community-based vaccination and performance in mobile team areas was highly variable. “Number of refusals remains high,” admitted the official. However, he added, mostly refusals were not clustered but scattered.

In this regard, human resource issues were described as the key obstacles, as some junior officials were looking after eight of the 18 towns of Karachi; the poorly performing staff could not be replaced while many medical officer positions remained vacant, officials said.

The officials further claimed that the health facilities managed by the Karachi Metropolitan Corporation were reluctant to participate in polio and EPI activities.

Regarding the situation in the rest of Sindh, the officials said most districts in northern Sindh sustained their good performance, but the lower parts of Sindh made some improvement since the detection of the first case in September. Although proportion of female workers was steadily increasing, it remained a challenge, they said. Besides, the officials highlighted the need for the introduction of special mobile teams in the coastal belt and other remote areas of Sindh.

Published in Dawn, June 1st, 2017