PESHAWAR: Khyber Pakhtunkhwa is set to launch an anti-polio campaign amid challenges of vaccination refusal, missed targets, fake finger marking, and lack of support by the district administrations and district health officers.

The province is home to around 7.3 million children of the countrywide 44m population aged below five, and is facing chronic challenges posed by non-vaccination of less than one per cent of the total target population, according to health officials.

They told Dawn that the province had reported no polio cases for a long time a few times, but the dream of eliminating the virus couldn’t be fulfilled due to its presence in sewage, which was causing the infection to those unvaccinated.

The officials said Pakistan had so far recorded 59 cases this year, including 26 from Balochistan, 16 from Khyber Pakhtunkhwa, 15 from Sindh and one each from Punjab and Islamabad.

Officials complain about vaccination refusal, missed targets, lack of admin support in districts

According to officials, Dera Ismail Khan, the native district of Khyber Pakhtunkhwa Chief Minister Ali Amin Gandapur and Governor Faisal Karim Kundi, is leading the list with eight polio cases, while two cases have been reported in Lakki Marwat, Kohat and Tank each and one in Mohmand and Nowshera each.

They said that the last polio campaign of the current year was going to begin from December 16 but there was no indication that it would be any different from the previous ones that saw parental refusal for children’s vaccination, while other children were bracketed as “missed” ones for being unavailable when health workers visited their homes.

“More than 110 persons, including vaccinators and policemen guarding them during door-to-door campaigns have lost their lives to the bullets fired by unidentified people since 2012 due to which fear gripped the health workers and agreed to fake finger marking,” an official said.

He said as per protocol, the health workers were required to mark the fingers of vaccine recipients with indelible ink as a proof that they had been inoculated but the hesitant parents put pressure and forced workers to mark fingers of their children without giving them polio drops.

The official noted that in every campaign, the same children remained unvaccinated and even authorities knew about them, but corrective steps weren’t taken.

Chief secretary Nadeem Aslam Chaudhry, who, in his capacity as chairman of provincial task force on polio, has repeatedly asked district administrations, police and DHOs to ensure that all targeted children are immunised in their respective areas, but all his directives have fallen on deaf ears, according to officials.

They added that the Emergency Operation Centre, which led anti-polio efforts in the province, was confronting a vicious cycle of refusals, missed children and fake finger marking.

The officials insisted that polio eradication required vaccination of all targeted children, with the responsibility to woo the reluctant parents and do away with fake finger marking lying with the district administrations and police.

They added that vaccinators couldn’t face the wrath of the people, given the series of killings of their team members and policemen in the past.

The officials said in the last meeting, the chief secretary declared the situation a “blessing” to eliminate poliomyelitis from the province as international donors continued funding and warned if cash flow stopped, the province won’t be able to allocate more resources for the cause.

They said effective coordination among administrations, police and health authorities could make a difference otherwise the vaccine-preventable childhood disease would continue to haunt children and add to the pool of disabilities.

Published in Dawn, December 13th, 2024