Poliomyelitis, or more commonly known as polio, is an extremely contagious and infectious viral disease caused by a virus that accumulates and multiplies in the intestines. In many cases, this virus can easily invade and harm the nervous system, which can result in paralysis. It mainly affects children under the age of 5. According to World Health Organization (WHO), 1 in 200 cases of infection inevitably leads to paralysis. Furthermore, amongst these cases, 5% to 10% die due to immobilization of breathing muscles. Since it is transmissible it can travel from person to person especially if a person comes in contact with an infected person’s fecal matter or oral airborne droplets.
Notwithstanding the potential severity of the said disease, there still exists a somewhat definite cure in the form of a vaccine created by Dr. Jonas Salk in 1952. It has helped bring down the disease by globally reducing the numbers from 350,000, in 1988, to 33 reported in 2018. Many countries including the USA and Europe have managed to completely eradicate the epidemic, however, it still persists considerably in Pakistan. This begs the question as to why polio still exists despite the countless campaigns conducted by the government and NGOs. What is hindering the eradication of the disease?
There are three types of Poliovirus known respectively as Type 1, Type 2, and Type 3. In order to achieve complete eradication one needs to be protected against all types of the virus. According to the Centers for Disease Control and Prevention (CDC), the type 2 virus was finally declared completely eliminated in 2015, with the last documented case recorded in 1999 in India. Type 3 virus was also declared eradicated in October 2019 with the last case recorded in November 2012. The only existing Type 1 poliovirus is still causing severe cases in Pakistan.
As stated by CDC, 1 out of 4 people infected with the poliovirus will exhibit flu-like symptoms including fever, sore throat, headache, nausea, and stomachache. These symptoms stay for 2-5 days then naturally disappear. However, an even smaller percentage of people will develop more severe signs that eventually go on to affect the brain and spinal cord with symptoms ranging from Paresthesia which is a feeling of pins and needles in the legs, Meningitis which is an infection in the coving of spinal cord or brain and, lastly, Paralysis.
According to Eastern Mediterranean WHO, Pakistan remains one of the two countries to still have an ongoing wild poliovirus (WPV1) transmission along with Afghanistan. Even so, there has been an exponential decline in the cases in Pakistan, that is, from 20,000 cases per annum in the 1990s to 12 in 2018. However, 2019 in Pakistan witnessed a conspicuous increase in cases across all the provinces numbering 147. And as of yet, in 2020, a total of 84 cases have been reported from all over the country.
Even if we take into account the raging epidemic known as COVID 19, the polio eradication campaigns have not inhibited their work and the volunteers are still relentlessly going from door to door to administer the vaccine. This then raises the question of who is responsible for the still existing virus.
Amongst the numerous NGO’s working to eliminate polio in Pakistan, there are 4 forefront organizations including PPEP (Pakistan Polio Eradication Programme), Polio Global Eradication Initiative, and Polio eradication Initiative, taken both by WHO and UNICEF, which have successfully brought down the numbers from thousands to hundreds. However, this achievement has come at a cost as many polio workers have lost their lives trying to reach the deep rural areas of Pakistan. As stated by The News, since 2012, as many as 70 polio workers have lost their lives. Majority of them were killed in the Khyber Pakhtunkhwa.
In June 2019, an article posted by Devex.com suggested that many of these deaths can be attributed to nothing but the spreading of false information. It followed a case of misinformation in the province of Khyber Pakhtunkhwa, where over 25,000 children, with nausea or diarrhea, were brought to hospitals after being vaccinated because of the mass panic that was spreading like wildfire due to the rumors about the polio vaccine on Facebook. All of the children were sent home as there were no symptoms that linked their condition to the vaccine. However, on the same day, due to this mass hysteria based on zero factual evidence, a health clinic in Peshawar was torched, and later that day, two policemen accompanying polio teams were shot dead in the same province. Reports from the same day state that a female health worker was also shot dead in Balochistan, and her fellow college severely injured. In November 2020, a group of polio workers was chased out of a village in Chiniot when a man attacked them with an axe. He, allegedly, did not approve of the drive.
The polio drive the started in January 2021, with the ambition to administer the vaccine to 40 million children across Pakistan, has faced the same situation. Up until now, a policeman, who was escorting a team of polio workers, has been shot dead by an unknown gunman in Karak, KPK. Following that, in March 2021, according to Dawn, a male polio worker was kidnapped and held hostage in Dera Ghazi Khan where he was beaten and then left him in a room.
Not only that but back in 2015, the government had to prove to the people that the vaccine was in fact ‘HALAL’ after a rumor popped up about the said vaccine containing hormones which made the children sterile.
This, seemingly, is the result of nothing but false information spread by a few people, which is taken as the truth by millions and is doing nothing but putting human lives at stake, the very humans who have dedicated their lives to eradicate polio in Pakistan. The constant and consistent attacks in various parts of KPK and Balochistan are said to be the biggest hindrances standing in the way of total eradication.
After the several cases of murder and misconduct against the polio teams started surfacing, the government formed the National Strategic Advisory Group (NSAG), in 2019, to help tackle the issues regarding polio elimination. However, none of these actions will mean anything if people kept refusing vaccines on the basis of false and fabricated information. In a nation with over 60 million adults who are illiterate, spreading of false information has the potential to put lives at risk, and the ones suffering in the end are none other than the innocent children.
Every single child needs to be vaccinated for polio to be completely eradicated from this country. But will our own people allow that?
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