Exodus provides chance to stem spread of polio

A Pakistani volunteer gives polio vaccine to girl in Bannu, Pakistan, on Friday. The North Waziristan region is a hotbed of polio infections after Taliban militants in the isolated area banned immunizations. (Associated Press)

Pakistani refugees’ flight also could spread disease

BANNU, Pakistan – The rugged Pakistani region of North Waziristan emerged as a hotbed of polio infections after Taliban militants in the isolated area banned immunizations. Now the Pakistani government’s offensive against the militants has sent a half-million refugees fleeing the territory, creating both perfect conditions for the disease to spread and a golden opportunity to immunize many thousands of people.

“We know polio is a disease, but we also know the Taliban can kill if you violate their instructions,” said Mohammed Gul, who fled North Waziristan last week and is living in an empty government school with his nine children.

Taliban militants banned vaccinations in the summer of 2012, saying they would allow them only if the U.S. stopped drone strikes. The result has been a spike in polio infections in Pakistan, which is one of only three countries where the disease has never been eradicated.

The number of cases in Pakistan dropped from 198 in 2011 to 58 in 2012. Infections then rose to 93 in 2013. So far this year, 54 of Pakistan’s 83 confirmed polio cases have been in North Waziristan. In fact, North Waziristan accounts for roughly half of the total polio cases confirmed worldwide so far in 2014, according to the World Health Organization.

The massive Pakistani military operation started June 15. Health officials did not have any advance notice of the offensive, but the WHO made plans as early as February to be prepared if anything happened.

Polio, a highly contagious virus transmitted in unsanitary conditions, is easily fended off with a vaccine. But once a person’s nervous system is infected, paralysis can happen within hours, and there is no cure. The virus affects mostly children under 5.

“In a nutshell, this is an opportunity, but the risk is also there,” said Dr. Nima Saeed Abid of WHO’s Pakistan office, which helps the government with its polio-eradication program. “If we reach the children with this opportunity, there is great hope.”

The government has been trying to vaccinate refugees as they cross into the neighboring regions. Dozens of checkpoints are set up along the roads where refugees are offered drops of the oral polio vaccine. About 265,000 people have been vaccinated that way in June, said WHO officials.

But polio-eradication efforts usually rely on multiple rounds of vaccination. The goal is to have enough people immunized so the disease can’t find a suitable host and eventually dies out. But there is no central place in which to give vaccinations because almost all the refugees from North Waziristan have chosen to stay with family members or to rent homes instead of living in the government-run camp.

Instead, officials will go door-to-door in blanket vaccination campaigns that target all residents, including refugees. One such campaign just finished, and Dr. Raheem Khattak, who’s in charge of the provincial immunization program, says four more are being planned.

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