EOC COMMUNICATION UPDATE Issue no. 61 IVv

EOC Communication update

WWW.ENDPOLIO.COM.PK ISSUE NO. 61 – APRIL 1, 2015

The national leadership lauds the efforts of provincial teams to fight polio

The federal leadership praised the commitment and hard work of the provincial, divisional and district teams to combat polio virus in the province during the recently concluded task force meetings in Sukkur and Larkana.

The meeting was attended by the Prime Minister’s Focal Person on Polio Senator Ayesha Raza Farooq, National EOC Coordinator Dr. Rana Safdar, Dr. Azra Fazal Pechuho, commissioners and provincial team members.

During the meeting, the Commissioners declared Polio eradication as the top most priority of district administration. They themselves along with all Deputy Commissioners and Assistant Commissioners will be in the field to ensure the highest quality future campaigns particularly in problematic Union Councils.

The establishment of recent Task Forces under respective Commissioners was discussed as a welcome step. The positive outcomes are already evident from March nationwide immunization campaign against polio results. Nevertheless, pursuing the concept of 'One Team' led by Government, an extraordinary effort would be required to clean this region during next 2-3 months.

It was also decided that Micro plan updating and field validation will be undertaken on priority basis using all available government and partner staff well before the next campaign. Additionally, surveillance will be given priority and the Deputy Commissioners will ensure provision of required logistic support to the Surveillance Officers. Moreover, one of two PEOs in each district will focus on surveillance.

Pakistan and Afghanistan are the last two polio endemic globally and responsible for all the polio cases during the last six months on the global scenario. The global community looks forward to both the countries to step forward and cross the success line on behalf of the children of the world. Polio Eradication is the largest ever community based public health program, very close to success with final battle in Pakistan and Afghanistan.

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Highlights of the Task force meetings in Sukkur and Larkana

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Good neighbours ease fears in country's polio fight

Published on Dawn – 21 March, 2016 - http://www.dawn.com/news/1247052

In a rundown district of Karachi, Rabia balks at a neighbour's proposal to vaccinate her children, demonstrating one of the biggest hurdles to eradicating polio in Pakistan by the end of the year: confused and frightened parents.

Rabia, perplexed and surrounded by children in her modest two-room home, voices fears the vaccine to the crippling disease may in fact cause infertility.

“She was afraid there might be some harmful elements in the vaccine,” says Sharmeen Aslam, neighbourhood supervisor of a team of vaccinators.

“I told her there weren't — and now, since I live here, she knows she can come and see me if there are any problems, so now she believes me."

Each month, Aslam and her team divide a handful of dusty streets, each going alone to knock at door after ornate door armed with nothing but their anti-polio drops.

She is part of a community vaccination programme launched in Karachi two years ago to ease distrust and suspicion from parents by using staff from their local area.

Pakistan's anti-polio campaign has long been a dangerous task. One hundred people — both police and health workers — have been killed in attacks targeting polio vaccination campaigns since 2012, including three in Korangi in eastern Karachi in 2014, who were not part of the community programme.

The nation of some 200 million people is one of only two countries in the world where polio remains endemic — the other being war-torn Afghanistan, just over a porous border.

Some Taliban and ultra-conservative religious leaders spread rumours that the vaccine contains ingredients forbidden in Islam, such as pork derivatives, or that can cause infertility as part of a western plot to reduce the population.

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'Everyone knows me'

To dispel doubts, in 2014 the Sindh Emergency Operation Centre (EOC), spearheading the fight against polio in Karachi, began hiring local women to take the lead on vaccinations.

“Here, everybody knows me, I do not have to worry about my safety,” says vaccinator Shahnaz Ayaz. She has worked in other neighbourhoods before, she says, but admits she was “a bit afraid”.

Ayaz marks each door with a chalk “R” if the inhabitants refuse vaccinations, and darkens the pinky fingernail of children who have been vaccinated with a black marker, a sign that the drops have been administered.

Some 2,500 neighbourhood vaccinators like Shahnaz are now working in the metropolis of 20 million.

In areas of Karachi covered by the community vaccination programme, staff are no longer accompanied by police escorts, with a discreet police presence now deemed sufficient.

Escorts are still necessary in neighbourhoods of Karachi with no community programmes and parts of other provinces, but a shortage of officers can often hamper progress.

Pakistan's goals are ambitious: authorities want to vaccinate 35 million children under the age of five, eradicating the crippling childhood disease by the end of 2016.

Authorities are now targeting the main geographical incubators of the disease, the tribal areas bordering Afghanistan and the province of Khyber Pakhtunkhwa.

Karachi is a hub for migrants from these areas, posing a major risk to eradication hopes, polio officials say.

Vaccinators had previously found it almost impossible to penetrate the remote tribal areas, where militants had operated with impunity.

But operation Zarb-i-Azb launched against extremists by Pakistan Army there is giving authorities new leverage — such as refusing to allow families fleeing the fighting through checkpoints unless they allow their children to be vaccinated.

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'We need healthy children'

These measures saw the number of new polio cases drop to 54 in 2015, down sharply from 306 new cases in 2014 — but the improvement did not prevent 18-month-old Mohammed from losing the use of his right foot before learning to walk.

In Baldia, the Karachi neighbourhood where he lives, vaccination has long been hampered by insecurity and distrust, but is now being targeted by the community programme.

“I dream of the day we have so much community support that children will be walked to the vaccination centre to the beat of the drum, as I heard it happens in Yemen,” sighed Shahnaz Wazir Ali, a provincial polio adviser.

More than 2,000 religious leaders have joined in the fight, such as Baldia cleric Maulana Umar Sadiq, who is trying to persuade the neighbours of little Mohammed to have their children vaccinated.

“Islam advocates a better society in which every child is raised with the best possible hygiene standards. We need healthy children,” he explains.

Authorities have also built more than 2,500 clinics in Karachi providing vaccines along with basic care in response to parents suspicious about the vast resources deployed against polio while their children have no access to health care or clean drinking water.

The strategies seem to be working: in Karachi, the number of refusals was slashed fourfold in 2015 to about 10,000.

But the gains are fragile. Six cases have been reported so far in Pakistan in 2016 — including one child who had already been vaccinated, fuelling parents' mistrust of the drops.

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Polio case update:

PROVINCE 2009 2010 2011 2012 2013 2014 2015 2016

PUNJAB 17 7 9 2 7 5 2 0

SINDH 12 27 33 4 10 30 12 3*

KPK 29 24 23 27 11 68 17 3

FATA 20 74 59 20 65 179 16 0

BALOCHISTAN 11 12 73 4 0 25 7 1

GILGIT-BALTISTAN 0 0 1 1 0 0 0 0

AZAD JAMMU & KASHMIR 0 0 0 0 0 0 0 0

TOTAL 89 144 198 58 93 306 54 7

* Last reported case from Shikarpur, Sindh province on March 25, 2016.

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