Polio rises in Pakistan after rumors over immunization

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DANGEROUS MISINFORMATION: The scaremongering kept tens of thousands of children from being vaccinated in the North West Frontier Province, despite government efforts

THE GUARDIAN, PESHAWAR, PAKISTAN
Friday, Feb 16, 2007, Page 5
The parents of 24,000 children in northern Pakistan refused to allow health workers to administer polio vaccinations last month, mostly due to rumors that the harmless vaccine was a US plot to sterilize innocent Muslim children.

The misinformation -- spread by extremist clerics using mosque loudspeakers and illegal radio stations, and by word of mouth -- has caused a sharp jump in polio cases in Pakistan and hit global efforts to eradicate the debilitating disease.

The WHO recorded 39 cases of polio in Pakistan last year, up from 28 in 2005. The disease is concentrated in North West Frontier Province, where 60 percent of the refusals were attributed to "religious reasons."

"It was very striking. There was a lot of anti-American propaganda as well as some misconceptions about sterilization," said Sarfaraz Afridi, a campaign manager with the WHO in Peshawar.

The scaremongering and appeals to Islam echoed a similar campaign in the Nigerian state of Kano in 2003, where the disease then spread to 12 polio-free countries over the following 18 months. Pakistan is one of just four countries where polio remains endemic. The others are Nigeria, India and Afghanistan.

The North West Frontier Province government made strenuous efforts to counter talk of an "infidel vaccine."

Public health workers fanning across the province last month were equipped with copies of a fatwa (religious order), endorsing the vaccinations and signed by Maulana Fazlur Rehman and Qazi Hussain Ahmed, the leaders of the nation's most powerful religious parties.

The move reassured many doubters. More than 5.7 million children were vaccinated last month, with another 3 million targeted in a second round due to start on Tuesday.

"The elephant is over. We are left with just the tail," Afridi said.

But the tail has a deadly sting. Even though only 24,000 children missed the vaccine, the WHO officials said failure to vaccinate in small pockets of the country gave the virus a fresh toehold to spread.

The vaccination struggle is entangled with the confrontation between the government and powerful militants in the tribal areas. Refusals were highest in areas where conservative clerics and self-styled "Pakistani Taliban" fighters hold sway, flouting government authority and making their own strict laws.

Almost 2,000 children were not vaccinated in Bajaur, a tribal agency on the Afghan border where US warplanes bombed a house last year in the hope of killing al-Qaeda's No. 2, Ayman al-Zawahiri. The jets missed their target but inflamed extremist sentiment.

In nearby Swat Valley, a young firebrand cleric, Maulana Fazlullah, denounced the vaccination campaign through a local FM radio station. His brother was killed in a Pakistani army attack on a madrasah (Islamic school), late last year. Almost 4,000 children were not vaccinated in Swat.

Demands for "assistance" from local officials and elders was the other major factor behind the refusals. In the Mohmand tribal agency, policemen demanded their salaries before allowing vaccination to proceed.

But some brave women were uncowed. Up to 200 babies a day are vaccinated at the Khyber teaching hospital in Peshawar, where burka-clad women arrive with children in their arms. Some arrive in secret, defying male relatives.

"One woman told me, `My husband is illiterate. He has no idea how important this vaccine is,'" said a male nurse.
 

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