Just over two years ago in November 2011, health authorities in Lahore were puzzled over inability to reach a large number of population who had migrated to Lahore from the polio virus high risk areas, including the Federally Administered Tribal Areas (FATA) and Khyber Pakhtunkhwa (KPK).
“More than 1,000 families were reported averse to polio drops in the high risk union councils (UCs) of the city the same year”, says Omer Feroze, District Health and Communication Support Officer of Communication Network (COMNet).
“Language barriers, continuous movement to and from the polio high risk areas, inadequate knowledge about the customs and traditions of the migrant population have been major reasons behind the spike in opposition and apprehensions towards polio vaccine”, adds Feroze.
The situation in 2014 has changed after hundreds of community influencers including Pakhtun elders joined the fight against polio.
Latest Polio Control Room data suggests that now only 23 families remain opposed to polio vaccination; an increase of almost 100 percent in the coverage of pockets of refusal communities.
Maulana Wasim is one of the tireless activists against misconceptions. He is the Imam (prayer leader) in Hazrat Siddiqul Farooq mosque in UC-84.
In the run up for every vaccination round he makes announcements from mosque to inform community about polio drives asking them to cooperate with the visiting vaccinators and health teams. Sometimes he also joins health teams vaccinating children in the community on his bicycle.
“Let’s not read into suspicions and misconceptions attached to Oral Polio Vaccine (OPV). After consultation from doctors it has been verified that OPV is not harmful”, Maulana Wasim says as he knocks a door along with health team in UC 84-A during a recent campaign launched after Lahore’s polio environmental sample tested positive.
“It is the responsibility of all parents to vaccinate their children and show no carelessness in this regard every time polio drops are offered”, Maulana reiterates.
Maulana, is a smart man in his mid-40s. He hails from Chaveri, a remote village in Buner,
Khyber Pakhtunkhwa. He shifted to Lahore eight years back and is one of at least one million Pakhtuns living in the city after migrating from their native towns in FATA or Khyber Pakhtunkhwa.
Referring to the statement of Aqsa Mosque Imam which Maulana reads out in Friday sermons, he says: “concept of preventive health is clearly enshrined in Shariah. Polio drops, being part of preventive health, are not forbidden in Islam. We should be vigilant about spread of polio virus”.
Union Council (UC) 84 is one of 29 UCs that have been declared high risk for polio in Lahore. High risk districts are identified due to the presence of wild polio virus, very low routine immunization poor sanitation, scarcity of clean drinking water and public health facilities for a population of more than 30,000.
A substantial number of people in the community is Pashtu-speaking, which is a priority population for polio eradication since all children paralysed by polio in 2014 so far have Pashtu speaking backgrounds.
Pakistan is one of the last three remaining strongholds of polio virus in the world. The number of polio cases has reached 88 so far this year. Almost all polio cases reported from North & South Waziristan agencies in 2014 did not receive any dose of oral polio vaccine (OPV). The only polio cases reported outside FATA/KP in 2014 are from the greater Karachi area.
“Vaccine used in Pakistan is the same used in Saudi Arabia and all other Islamic countries to wipe out polio and we should double efforts to do so”, says Maulana during the sermon of the Friday prayers.
“Islam lays stress on hygiene and therefore it is rightly said that cleanliness is half of religion. Organisation of Islamic Cooperation (OIC) in a declaration has urged all Muslim states to conduct effective polio campaigns in their countries to eradicate polio”, he explains.
“Most Pashtun communities are guided by strong traditional values. Dominant social norms and conservative religious orientation requires special, contextually acceptable communication approaches.
“Sessions with Pakhtun elders and religious leaders are held in madrassahs and mosques to educate the children on the debilitating impacts of polio, to increase acceptance for polio vaccination and encourage students to maintain good hygiene to help protect them”, explains the COMNet Officer.
“Environment in the union council is so amicable now that Pakhtun families even exchange gifts with us when we go to their homes for vaccination their children”, says Nadia, polio team member working in the UC.
Although nearly all parents accept polio vaccine if workers are able to deliver it, findings of the Knowledge, Awareness and Practice (KAP) survey conducted recently among parents and other caregivers of children under age five in select parts of Pakistan that are at greatest risk for polio transmission suggest there are some misperceptions about polio and oral polio vaccine. These misconceptions could erode demand in the future, if parents do not see this terrible disease as a real threat to their children’s health, or if they are not convinced of the multiple dosing required for full protection.
A sizable share of parents in Pakistan (30%) believe that the paralysis from polio would be curable if their child got sick. As another example, fifth of parents were not aware that OPV must be taken every time it is offered in order to maximize protection for their children against the disease (37% in FATA, 19% in lower-conflict areas of Pakistan.
“Do you know how difficult it is for a paralyzed child to live shoulder to shoulder with his age fellows who are leading normal life? Nobody can understand the pain of these children except their parents and the child himself”, maintains Maulana Wasim.