LAHORE - “Go away and don’t come back”, a Pathan working in his godown of animal fodder in Lahore, the second biggest city of Pakistan, yells at the anti-polio team. “I will not allow you to go upstairs and why do you keep on coming back even when we have vaccinated our children against polio several times?” he rages.The government teams often come across such behaviours and questions during mass immunization campaigns from several quarters including the high risk groups. “Why are you Pathan so ill-mannered?” the government team member, a lady health worker, hits back at the burly Pathan. “We do not face such kind of behaviour from any quarter including Punjabis but you people always make a fuss”, says middle-aged LHW Ms Azmat Sultana, who works in Union Council 84-B of Sammanabad Town.Before the situation could aggravate Social Mobilizer Rabia Ikram chips in and cools down the tempers. She is one of over a thousand social mobilizers of the Communication Network who have fanned out across the country to track and convert families who refuse polio vaccination and ensure parents understand polio and the importance of vaccine. They are trained in interactive communication and community engagement techniques, and equipped with culturally relevant education materials for conducting individual and group awareness-raising sessions for sustained behaviour change. UNICEF Pakistan supports communication and awareness activities through COMNet across Pakistan to increase acceptance for polio vaccine, raise public demand and address refusals.After a brief chat with the social mobilize, the agitated Pathan looks visibly calm and allows the team to vaccinate children who are 8 in number.“The Pakhtun (Pathan) women and children have special rapport with Ms Rabia who visits them every now and then to listen to their doubts and problems and they say that they won’t vaccinate their children without her”, LHW Azmat says.The area where Rabia Ikram works lies in neighbourhood which lacks even basic health and sanitation services, has limited or no access to safe drinking water and not even a single public health facility for a population of more than 30,000. A substantial number of population belongs to the Pashtu-speaking community, which is a priority population for polio eradication since 46 of the 58 children paralysed by polio in 2012 were Pakhtuns. “The children living in the UC are at risk of contracting the polio virus. They live jointly in small compounds with their siblings and cousins and the number of children in one compound could go up to 20”, Rabia says. “It is very difficult to identify the children and ascertain their number and ages and most of the time government teams overlook a child or two during campaigns”, she explains. “The children who have been missed or who refuse are brought into the vaccination web at some stage but the children who are overlooked cannot be given OPV at any stage and thus they are vulnerable to the disease and at the same time are potent carriers of polio virus,” Rabia adds.Pakistan is one of only three polio endemic countries in the world. In 2011, the country reported 198 cases, the largest number in the world. But thanks to significant work and commitment by the government and partners, the situation improved significantly in 2012 with only 58 cases. Since the deployment of Communication Network staff in January 2012, the refusal conversion rate has increased steadily and is now approaching 70 per cent. The Communication Network works on the pattern of SMNet of India which is responsible for proper mobilization and involvement of locally-based civil society organisations, opinion-makers and leaders/elders of society. “We go door to door to listen to parental doubts, analyse the reasons for refusals, establish rapport, clarify misconceptions, provide credible information and engage influencers and community leaders”, Rabia says.“The COMNet has given government teams maps indicating points to start campaigns, list of nomadic populations and important information of the area which plays an important in vaccinating children”, government vaccinator Noor Muhammad says acknowledging the invaluable contribution of COMNet staff.  –The writer is a contributor

This news was published in The Nation newspaper. Read complete newspaper of 24-Apr-2013 here.