The Viral Threat — Polio and National Security
The statistics keep shifting, the upward tick of numbers painting a grim picture. In 2013, 91 new cases of Polio were reported in Pakistan, an increase from 58 in 2012. 290,000 children, mostly in Waziristan and North Western Regions are held back from being vaccinated for religious reasons, and more than 7 million kids will be left in the lurch as vaccination programs are cancelled yet again due to violence. Pakistan is now one of the three remaining countries (Afghanistan and Nigeria) to be declared as Polio endemic. The worrying statistics however has not affected the authorities in Pakistan. They have done precious little to ensure its children grow up without the fear of being crippled by a viral disease that is 100% preventable.
The increasing number of attacks against polio workers, 37 killed since 2012, have dissuaded the UN and other health organizations from sending in the man power required to persuade and vaccinate children. Workers face a number of hurdles including inaccessibility to areas, delayed or no payment of salary, hostile tribes threatening violence and spreading false rumors about the ill effects of vaccination and an increasingly violent city environment with little or no protection. Despite pleas from health supervisors and volunteers, the government has not increased security for the health workers in high risk areas, and has steadfastly refused aid and vaccinations to thousands of children claiming lack of accessibility and threat to life.
Ayesha Bibi, a Lady Health Supervisor in the northwestern city of Peshawar, argues that the level of security provided by the government is severely inadequate in the country’s high-risk areas. “There have been numerous killings and the girls are very scared. Volunteers have dropped out of the campaign and even the policemen are afraid,” she said. Ayesha told stories of changing cars and license plates to avoid Taliban monitoring but claims that she continues to receive death threats.
The danger comes from the risk that Pakistan poses to other countries in the region including India. The high level of internal displacement, terrorist activities, sleeper cells in the Middle East originating from Pakistan and people traveling from Pakistan to other countries can become carriers of the virus. Polio virus originating from Pakistan has been found in Egypt, Israel and has crippled 13 Syrian children last year. Syria had been Polio free since 1999, Israel since 1988 and Egypt since 2004.
The endemic nature of the virus in both Pakistan and Afghanistan should be of serious concern to India. WHO has only recently declared the country to be free of the virus for the past 3 years. The Indian government has since taken steps to ensure that people who travel into the country from countries where the virus is endemic are to be given immunization before crossing the border.
The greater threat however, will come from people who use dubious means to cross into the country. The issue has to be considered very seriously and regarded as a national security issue. We have people from Nigeria and from Pakistan using unorthodox means to get into the country. Refugees from Afghanistan have settled into camps in Delhi. Even a single carrier of the virus can put millions of kids in the country at risk again.
India cannot be lackadaisical about the idea of Polio making a resurgence in the country. Our broken healthcare system, our despicable sanitation infrastructure and the prevalence of suspicion against any form of vaccination in large pockets of the country makes it hard enough to ensure that our kids remain disease free. Extra steps need to be taken to ensure that our health care workers remain vigilant and open to the possibility of a resurgence. The government also needs to bring up the issue at the international level to force countries like Pakistan into action and to get their governments to ensure that aid workers and health workers are given the security they deserve. The risks that country’s like Pakistan pose to its neighbors due to its own internal failures has increased many times over and the world needs to pay more attention.
