Hundreds of parents in Peshawar, Pakistan, were arrested in recent weeks for refusing to administer polio vaccinations to their children.
A spokesperson for the Peshawar district of Pakistan reported that 471 people had been arrested in the area for endangering public safety as part of Pakistan’s “war” on polio, according to The Washington Post.
“We have decided to deal with the refusal cases with iron hands,” Riaz Khan Mehsud, deputy commissioner of Peshawar, told BBC. “Anyone who refuses will be sent to jail.”
Local Peshawar authorities reported that the parents would not be released until they pledged to vaccinate their children.
Professor Muhiuddin Haider, who teaches global health courses at the University of Maryland and researches pandemic influenza, said he believes that arresting the parents is not the solution.
“Arresting people — the government can do it to show importance or to symbolically show that they are serious about it,” said Haider. “But to me, punishment is not always the best way to teach behavioral change.”
He questioned whether the Pakistani government was tailoring how they communicated information about the vaccination based on different provinces and their distinct characteristics.
“This kind of polio vaccine is a part of primary healthcare,” said Haider. “Primary healthcare development should be a part of the local government in the developing countries.”
Polio, an infectious viral disease that mainly infects children under the age of 5, can cause paralysis in a matter of hours and can lead to death. The disease is transmitted through fecal matter and is incurable, but it can be prevented with multiple vaccinations.
Pakistan had 306 reports of poliovirus — which causes the disease — in 2014, accounting for 90 percent of reported cases in the region, according to the World Health Organization (WHO). As of March 8, 16 cases in Pakistan have been reported for the year.
According to its website, the WHO’s efforts have helped reduce the number of polio-endemic countries from 125 in 1988 to three remaining today: Pakistan, Nigeria and Afghanistan. The organization hopes to remove the disease globally by 2018.
The presence of polio in these remaining areas could spread to and rapidly within currently unaffected countries, warns the WHO.
The Taliban banned vaccinations in areas of western Pakistan in 2012, threatening to kill health workers and parents who immunize their children. These Islamic militants have claimed for over 10 years that the polio vaccination drive is a conspiracy to sterilize children, according to BBC.
At least 70 workers have died in the conflict during the past four years, including four vaccination team members who were found dead in February after being abducted near the Afghanistan border, according to BBC. Haider said the dangers to health workers are as bad today as when he worked with reproductive health and family planning there in the 1990s.
Health workers are working diligently to correct the virus problem in Pakistan but are met with violence and reluctance from parents.
The distrust of vaccination programs also stems from the CIA’s hepatitis vaccination front when trying to locate al-Qaeda leader Osama bin Laden. The program was used for intelligence purposes and it partially fueled the Taliban’s ban, according to NPR.
Ibraheem Khan, a geographical sciences graduate student at UMD originally from Lahore, Punjab, said that the distrust is a general perception of the West.
“It is the opinion of the people because of the ongoing situation in the area,” said Khan. “In general they don’t like strangers walking around, meeting with the families. So that is the main thing, I think.”
Khan said he is hopeful about the outcome of the situation. He said many organizations are working with the government to communicate the importance of vaccinating children, especially to parents in rural areas.
“[Parents] are not anti-vaccination,” said Khan. “People don’t feel that they should not get vaccinations for their kids.”
The current efforts of education, vaccination and elimination of militant threats by the Pakistani government will be instrumental in the removal of polio from the country, according to Khan.
Khan said that once the local issues in the region are resolved by the government’s current actions, there will not be a problem with educating and vaccinating people.
“Then the country will be free of polio, I think,” said Khan. “People want a good life. People want happy lives, but local elements intervene and that’s a big issue at the moment. But I am hopeful and I see light at the end of the tunnel.”
Faizan Ali, a computer science major and board member of UMD’s Pakistani Student Association, said prevalent illiteracy and lack of education in areas with polio hinders vaccination efforts.
“Parents who don’t vaccinate their kids are almost voluntarily putting their children in harm’s way,” Ali said.
He said he believes parents should be reprimanded for not vaccinating their children, but understands it is not their fault they are not educated enough to make an informed decision.
With the possibility of the disease spreading to other countries, polio is a global concern.
To combat it, Haider suggested Pakistan could follow India’s example.
“India had difficulty with Muslim population when vaccinating for polio,” said Haider. “But they were able to overcome it by involving the community, including religious priests of the mosques and dissemination.”
Haider also suggested Pakistan use midwives to spread information, given that many births in Pakistan happen at home. Midwives have direct communication on the household level, fostering trust with the families.
“It takes time,” said Haider. “It takes time to connect with the right people and it takes also political goodwill and effective strategies on the community level.”
Photo by Gates Foundation via Flickr Creative Commons
