Balochistan polio-free: myth or reality?

QUETTA: The world is set to eradicate poliovirus from the face of the earth, but Pakistan ranks in the lists of the countries, along with Afghanistan and Nigeria, where the virus still thrives. 
According to the recent reports, polio cases in Pakistan have surged to 88 out of which 69 belong to FATA, 7 to Sindh and 12 to KPK. Whereas, the total cases in Afghanistan are 4 and Nigeria 3. Pakistan was also slapped with travel sanctions and immunization was made necessary by WHO this year to prevent the possible carriage of virus. Experts believe that 90 % polio cases in 2013 came from areas with barriers for vaccination. Interestingly, no case has been detected since October 2012 in Balochistan. This leads many to perceive Balochistan as a polio-free province. But, how far this assumption is rightly inferred is a question to ponder. Moreover, the influx of the IDPs into Balochistan further multiplies the risks in the wake of operation Zarb-i-Azab in North Waziristan.
When contacted in this regard, the Provincial Health Minister Rehmat Saleh Baloch ruled out any assumptions of a polio-free status of Balochistan, saying, “Although no cases have been detected since October 2012, the environmental samplings have surfaced positive. The minister said government is working on war-footings to cope up with the issue. He said that although the Lady Health Workers (LHWs) are normally paid by the UNICEF and WHO, the Government of Balochistan is also paying them in the face of the alarming situation. He said that Government has also involved the Deputy Commissioners other than the District Health Officers to supervise the surveillance programmes in high-risk areas and secretaries have also been involved. “The campaigns have also been exacerbated and we have involved the political and community members and have arranged awareness sessions for the parliamentarians,” said Minister Health Rehmat Saleh Baloch. 
He said that after the WHO travel sanctions, immunization vaccinations would be arranged at various airports and the District Health Officers would be involved to ensure immunization at border areas. When asked if Balochistan Government has made necessary preparations for meeting with the possible virus carriers in the form of IDPs from North Waziristan, he said there are no formal camps of IDPs in Balochistan; however, they would most probably stay at their relatives’ here, if they happen to come. “Government is planning to make sure their immunization,” said that minister. 
When contacted, Dr Abid Saeed, National Stop Officer Prime Minister Polio Cell Islamabad, who is supervising district Pishin in Balochistan currently, said that no case detection since October 2012 may be seen as either surveillance is too weak or due to repeated round of immunization campaigns, the virus is left with little space to affect. Dr. Abid Saeed said that environmental sampling in Balochistan is only done in Quetta and results are inferred on its basis, adding that it is highly recommended that environmental sampling should also be done in other high risk areas such as Killa Abdullah and Chaman. “WHO is also facing Human Resource shortage in security sensitive areas such as Kalat, Awaran and Makran. Therefore, the standards of the surveillance can be questioned,” he said. 
When asked if refusals were any obstacle in the way of immunization campaigns, he said that the religious refusals have mitigated considerably; however, the ‘repeated-round refusals’ have surfaced in the province as people question repeated rounds of immunization. Dr Abid Saeed said that the role of paramedics is also letting down the programme considerably. The Provincial Surveillance Officer World Health Organization (WHO) Dr Waheed Kakar, talking to Daily Times, said that in the face of various obstructions in the province, it cannot be established that province is polio-free. “Effective surveillance at grass root levels has to be ensured through corruption free practices and when corruption hits the grass-root level, the accuracy of the data becomes suspicious,” he said and added that all the stake-holders need to work in coordination to ensure a polio-free province. The analysis of the experts are unanimous that the province is far from achieving the polio-free status and it has to tighten the measures to reduce the risks of the virus affecting further children in the province.

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