KARACHI: Officials in Islamabad have sought answers from provincial governments as to why a persistent increase in polio cases across the country have been recorded, especially in 80 days after the World Health Organisation (WHO) imposed travel sanctions on the country for bearing a heavy burden of all the cases of the crippling disease recorded in the world.

Since June 1, when the WHO sanctions came into effect, Pakistan had recorded 36 polio cases with, as was feared, the Federally Administered Tribal Areas (Fata) remaining the foremost contributor with 23 cases, officials said.

They added that almost 80 per cent of cases in Fata were reported from North Waziristan Agency (NWA) — the lawless region where the last time polio workers went to administer vaccine to children aged less than five was in June 2012.

With a military operation launched two months ago in NWA a large population got displaced and took shelter in various parts of the country, including Karachi.

Certain special campaigns had been launched in the districts bordering NWA to target the children who missed the vaccine for so long; besides, similar campaigns had also been organised in the four provinces for the internally displaced people.

However, officials still fear that danger lived next door and quite ready to stalk the large young populations given the fact that a significant number of people who now no longer live under the influence of Taliban still pose a resistance to vaccination of their children for reasons best known to themselves.

“It is hugely frustrating and, at the same time, dangerous to see that we are still facing refusals from the people who have migrated from NWA along with their families who were already here but have always put resistance to our bid to immunise their children,” said a senior official in the provincial health department.

However, he said that the special campaigns carried out mostly discreetly would not be stopped as was required by senior authorities and the international health regulators.

The officials in Islamabad have asked all the provinces to contribute with their resources to control the dangers of polio posed by a large moving population.

“The pace with which new polio cases are being recorded in the country shows the situation is either the same or has aggravated further as far as actions are required to be taken to stop it,” a senior official in the federal government told Dawn on the condition of anonymity.

According to official reports, Khyber Pakhtunkhwa recorded seven polio cases, Sindh five cases and Punjab and Balochistan one case each after the WHO sanctions came into effect requiring all Pakistani international travellers to get inoculated and obtain a vaccination card before leaving for abroad.

Ironically, Punjab and Balochistan had recorded no polio case before the WHO sanctions. However, the officials in Islamabad said there were sanctuaries in some districts of Balochistan and Punjab requiring a constant vigilance by the respective governments.

In a letter, the federal health services ministry has asked again the provinces to “do more” to stop the dangers of polio as the increasing number of polio cases is going against to the cause of the government, especially when it wants a clean chit from the WHO when the latter will review the sanctions by the end this year.

Pakistan regularly recorded over 2,500 polio cases a year till 1993. Some 1,147 cases were reported in 1997 before figures receded satisfactorily. A total of 198 cases were recorded in 2011 which was the world’s highest as 117 cases so far this year are again highest in the world.

Barring a two-year-old child from a village of Sanghar district, the rest of 10 polio cases have been reported from Karachi and eight of them belonged to the families of Pakhtun origin — the community that records most refusals for their doubts regarding vaccination, officials said.

The community’s suspicions grew gravely particularly after the use of a doctor in a CIA-sponsored fake vaccination campaign launched to hunt down Osama bin Laden three years ago.

Karachi — which was polio free in 2012 — saw eight cases last year and officials feared that the number of affected children could be much higher as it was just eighth month of the year.

Polio workers have repeatedly come under attacks in Gadap town in recent years, compelling the authorities to suspend the immunisation campaigns quite often in Gadap and some other areas of the city.

On Jan 21, 2014, three polio workers, two of them female, were killed in Qayyumabad.

While the Sindh government initially ordered the law-enforcement agencies to provide security to polio workers during such campaigns, most such drives were put off for want of security as the government’s real priorities appeared to be lying somewhere else.

Pakistan now carries a huge burden of 117 polio cases: 85 from Fata, 19 from Khyber Pakhtunkhwa, 11 from Sindh and one each from Balochistan and Punjab.

Published in Dawn, August 22nd, 2014