ISLAMABAD: Federal health authorities are upset over the recent confirmation of polio cases in rural areas of Sindh and fear that they can become a reservoir of the virus.

A letter has been sent to the provinces to ensure that no child remains out of vaccination coverage. Moreover, a private firm has been engaged to monitor the quality of the vaccination campaigns and ensure that children are not missed.

An official of the provincial Emergency Operation Centre (EOC) on Polio said the Sindh health ministry would ensure eradication of the virus in areas other than Karachi.

Also read: Two more polio cases detected

For the past many years, most cases confirmed in the province belonged to Karachi and other areas had never been a big challenge for the health departments but this year incidence of the disease has started being reported from there.

An official of National Health Services (NHS) ministry said a recent case was an eye-opener as 54-month-old Rubina, daughter of Abdul Hameed, of Abdullah Mallah village in Mittoo Babar union council of Dadu district’s Khairpur Nathan Shah tehsil had been confirmed as afflicted with polio.

“When teams reached there for an inquiry, the parents of the child claimed that polio teams had never gone to the village and the vaccine had not been administered to her. There were about 30 houses in the village so the team decided to check them and was shocked to know that there were no door markings in the community,” he said.

“During the inquiry it was learnt that a vaccinator visited the place, called all the children outside the village and vaccinated only those who went there,” the official said.

“It is mandatory for a vaccinator to visit every house, ask about the children and mark the door. The vaccinator is also bound to inform the supervisor in case of refusal by the parents,” he said.

“This incident created doubt that there may be more villages in which the same practice has been going on and this can be the cause of the recent emergence of poliovirus in the ‘interior Sindh’,” he said.

Meanwhile, a letter sent by the Prime Minister’s Focal Person for Polio Eradication Senator Ayesha Raza Farooq, has instructed chief secretaries to ensure the placement of full-time emergency coordinators in all provincial EOCs.

It said the programme might shift its focus towards the consistently missed children and constantly follow up until no ‘zero-dose’ child was left.

It said that besides known reservoir areas, the country’s central region should be given special attention and a mechanism for coordination among Sindh, Punjab and Balochistan should be devised urgently.

The provinces were urged to ensure appreciation and adequate monetary reward for frontline workers, including vaccinators.

They were advised to implement the suggestions and report in a meeting of the PM’s focus group to be held early next month.

The NHS ministry official said the National Institute of Population Studies had been hired to monitor a nationwide vaccination campaign held in January.

“However, now a private firm, ‘Eycon’, has been engaged to monitor and analyse the quality of the anti-polio campaigns all over the country,” he said.

The firm has already been monitoring the performance of a Communication Network created by Unicef, the United Nations fund for children, regarding anti-polio campaigns.

A letter by Senator Farooq said the firm would utilise experienced third-party monitors to validate in ten field the micro plans before each campaign.

“Subsequently, the independent monitors will also conduct intra-campaign monitoring to facilitate the local authorities in filling the observed gaps on a real-time basis.”

On Saturday, Dr Azra Fazal Pechuho, Chairperson of the Sindh Oversight and Coordination Cell for Public Health, presided over a meeting held to discuss the issue where a decision was taken to remove from service the official responsible of Dadu.

The districts will prepare log books of missed children with reasons and monitoring and supervision at the UC level will be enhanced.

Sindh EOC representative Dr Manzoor Ahmad Memon told Dawn that “all the stakeholders, including the World Health Organisation, have been involved and massive campaigns will be held in interior Sindh”.

“Moreover, response teams have been formed to visit various areas of the province to ensure quality of the campaigns,” he said.

Published in Dawn March 17th , 2015

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