PESHAWAR: Pakistan Paediatrics Association has shown concerns over what it calls the “flawed” communication and operational strategies regarding polio immunisation and asked for focused approach to eradicate the virus from the reservoirs through deployment of technical people to reach every child.

“Despite our requests, the government is not inviting us to the polio review meeting being held in Islamabad on August 29. We are the main stakeholders and know where the faults lie,” PPA central president Prof Gohar Rehman told Dawn

He said that there was no point to launch province-wide vaccination rather it was needed to quarantine the virus reservoirs first and then focus on the areas where the virus was not existent.

“Focus should be on Bannu division but with the involvement of paediatricians and technical people,” he said.

Prof Gohar, also a member of National Immunisation Technical Advisory Board, is an international master trainer to address vaccine hesitancy.

Seek focused approach to eliminate virus from affected areas

He said that training, awareness and preparedness were basic components for smooth sailing of immunisation but the government was threading the old way of knocking at the doors of people, who looked down upon the polio workers.

“Even the doctors are asking us if they should administer OPV to their children. Vaccination is the only way to do away with polio, but the way these vaccines are given is inappropriate,” he lamented.

The PPA president said that communication staff deployed by the government was finding it hard to answer questions tossed up by people regarding the authenticity of oral polio vaccine owing to lack of experience.

“The communication strategies are not effective to answer the common questions, like is it a government-owned programme? Is the polio eradication a Western agenda? And is the vaccine not harmful to children,” he said.

Prof Gohar said that people asked as to why the vaccinators came to their door for vaccinating their children against polio that caused only disability while free treatment was not available even at hospitals for killer ailments.

He said the missing link between vaccinators and people should be plugged to ensure better child health. “With a comprehensive strategy, we can cope with refusals against the vaccine,” he added.

Khyber Pakhtunkhwa had 58,913 refusal cases that shot up to 739,458 after the vaccine reaction drama four months ago in Peshawar. These include 8,658 hardcore refusals where strong communication skills are needed to convince people that vaccination is a national programme meant to safeguard children against disabilities.

Pakistan has registered 58 polio cases including 44 from KP, five from Punjab, four from Balochistan and five from Sindh in 2019 so far.

“Silent refusals, which are not recorded, are big obstacle,” said another paediatrician.

Poliomyelitis has been eliminated worldwide except Pakistan, Afghanistan and Nigeria since launch of the Global Polio Eradication Initiative in 1994, using the same vaccine, but less than one per cent unvaccinated children are constant threats to the immunised ones.

Owing to nonexistence of communication strategy to convince the defiant parents that OPV is meant to safeguard their children from disabilities, the people continue to thwart vaccination on one pretext or another.

Health officials said that communication support was provided by Unicef that recruited people, who lacked skills to interact with the people refusing the OPV.

The Unicef has deployed about 500 communicators to prepare printed material to overcome vaccine hesitancy but they were also assigned operational tasks, leaving them with little time to perform their primary task of wooing people on immunisation.

Lately, sources said, many social media activists of the ruling PTI were hired in polio programme and were paid by Unicef. In the past too, communicators were hired without floating advertisements to find skilled people through competitive process.

Prof Gohar said that it was untrue that illiterate people reused vaccination as doctors, professors and educated people were among the unwilling parents. He said that inclusion of paediatricians could make a marked difference in the efforts to eradicate polio.

“We can impart training to polio staff to make the community realise that cheating on vaccination could cost lifelong disability of their children. “People listen to paediatricians as far as child health matters are concerned,” said the PPA chief.

Published in Dawn, August 26th, 2019