HYDERABAD: A staggering number of 20,800 children, including 2,800 refusal cases — eight per cent of targeted 255,000 children — could not be vaccinated in Hyderabad during the three-day polio vaccination campaign that started on Monday and concluded on Wednesday.

But the Emergency Operation Centre (EOC) for polio spokesman claimed that this figure of 20,800 would be brought down drastically during the catch-up campaign that would continue till Sept 2 in Hyderabad.

The figure seemed to be disturbing against the backdrop of two recent cases of polio — both girls — in urban centres of Hyderabad district.

One of them is 10 years old and the other is a year old.

Hyderabad’s last polio case was reported on Jan 27, 2012 in the Sehrish Nagar area and since then this district had remained polio-free.

The three day campaign that started on Monday concluded on Wednesday.

The campaign was launched to vaccinate 255,000 children in Hyderabad district as per target. During the campaign, out of 20,800 children, 18,000 were “missed children” who fall in category of “not available” as per chart of polio monitoring authorities.

These not available children are those for whom families attribute different reasons to visiting polio workers for non-availability of their children at home.

If the child is schoolgoing or staying with parents then the polio workers mark them as “not available” in their chart.

All these children are to be vaccinated during the catch-up campaign that follows three-day polio vaccination drive.

“This figure for us is not that huge as it will be drastically brought down when administration will take steps in collaboration with religious leaders, social activists or community representatives to get these children inoculated.

After this catch-up campaign true figures will be reflected,” said the EOC for polio spokesman from Karachi.

“We had brought down refusal cases to 332 in June 2019. Before that 5,571 refusal cases were recorded in Hyderabad,” said Deputy Commissioner of Hyder­abad Syed Aijaz Shah, who is in-charge of district polio control room (DPCR) by virtue of his post.

When the DC Hyderabad assumed charge in November last year refusal cases stood at 4,549.

“We have been trying hard to reduce these refusal cases number,” he stated.

Community’s response

Refusal cases are also reported at fast pace among families living in posh localities.

In the just-concluded campaign on Wednesday, 159 cases of refusals were reported in posh area of Latifabad Unit-6, 139 in Unit-8, 122 in Unit-9 Latifabad, 65 in Unit-2 and 35 in Unit-10, 92 in Qasimabad, 71 in committee-4, 44 in UC-3 of City taluka.

“There is fatigue factor which is taking heavy mental toll on families,” observed a former district health officer (DHO) of Hyderabad.

He believes that families refuse vaccination on the grounds it is not going to end in near future and after every few days polio workers start knocking at their doors.

“Fear of infertility is refusing to die down among families,” he remarked.

A senior health officer pointed out that perhaps community-oriented polio workers were not engaged for some specific areas where ratio of refusal was either higher or “missed children” factor remained constant.

“For instance a polio worker from Pakhtun community is to be engaged if area she/he is visiting is Pakhtun-dominated and this point is not being strictly adhered to,” he said.

There are reports that men from the community often come up with explanation for refusing polio drops that someone who has not been inoculated in last several months remained healthy and so this is not necessary that polio drops are administered every now and then to children.

“The same explanation is given to me in Sarfaraz Colony by a fellow from middle class,” said a health official.

Hyderabad Divisional Commiss­i­oner Abbas Baloch met some families in Khuda Hafiz Road, Amani Shah Colony and Airport areas in order to convince them to get their children vaccinated against polio.

He told families that a misperception existed about polio drops whereas ulema and medical experts believed that drops were essential.

He administered polio drops to children under five years of age.

Environmental sample

Both polio cases of 10-year-old Rubab Fatima and one-year-old Memona didn’t surprise health authorities considering the fact that Hyderabad’s environmental samples remained positive consistently since January this year.

Samples were collected from a sewerage pumping station. Hyder­abad’s sewerage system is broken and its lines mixed with drinking water supply lines. This system is considered a potential source for spread of polio virus.

Memona’s genetic sequencing showed she travelled to Karachi’s Gadap town where such cases were reported often.

“Rubab had three routine immunisation doses [polio drops] as verified from her card. Her genetic sequencing result is under process,” said an officer.

From health authorities’ viewpoint, it is high-risk mobile population (HRMP) which primarily thre­atens community as far as poliovirus was concerned. HRMP includes those who travel between core reservoirs of poliovirus like Karachi, Peshawar, Quetta, Qilla Abdu­llah, Qilla Saifullah quite frequently.

Published in Dawn, August 29th, 2019