SHANGLA: Fake finger marking has been termed a major challenge to covering the refusal cases in the remote areas of Shangla district, thus putting the children at greater risk of contracting the crippling polio disease.

In May this year, a polio case was reported from Kamach area of Shangla and the child was not vaccinated during the routine immunisation drives. According to the standard operating procedure, a finger of every child is marked after being vaccinated.

Polio programme is still unsuccessful in Khyber Pakhtunkhwa due to which new polio cases are reported from various parts of the province. According to the polio programme record available on its website, in 2017 there was only one case in Khyber Pakhtunkhwa, but in 2018 the tally increased to eight, and in 2019 the cases soared to 50.

The topmost reason attributed to the refusal cases during the anti-polio campaigns is the influence the religious clerics, strongly opposing the children’s vaccination as ‘un-Islamic’, have over the population in the far-flung areas of the district.

The clerics believe that the vaccine administered to children is actually aimed at family planning and thus a conspiracy against Muslims.

Tahir Altaf, a religious cleric, while commenting on the vaccination, stated: “There are numerous deadly diseases prevailing in Pakistan, but the government doesn’t give attention to them, and only focuses on polio.”

The vaccinators claim that the anti-polio propaganda is so strong that even educated people, including those in the government service, are reluctant to get their children vaccinated against polio.

Faisal Khan, a vaccinator, said during the last two campaigns family of a government officer had also refused vaccination of their children.

He said 30 per cent of children in his target area were silent refusal cases. Silent refusal means that parents pretend that their children have been immunised although they have not.

Wali Khan, union council medical officer at Kabalgram, said about 95 per cent of people in his area were refusals from routine vaccination and 60 per cent from polio immunisation.

Following the detection of polio case in Kamach area, a team of the National Rapid Response Unit investigated it and issued a ‘mission report’, which held the EPI programme responsible for the polio case.

The report said during investigation it was found that all the children had zero doses for routine vaccination, with a family even having prepared fake vaccination card in Kamach area. The report said mother respondents complained that hospitals did not give oral polio vaccines during the routine immunisation.

The mission report mentioned that the fake finger marker was found during the investigation. It said there were many instances where the children accompanied by their parents to schools were finger marked without being vaccinated.

“While monitoring the polio campaign we caught a fake finger marking case as a family had stained its child’s finger with marker,” Fidaul Karim, assistant commissioner Alpuri, and also the chairman of union council polio eradication committee, claimed, saying the family had bought a marker from the market for the purpose.

Arshad Subhan, a local resident, said whenever polio teams visited his house, on his request, they only marked the children’s fingers, as ‘we did not allow our children’s vaccination because polio drops are not good for their health’.

The WHO’s Technical Advisory Group on Polio Eradication observed in a recent report on August 29 that KP is a major barrier to polio eradication efforts in Pakistan.

The advisory group acknowledged that finger markings were major challenges in the region.

Zakerin Khan, an elderly man in Kabalgram area, insisted that his grandson was physically affected by polio drops. However, an EPI official said the child was refused polio vaccination.

Zahid Khan, union council medical officer, said he had recently reported an Acute Flacid Paralysis case to the polio programme, and the 18-month-old child, Ayan Hamid of Butyal, was found to be among the polio refusal cases.

A document obtained from EPI revealed that 54 refusal cases were reported in the last campaign in Kabalgram held from August 26 to 29.

“In view of fake finger markings we have warned the teams against marking the fingers of children without administering them with polio vaccine, and asked the vaccinators to inform the supervisors and UCMOs about such cases,” Wajid Ali, district coordinator EPI, said.

He said WHO should provide different coloured markers for every next campaign, which might help in curbing fake finger markings.

“In my 17 years experience first time I faced resistance from a family refusing polio drops to children while referring to the infamous Peshawar incident aired on TV in which people beat up the polio workers,” Tajida, an LHW, said.

The LHW, however, regretted that inadequate payments to the polio team members were the reasons behind the poor polio eradication effort.

She said LHW coverage in the district was just 32 per cent, while some areas had no lady health workers, where male vaccinators worked in both polio and routine vaccination campaigns.

Shangla deputy commissioner Imran Hussain Ranja told this scribe that fake finger marking was due to lack of community awareness on polio.

He said the polio case surfaced in Kamach was because the child was neither vaccinated during the routine immunisation nor during the polio campaigns.

Published in Dawn, September 30th, 2019