ISLAMABAD: Praising Pakistan for almost eradicating polio, Unicef Regional Director George Laryea-Adjei said there are still hundreds of thousands of “invisible children” who are susceptible and must be vaccinated.

“There is a group of children called the ‘missing children’ whose parents are refusing for them to receive vaccines for various reasons. They are not easy to find. They don’t go to schools or they don’t have birth certificates. These are the invisible children. There are quite a number of them. With eradication within reach in Pakistan, it has come to a stage where we must find all those children systematically and attract them to come for the dose. They have to be invited. Where there is refusal, we have to understand their need and why they are refusing,” George Laryea-Adjei told Dawn in an interview on Friday.

He said the message to the government was that the number of ‘missing children’ had come down but it was still high. This was their last mile of eradication. Pakistan must eradicate polio, he said. There are only two countries left - Pakistan and Afghanistan - and work must be intensified.

The senior official who is in Pakistan and visiting polio reservoirs in Karachi, Peshawar and Quetta said last year the polio programme like all others took a pause for four months and then the government realised that the impact was such that it would reverse all the gains made.

“We were allowed to come in again. The operations involve over 280,000 health workers, who interact directly with people. When the pause was lifted, we returned to retrain the workers and then ensured that vaccines were available. Workers were well equipped and protected with PPE kits and the campaign started again. Last year, the numbers were not good. This year we have seen just one case of the wild poliovirus compared to 54 the previous year. There is progress but the country has been there before,” he said.

He said disruption from Covid-19 made it difficult to find the invisible children. The pandemic had two impacts. Normal services for children had been disrupted and it was not just vaccination in Pakistan in India and elsewhere. There was disruption in schooling, child protection services at a time when children were under so much stress and their mental health suffered. There was no school, no interaction to play and parents were with them all the time, he said.

The regional director said he was personally concerned that most students may have lost a year of schooling in the region. The on and off had not been of good quality.

“This means there’s going to be a lot of dropouts, children given in marriage, and child labour will go up. The Pakistani government needs to focus on younger generation.”

“We understand that because of Covid, house to house is not going to be easy. It is important to continue to send the message that children have to be vaccinated. Vaccination must not stop. The consequences are not good if you refuse.”

After polio, Unicef was concerned with child mortality rates in the country.

“Pakistan has one of the highest newborn deaths in the region. “Every two minutes a newborn child dies. This shows there is something wrong in the system. If the right strategies are adopted, child mortality can be reduced. It concerns me a great deal,” he lamented.

Another issue that concerned the Unicef official was malnutrition. He said stunting was again one of the highest in Pakistan at 40 per cent. Two out of 10 children are stunted.

“If 40 per cent of your kids are stunted it means something is not happening. It’s a huge figure that stands out.”

Thirdly, we have 23 million children out of school of which more than half are girls. “You could imagine what would come out of it. “Child marriage will go up. It multiplies into domestic issues. Transition into labour force becomes precarious. You will have unskilled or low skilled people,” he said, adding; “The Kamyab Jawan programme is a good initiative but must go to scale and reach more and more.”

He said children must be assisted to learn skills for girls to delay marriages and for the younger generation to gain confidence.

He believed that the government was aware of these issues, had good programmes that needed to go to scale, and needed more investments and mobilisation of resources.

“Unlike most countries Pakistan recognises these issues. Pakistan needs a big push and encouragement and reaches as many children as possible. Despite the pandemic, these programmes should not be disrupted,” he added.

Published in Dawn, June 12th, 2021