PESHAWAR: North Waziristan tribal district is again in spotlight due to detection of two back-to-back polio cases one week apart, mainly due to parents’ defiance against oral polio vaccine.

Officials said that both the children were diagnosed with poliovirus in Mirali tehsil of North Waziristan in union councils No.6 and 7 due to non-vaccination. They said that polio immunisation was too hard to be carried out smoothly due to lack of security for vaccinators and parents’ reluctance.

Officials said that North Waziristan remained hub of poliovirus till 2014 when Taliban controlled the region. They said that the district reported two cases, the first and second in the country after a gap of 15 months.

“In papers, we have less than 2,000 refusals, which is below one per cent, but the number of silent refusals is far more than the recorded ones,” Peshawar-based officials, wishing not to be named, told this scribe. They said that the half of the residents of the village, where the second polio case was reported, were refusing routine immunisation let alone polio immunisation.

Samples from close contacts of infected children sent to NIH for analysis

Officials said that most vaccinators deployed for the campaign were threatened by parents and subsequently they entered names of their children as vaccinated but actually they were not given the vaccine. “Our workers do it out of fear. Vaccinators cannot report them as refusals,” they added.

The health workers in the area told this scribe that a small number of unimmunised children were putting at risk the health of all children. They feared that more cases would appear in the region as collection of stool sampling was enhanced. They added that five samples each from the close contacts of the polio-infected toddlers were sent for analysis.

The uncle of the male child, who tested positive for polio on April 22, claimed that the toddler was vaccinated regular during the door-to-door campaign but he was diagnosed with the crippling ailment. However, health officials in the area refuted the claim, saying that he was not immunised due to which he was infected by virus.

Officials said that the two-year-old female child, who tested positive for poliomyelitis, was also not immunised. They said that she had not received any shot in the routine immunisation.

“We have sent the sample for serology examination to National Institute of Health, Islamabad to ascertain the vaccination status. Report is awaited. Per guidelines of National Operation Centre (NOC) for Polio, we have completed polio vaccination in 15 union councils to safeguard children against the vaccine preventable disease,” Dr Gulistan Wazir, the district health officer of North Waziristan, told Dawn.

He said that the first case was reported in union council No.6 and the second in union council No.7. “We have administered vaccine to over 78,000 children below five years of age,” he said. He added that they had a total target of 110,000 children in 23 union councils and they were given the shots in every drive.

“In each campaign, we deploy 526 teams, each comprising two persons, under the dedicated security by the law-enforcement agencies to ensure that everyone gets drops and stays safe from being crippled. Security personnel help a great deal because we work in the hard and far off areas without fear,” said the DHO.

He said that recently the government increased the wages of health workers from Rs4,000 per campaign to Rs10,000 to improve vaccination.

Dr Gulistan said that they had about 700 paramedics, who were also required to work in the 1,200 health facilities, for general patients and therefore they were planning to hold a mega training event for Class-IV employees to utilise their services in the campaign.

Overall, Khyber Pakhtunkhwa has recorded drop in refusal against polio vaccination. According to Unicef office in Peshawar, the province registered 18,349 refusals in March 2022 campaign, less than 19,374 reported in December 2021.

Published in Dawn, May 2nd, 2022