Being an activist in Rotary International’s participation in the anti-polio campaign I was shocked by the ruthless killings of the vaccinators, particularly as we feel partially responsible for sending them out there unprotected and with a meager funding for their daily expenses during the campaign.
As we are all also responsible for protecting the children from polio, what could now be the way forward? Providing protection for 80.000 vaccination teams in the NIDs, the campaigns covering the whole country, looks impossible. Carrying out vaccination only in the high risk areas, where there have been cases this year, virus samples found in the local environment/sewage or vaccination coverage has been poor in the previous campaigns, e.g. refusals, non-available children, but vaccination at travel transit points, risks the outbreak in previously cleared areas.
Someone suggested to revert to the previous practice of carrying out the polio & other EPI vaccinations only at public health centers, e.g. hospitals, RHC, BHU, Dispensaries throughout the year and not the house-to-house campaigns, which could be protected by the Police. Than how could we mobilize the parents, to bring their children, especially where the distance is too great? Make the Health Dept. and the UC Chairperson responsible to set up and protect a health-centre in every village, e.g. at LHW-, TBA-home or at the local mosque, where there is no other healthcare facility, and provide training and supplies. Where this is not possible, offer food- or other voucher incentives to parents visiting the nearest health-center from far away places. Moreover enforce birth registration and follow-up through NADRA data-base and UC for detection of non-vaccinated infants, by linking the data-base through mobile-phones with the local health-centers, UC, LHW for vaccination registration and reminders and even those parents, who own a mobile-phone connection, via voice-mail. Punishments to be given to those parents, e.g. BISP, Bait-ul Mal, public employees, other public service beneficiaries, who fail to get their infants registered or vaccinated, verified on their own NADRA/NIC, which can be also checked at Traffic Transit Points manned by the Police. This sounds expensive, but is less costly than the vaccination campaigns.
Since this can be implemented only over a period of time, which cannot be wasted in the present and hopefully last low polio virus transmission season, the Government has no choice, but to enforce NEAP, the National Emergency Action Plan for Polio eradication, which hopes to end polio by the end of June 2013, through vaccination campaigns. The proposal presented above is therefore for the required follow-up on polio and routine immunization.
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Dr. Hans Frey
Pakistan Polio Plus Committee