Taliban blocks polio vaccination
[This report does not necessarily
reflect the views of the United Nations]
TARINKOT , 15 March 2007 (IRIN) - Gulalai, 45, has
always viewed the health of her children as a top
priority and is not afraid to speak up about it. "It's
been two years and still no one has come to vaccinate
my children against polio," the mother-of-five told IRIN.
But living in the heartland of Afghanistan's Uruzgan province - where a growing anti-government
insurgency has made vaccinations all but impossible -
Gulalai has no illusions as to why.
"The vaccinators don't feel safe. They won't come
and our children will suffer," she said from the town
of Madabot, a dust-ridden community of 15,000 people
just 15km from the provincial capital of Tarinkot.
Four other women in the area that IRIN interviewed
echoed her view.
"People say the children in Tarinkot have been
vaccinated, but unfortunately our children haven't," Moahboba, 28, said from the doorway of her simple mud
brick home in Dorafshan, 20km northwest of Tarinkot.
"The vaccinators do not come here because the security
situation doesn't allow it."
Polio is a debilitating disease that mainly strikes
For polio vaccinators working on the frontlines of
an emerging Taliban resurgence and earning just US $50
per month, the 15 or 20km trip from the provincial
capital to outlying towns and villages is too much of
a risk to take.
"While I was traveling to Tarinkot, the Taliban
stopped my bus and forced me outside," said Hamdullah,
a government polio vaccinator who was beaten and
harassed on 16 February while on duty.
"They slapped my face. They held me for eight hours
before releasing me," the 35-year-old said. "They made
me promise that I would not vaccinate any more
children - threatening to kill me if I did."
Aid workers threatened
The Taliban have long eyed aid workers with
suspicion, suspecting them to be collaborating with
Western military forces. Aid workers have repeatedly
been warned and threatened to leave the country or
face the consequences. "If they won't stop their work,
we will target them, like we've targeted them in the
past," said Qari Yousef Ahmadi, purportedly a Taliban
spokesman, to the Associated Press late last year.
Threats of violence are having a serious impact on
Afghanistan's overall polio eradication efforts.
According to the World Health Organization (WHO),
Afghanistan had a severe polio outbreak in 2006,
largely because of conflict in the south severely
impeding access to children during immunisation
Health specialists agree that eradicating the polio
virus is no longer a technical issue only. Polio
eradication hinges on vaccine supply, the outlook of
the local community, funding and, most of all, support
from political leaders at all levels.
While the first three points are essentially in
place in Afghanistan, getting support from political
leaders will prove key to the success of a polio
eradication campaign, specialists say.
Afghanistan, India, Pakistan and Nigeria are the
four countries worldwide where polio remains endemic,
according to the WHO.
Impact of insecurity
Specialists say the transmission of the virus
continues to take place in areas where insecurity is
high as large immunity gaps among young children
To control outbreaks and interrupt transmission,
vaccinators need to reach all children everywhere
through high-quality vaccination campaigns, with a
particular focus on children in border areas and in
Of the 31 confirmed cases of polio in Afghanistan
in 2006, 29 occurred in rural areas of the south -
designated by UN security officials as "very high risk
The WHO estimates that in 2006 alone, vaccinators
were unable to access an estimated 125,000 children in
the south and south-eastern regions of the country due
Of this number, about 75,000 were in the southern
provinces of Helmand, Kandahar, Uruzgan, Zabul and
Nimruz, and 50,000 in the south-eastern provinces of
Paktia, Paktika, Khost and Ghazni.
"Security is the primary challenge we face in
successfully eradicating polio from Afghanistan
today," Dr Tahir Pervaiz Mir, head of WHO's polio
eradication drive in Afghanistan, told IRIN in Kabul.
Each year, WHO, in collaboration with the UN
children's agency, UNICEF, and the Afghan health
ministry, initiates four national immunisation drives
(NIDs) and has additional sub-national immunisation
drives in the areas deemed to be at particularly high
Supplementary rounds generally carried out in
January and February annually in the south - 10 in
2006 alone - have proven especially difficult for
vaccinators. "During the February vaccination rounds,
our teams were not able to access around 100,000
children in the southern region because of
insecurity," Mir noted.
Echoing Mir's concern on the impact insecurity was
having, Saifudin Khan, a health officer for Urozgan's
provincial health department, said, "We have not been
able to carry out any vaccinations in areas like Dorafshan, Madabot and Charmestan because of the
security situation. When any of our volunteers go to
these areas, the Taliban destroy their tools and
threaten to kill them."
- In 1988, the World Health Assembly
unanimously resolved to eradicate polio, a
disease which has been crippling thousands of
children for life each year
- Since 1988, global eradication efforts
reduced the number of polio cases from an
estimated more than 350,000 annually to 1,956
cases in 2006
- Polio remains endemic in four countries
today: Nigeria, India, Pakistan and
Afghanistan - with a total of 1,828 cases
- In Afghanistan, WHO, in collaboration with
its partners, will launch a nationwide
campaign to vaccinate 7.3 million children
over the course of two days on 25 March
- Of that number, 1.2 million children under
the age of five are being targeted in
Afghanistan's southern region
- Some 40,000 vaccinators will take part in
the nationwide effort
- There will be a total of four national
polio vaccination campaigns in Afghanistan in
2007, as well as between four to five
additional rounds in high-risk areas such as
- The Afghanistan Polio Programme is facing
a funding gap of US $30 million for 2007-2008
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the views of the United Nations or its agencies.