PAKISTAN

Perils of Polio Workers

During a span of three days, between April 23 and April 25, 2019, three persons, including two Policemen providing security to Polio vaccination campaigners, were killed while two Polio workers sustained serious injuries in different parts of Pakistan. The country-wide five-day campaign to administer the polio vaccine to children under five years of age started on April 22 and continued till April 26. Authorities reportedly acquired the services of more than 260,000 health workers for this door-to-door campaign.

After the series of attacks and rising security threats to polio workers in different parts of the country, the Federal Government, on April 26, suspended the anti-polio campaign “for an indefinite period”. The Government has also suspended the post-campaign evaluation — Lot Quality Assurance Sampling (LQAS).

As envisioned in the National Emergency Action Plan (NEAP) 2018/2019 of the Pakistan Polio Eradication Programme, five five-days polio eradication programme were planned for the months of September, November and December of 2018 as well as in January and April of 2019. During the September 2018 Polio campaign, unidentified militants shot dead a Policeman assigned to protect polio workers in the Khar area of the Bajaur District in Khyber Pakhtunkhwa (KP) on September 25. Similarly, during December 2018 Polio campaign, unidentified assailants opened fire on two female polio workers while they were participating in a polio vaccination campaign in Bhosa Mandi area of Quetta, the provincial capital of Balochistan, on December 26. While one polio worker Ghazala sustained bullet injuries, the second survived the attack. No incident was reported during the campaigns in November 2018 and January 2019.

Attacks on polio vaccination workers as well as on Security Force (SF) personnel deployed for their protection have a long history in Pakistan. Terrorists not only kill health workers but also spreading negative propaganda against the vaccination campaign, including the canard that the vaccination drops were part of a western plot to sterilise Muslims.

Pakistan’s polio vaccination campaign and people associated with it have not only suffered at the hands of terrorists, but also as a result of Islamist Fatwas (religious edicts). Though Tehreek-e-Taliban Pakistan (TTP) had been pursuing an anti-polio campaign in Swat Valley of KP since 2009, the first Fatwa came from cleric Maulvi Ibrahim Chisti in the Muzaffargarh District of Punjab, on June 12, 2012. Declaring the anti-polio campaign “un-Islamic”, Chisti warned that a jihad (holy war) would be launched against polio vaccination teams. 

Meanwhile, opposition to all forms of inoculation grew after the Central Intelligence Agency (CIA) in 2011 organised a fake vaccination drive by Dr. Shakil Afridi in the Abbottabad town of KP to track down al Qaeda's then chief Osama Bin Laden, who was later killed at Abbottabad by US SEALs on May 2, 2011.

Polio immunisation programmes in Pakistan have been reeling under terrorist attacks with a total of 51 health workers killed and 52 injured since 2012 (data till April 26, 2019), according to partial data compiled by South Asia Terrorism Portal (SATP). During the same period, 54 security personnel were killed and 21 sustained injuries while providing security to Polio campaigner. The first casualty in this database was reported on July 20, 2012, when unidentified terrorists shot dead doctor Ishaq (45), associated with the World Health Organization’s (WHO’s) polio prevention campaign, at Al-Asif Square in the Junejo Town of Karachi.

13 persons (all Polio workers) were killed in 2012, 18 (8 polio workers, 10 SF personnel) in 2013, 39 (12 polio workers, 27 SF personnel) in 2014, 12 (six polio workers, six SF personnel) in 2015, 13 (five polio workers, eight SF personnel) in 2016, none in 2017, six (five polio workers, one SF personal) in 2018 and four (two polio workers, two SF personnel) in 2019 (data till April 26).

These attacks have had severe impact on the incidence of polio in Pakistan. According to Endpolio Pakistan data, there were 58 reported polio cases in 2012, increasing to 93 in 2013 and 307 in 2014. Health officials blamed the rise on attacks on immunisation teams as the reason (SATP data indicates that the highest number of fatalities were recorded in 2014). The number of reported polio cases came down to 54 in 2015, 20 in 2016 and eight in 2017. In 2018, 12 cases of wild poliovirus were reported in the country — five from Bajaur District (KP), three from Dukki District (Balochistan), and one each from Charsadda District (KP), Lakki Marwat District (KP), Khyber District (KP) and Gadap town of Karachi (Sindh). Two new cases, confirmed on April 23, 2019, are from Bannu and North Waziristan Districts of KP.

Pakistan is one of just three countries where polio remains endemic, along with Afghanistan and Nigeria. Though the Government provides security during vaccination programmes, the militants and anti-social elements take advantage of mass hysteria, and the Government has failed to take the initiative to create social awareness in a deeply radicalised society.

Tushar Ranjan Mohanty
Research Associate, Institute for Conflict Management