Pakistan - No let-up in polio cases

[sharon sanders]

No let-up in polio cases


<center> By Mukhtar Alam</center>
KARACHI, May 1: There has been no let-up in polio cases in the country as a 27-month-old girl, a resident of Mirpurkhas district, Sindh, was confirmed as suffering from the disease on Thursday.

The latest victim of the dreaded virus had an attack of paralysis on April 5, following which stool samples were collected and sent to the National Institute of Health.

The latest detection took the number of cases in the country so far this year to five, mocking the government?s claims that Pakistan was all set to give the disease ?one final push?.

Earlier this year, Sindh reported one polio case each from Nawabshah (Jan1), Hyderabad (Jan 25), Shikarpur (Feb 25) and Karachi (April 1). The province has been reporting one case per month since May of last year.

While 13 polio cases have been confirmed in Sindh over the past 13 months, Punjab showed only one case, NWFP seven, Balochistan six and Fata two over the same period.

Islamabad has not reported any case since Dec 2003, the AJK has not had any case since June 2000 and Fata has remained polio-free since Jan 1998.

According to a source, the trend of polio cases reporting in Sindh is similar to last year?s when the province reported seven new cases from January to April. Of the five polio-affected children, three happened to be girls.

The latest affected girl was given 12 doses of oral vaccines, claimed another source.

Till Thursday night, the polio eradication executives of the province had not admitted that Reshma, the Mirpurkhas girl, had tested positive for polio.

Dr H.B. Memon, National Manager of the Expanded Programme of Immunisation, confirmed that the fifth polio case had once again been reported from Sindh.

According to the World Health Organisation, there is a discrepancy between figures furnished by the district administrations and independent evaluators vis-?-vis the polio immunisation drive.

?The difference of five per cent or more in the cases of Qillah Abdullah, Qilla Saifullah, Masgung, Khuzdar, Karac hi, Badin and Umerkot reinforces the need for improving campaigns quality as well as the post-campaign assessment,? a summary said.

http://www.dawn.com/2008/05/02/top10.htm

 

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Re: Pakistan - No let-up in polio cases

Source: http://thepost.com.pk/CityNewsT.aspx?dtlid=159541&catid=3

Anti-polio drive being mishandled

Health officials showing no enthusiasm | Untrained teenagers employed for the sensitive task

Manzoor Qadir

LAHORE: At a time when polio is showing backsliding, the health officials appear as giving a dam to the matter the way they are conducting anti- polio drives for making the country free from this lethal disease.

A three-day national anti polio drive will also be starting here today (Tuesday) like other parts of the country to ensure immunization of children up to five years of age. The city district government has set a target population of 1.3 million children during the campaign that would be vaccinated till August 9.

However, it is feared that a large number of children will probably be missed here during the polio vaccination drive due to multiple reasons.

These is insufficient staff for out-reaching teams, ill trained Campaign Support Personals (CSPs), Town Supervisors, Zonal Supervisors, Areas In-charge, mobile teams' members including volunteers and shortage of lady workers.

In addition to these, absence of proper advertising about the drive, a little exposure of the Executive District Officer (health) Dr Ahmad Afifi and Deputy District Officer (Health) Dr Shafqat about the national immunization due to their new arrival in the city district government, sub-optimal and poor coverage activity in the recent past and non management of health indicators are other factors which are making the things worst for the campaign in the beginning.

Sharing details, a health official, not revealing his name, said that before starting the immunization campaigns, the health department used to spread information to the target population about the drive by using different means. It advertises the drive on the print and electronic media besides engaging the services of opinion leaders so that they could convince parents about the importance of immunization. However, in this campaign, such things are missing owing to lack of commitment among the concerned officials.

Furthermore, special workshops as well as training sessions are supposed to be held extensively for the training of the area supervisors, staff and volunteers who monitor, supervise and administer the polio drops as well as Vitamin-A to the children, but City district government did not maintain such training sessions properly.

He alleged that Executive District Officer (Health) Dr Afifi has hired the services of some untrained CSPs like Dr Rubina Hanif only to oblige his near and dear. He also posted some untrained officials as Town Supervisors, Zonal Supervisors and Areas In-charge for conducting the drive who have not much knowledge about the immunization procedure. According to rules, only government employee would serve as Area In-charge but the health department has posted some volunteers too.

"The latest outbreak of poliovirus in the Sindh province has demanded the Punjab health authorities to make extra efforts to control the menace in the province," he remarked. He further maintained that during the meeting of all Provincial EDOs held on May 2, 2008, it was told that the city district health authorities are not performing up to the mark. He added that reports of low levels of coverage and deteriorating quality of campaigns were discussed in the meeting of various districts including Lahore.

Some insiders of EDO Health office apprehended that the drive would not yield required results as the morale of concerned health authorities as well as teams is not high due to lack of proper arrangements.

They said that in the past the government managed colleges and schools' teachers and students for administrating the drops, but this time teenagers, taking their final board examinations have been engaged, thus they can not be made available for the purpose. How the city district health department would be able to constitute about 238 camps and 2,452 mobile teams comprising 6500 persons to vaccinate all the target groups in the city, they questioned.

Moreover, the EDO Education so far did not circulate a notice to the schools especially private schools where a large number of children aging below five are studying to lend helping hands with the mobile teams for immunization the children.

EDO Health Dr Ahmad Afifi could not be contacted. DDO Health Dr Shafqat admitting some flaws in the prepration of the campign said that the health department is striving hard for making the drive sucessful and it is hoped that it would achieve its set target.

 

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Re: Pakistan - No let-up in polio cases

Source: http://www.thenews.com.pk/print1.asp?id=111513

By Shahina Maqbool
5/9/2008
Islamabad

The provincial health authorities of Sindh, who were yet to recover from media criticism and growing political pressure for low quality of campaigns in Karachi and other parts of Sindh, got another shocker on the last day of the National Anti-Polio Immunisation Campaign on Thursday when the National Institute of Health declared two hot cases under investigation as confirmed for polio.

This time, the deadly virus has paralysed for life, a 56-month-old male child Ashfaq from Jacobabad and 36-month-old Shifaat from Noushero Feroze. A credible source at NIH has revealed that both the children were deprived of many routine as well as special doses of oral polio vaccine (OPV). Shifaat had not received a single routine immunisation dose while Ashfaq had only received one routine immunisation dose and 3 additional OPV doses.

When contacted, an official working for the World Health Organisation said, parents must understand the importance of additional doses and should not trust misconceptions about additional doses being associated with health risks. ?The paediatricians should also help us by informing parents about the importance of strengthening a child?s immunity level by giving multiple doses during every campaign,? he pointed out.

According to the WHO official, the only way children can be saved from the deadly virus is making sure they are vaccinated every campaign and receive all routine and extra doses. ?All parents to make sure their child is immunised, and has received his share of the two drops during the ongoing campaign. If a child is missed, parents should contact the nearest hospital till Saturday,? he added.

With the addition of two new polio cases, Pakistan?s count has risen from 5 to 7 so far this year.

 

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Re: Pakistan - No let-up in polio cases

Source: http://www.daily.pk/culture/health/70-health/3420-10000-children-vaccinated-at-toll-plazas.html

10000 children vaccinated at toll plazas
Thursday, 08 May 2008 22:13 Bliss

More than 10,000 children were vaccinated on the first day of the national anti-polio immunisation and vitamin A supplementation campaign at the 54 toll plazas falling under the jurisdiction of the National Highways and Motorways Police (NH&MP), a source working for the Ministry of Health told.

A break-up of data on the first day shows the Karachi-Hyderabad Toll Plaza on the Superhighway in Karachi leading the count by vaccinating 1,033 children, followed by the Motorway Toll Plaza at Peshawar and the Islamabad Toll Plaza where 756 and 612 children respectively, were vaccinated. Three toll plazas falling under the jurisdiction of district Attock on GT Road at River Indus, Harro and Burhan also vaccinated 523, 304 and 388 children, respectively. Similarly about 1,000 children were vaccinated at Sungjani, Mandra and Jhelum Toll Plazas on the GT Road.

?The new joint venture with NH&MP has proved fruitful in ensuring that traveling children that previously used to be missed being in transit are covered this time. Scientific results have proved that children that were affected by the crippling poliovirus in Sindh were of the same strain that affected children in areas of Karachi in 2007,? the source said.

New cases of polio in parts of Sindh have proved that a more efficient system needs to be introduced to stop the transfer of poliovirus through children that remain in transit during the vaccination days. ?Looking at the results of the first day, we are hopeful that our partnership with the police will go a long way for polio eradication,? the source said.

Replying to a questing regarding the challenges being faced by vaccination teams during the ongoing campaign, the source revealed that reaching children living in posh localities of big cities such as Islamabad, Lahore, Karachi and Peshawar was becoming a growing challenge as private pediatricians were advising parents against repeated doses.

?Parents must understand the importance of multiple doses as to make sure that the virus does not reproduce itself by finding and targeting a child with low immunity levels. Giving multiple dozes every campaign is extremely important for bringing the immunity levels of children to optimum levels where the polio virus cannot target them,? he said.

Five children have been affected by polio so far this year against 13 in the first four months of 2007. ?The history of all polio-free countries has shown that the virus was cornered to one area, as in our case its Sindh, before being wiped from the country forever,? he said.

 

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Re: Pakistan - No let-up in polio cases

Source: http://www.dawn.com/2008/06/20/top15.htm

Polio case detected
By Saleem Shahid

QUETTA, June 19: A new case of polio has been detected in a village near Chaman town in Qila Abdullah district.

?A two-year-old boy was found infected with polio virus,? Dr Aurangzeb Kamal, project officer the Polio Programme in Balochistan, told Dawn on Thursday.

Provincial health officials collected stool sample of Zahoor and sent it to the National Institute of Health (NIH) laboratory.

?The NIH conducted Eliza test that confirmed the boy is suffering from polio,? Dr Kamal said, adding that it was the first polio case detected in the province over the past six months. Three polio cases were detected in 2007.

Fourteen confirmed cases of polio have been detected in the country over the past six months, including seven in Sindh.

?Most of the polio cases have been detected in Balochistan?s border districts near the Afghan border,? he said.

?The boy?s father refused to allow the medical team to administer polio drops to his son,? Dr Kamal said.

 

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Re: Pakistan - No let-up in polio cases

Source: http://www.dawn.com/2008/08/21/top14.htm

Two more hit by polio virus

PESHAWAR, Aug 20: Two children have tested positive for polio in Charsadda district, taking to 14 the number of such cases in the NWFP and Fata this year.

Health officials said on Wednesday that the afflictions had been confirmed by the National Institute of Health in Islamabad. They said that 10-month-old Haris Khan of Najeemabad had received four doses of oral polio vaccine (OPV). But his family has been refusing the OPV since March and the officials fear that two other children could also get infected.

In Gujjar Qilla, three and a half years old Amina Bibi was diagnosed positive for the disease despite having received 14 doses of OPV. Although she had no symptoms of the disease, polio virus was found in samples of her stool.

With the two cases, the number of polio cases detected in the country this year has risen to 33 ? 14 in NWFP, 12 in Sindh, two in Punjab, four in Balochistan and one in Islamabad.?Bureau

 

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Re: Pakistan - No let-up in polio cases

Source: http://www.thenews.com.pk/daily_detail.asp?id=131865

One more polio case detected in Sindh
Monday, August 25, 2008
By our correspondent

A 30-month-old boy, Naushad, was diagnosed with polio in union council Khanpur, district Khairpur, health officials said. Khairpur is the home district of Sindh Chief Minister Qaim Ali Shah

Expanded Programme on Immunisation (EPI) Project Director Dr Mazhar Khamisani told The News that the child had received around 16 polio dozes so far. This case also belongs to P-1 category of the virus, he said.

A total of 36 polio cases have been reported so far in the country this year. Twelve cases were reported in Sindh, 16 in the NWFP, one in Islamabad and three in Punjab.

Dr Khamisani claimed, however, that the EPI?s efforts to control polio virus in Sindh were producing results. Concerted efforts were launched a couple of months ago and so far only one case has surfaced, he said.

?This is the ?peak season? for the polio virus. It is also evident from the fact that there were a total of seven cases in the NWFP but now its number has increased to 16. Similarly, more cases are being reported from Punjab and Islamabad as well,? Dr Khamisani said.

 

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Re: Pakistan - No let-up in polio cases

Source: http://regionaltimes.com/18sep2008/nationalnews/fifth.htm

Fifth polio case in Peshawar confirmed

PESHAWAR: The outbreak of polio virus in the capital city has been continued as another child a one year old Bibi Naeema daughter of Ghani Khan was attacked by crippling decease and she was declared polio positive on Tuesday.
It has been apprehended that more polio cases in Peshawar would be detected in the coming days as P-3 virus was in circulation in a particular area of the Town four of the district Peshawar.
According to the health department NWFP, the new confirmed polio case would raise the number of affected children in Peshawar to five as four children in the city were already been attacked by polio P-3 virus in the current year that compelled WHO, Unicef and NWFP health department to run special campaign of P-3 vaccines on emergency basis which had been continued in the selected district of NWFP where so for 18 children were found polio positive.
The new polio case belongs to the Surai Zai Payan where a week before 18 months old Zubair, an Afghan Child was also attacked by P-3 virus while the third polio case in Peshawar had also belonged to the same Town when 9-month old Afghan child Mohammad was declared polio positive.
Mohamad belongs to Zindai Refugee camp, the same locality from where the 2nd polio case of district Peshawar in the current year was reported.
According to health officials NWFP the child Naeema Bibi belongs to Korram Agency however her family was permanently living in Suraizai Payan. He said that all of the five affected children were attacked by the P-3 virus of the crippling disease. The virus was very active in Afghanistan and there was the possibility that Afghan refugees, who were frequently visiting Afghanistan, might have transferred the virus to the area.
The un unhygienic conditions and frequent visits to the Afghans helped the virus to attack the newborn in Zindai Refugee camp whereas the virus is in circulation in the whole area therefore it has attacked another child of the same town, the health official said apprehending that more cases from the same area could be confirmed polio positive in the coming days.
He said majority of the affected child of Peshawar in the current year had received only 4 dozes of the P-3 vaccines however they should had been given at least 12 dozes to protect them of the polio virus, he informed. ?Agencies

 

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Re: Pakistan - No let-up in polio cases

Source: http://www.thenews.com.pk/updates.asp?id=55613

Number of polio cases climbs to 50
Updated at: 2100 PST, Thursday, September 18, 2008

PESHAWAR: The total number of polio cases registered this year in the country climbed to 50 after confirmation of one case in District Batgram.

Sources of National Health Organization (NHO) told Geo News that two-year old Shakila, resident of Batgram, has tested positive for P-1 virus, bringing the total number polio cases in the country to 50.

So far 19 polio cases have been reported in NWFP, 14 in Sindh, 10 in Punjab, 6 in Balochistan and 2 Islamabad.

 

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Re: Pakistan - No let-up in polio cases

Source: http://www.thenews.com.pk/print1.asp?id=137507

NWFP confirms its 21st polio case
By by Mushtaq Yusufzai
9/23/2008
PESHAWAR: A nine-month young Najeebullah may never forgive his father, a hardliner tribesman living in the militants-dominated Mohmand tribal region, for repeatedly barring Najeeb?s mother to allow the polio vaccination teams to enter the house and administer him the vital anti-polio vaccine.

Sources in the World Health Organisation (WHO) told ?The News? here Monday that Najeebullah was confirmed by the Regional Polio Virology lab based at the National Institute of Health (NIH) in Islamabad as the 57th victim of the deadly poliovirus during the current year.

With the detection of this latest polio case in NWFP, the total number of confirmed polio cases in the province rose to 21, out of which five cases have appeared in the Fata, while the remaining 16 in settled districts of the province.

In a recent meeting held in Peshawar, Provincial Health Minister Zahir Shah also expressed his concern over the ever-increasing number of polio cases in the almost peaceful settled districts of NWFP.

?There is no war or Talibanisation in settled areas which can be used as an excuse for the rising number of polio cases in the areas,? said the sources while quoting the health minister as saying.

Apparently, a lot of children like Najeeb have remained unvaccinated over the last many months in different parts of NWFP, including Swat and tribal regions of Khyber, Mohmand, Bajaur, South and North Waziristan.

Also, it is feared majority of such children may remain unvaccinated in the days to come due to operation against militants. Militants affiliated with Maulvi Omar Khalid, Baitullah Mahsud-led banned Tehrik-e-Taliban Pakistan (TTP) leader in Mohmand Agency, recently kidnapped an Expanded Program on Immunization (EPI) team even from Peshawar for visiting the area to supervise a just concluded polio vaccination campaign.

The militants also snatched motorcycles and other equipment of the EPI team and put them in their private detention centres for a few days.It terrified the health workers and no polio team after the incident took security risks to visit the area.

?Cases like Najeeb clearly show there are some areas where we have refusals but portraying an image that each and every missed child of NWFP is a refusal is simply exaggerating the situation. Parents are wise enough to make the right decisions for the future of their children,? said an official working for the EPI.

Pakistan, it may be mentioned, is currently ranked the best in polio endemic countries in the world as India has recently crossed 400 while Nigeria is about to hit 600 polio cases during the current year.

Another factor that makes Pakistan a polio eradication initiative the best is the accurate information to know the reservoir behind the spread of the deadly poliovirus. Currently Pakistan has two virus transmission zones, one in the Fata areas and second in Karachi.

Meanwhile, World Health Organisation (WHO) in collaboration with NWFP Health Department would launch a three-day polio immunization campaign in Battagram from September 24 after fresh polio case was detected in the district.

Dr Mohammad Saleem, district coordinator EPI programme, Battagram, said Shakila Bib had been vaccinated seven times in two years as parents of the girls had the record with them. Dr Saleem said post campaign monitoring would be held on September 27 and 28, respectively. Saleem said during the three-day polio immunisation campaign as many as 70,400 children of age 5 and below would be administrated polio drops in the district.

 

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Re: Pakistan - No let-up in polio cases

Source: http://www.thenews.com.pk/print1.asp?id=138966

63 polio cases confirmed in country so far this year
By by Mushtaq Yusufzai
10/1/2008

PESHAWAR: Weak anti-polio campaigns and low routine immunisation in the last two years have started showing its adverse results as 63 polio case has so far been confirmed in the country this year.

Sources working for the Pakistan Polio Programme revealed to ?The News? that a lot of children that have remained unvaccinated during the last two years, whether through campaigns or routine immunisation, are causing an upsurge in the number of polio cases.

?In the last couple of years large numbers of children had remained unvaccinated in the militancy-hit areas in Fata and settled districts of NWFP, while a number of them remained unvaccinated in Sindh without any unavoidable reason which clearly speaks volumes about the poor performance of the provincial health authorities in Sindh?, an official associated with anti-polio campaign based in Islamabad said.

According to a survey conducted by independent observers in areas with recent polio cases, recorded big lapses in the number of reported children covered when cross-checked against the number of children that could be identified as ?vaccinated? by finger-marking records. In some places a difference of 15 to 20 per cent was recorded when confirmed vaccinated children?s records were tallied against the ones that could be confirmed by finger-markings, the officials disclosed.

Replying to a question regarding the recent upsurge of polio cases in Punjab, the sources said that none of the single out of thirteen cases reported so far from Punjab could be traced back to the same province. ?All the cases reported so far from Punjab, each case could only be linked back either to a case from NWFP or from Sindh. This shows that generally the quality of campaigns conducted in Punjab were better than the ones conducted in rest of the country,? the officials maintained.

However, low routine immunisation, which is the backbone of the polio eradication programme, provided a weak point for the virus to be re-introduced back into Punjab. There is a need to maintain vigilance at all levels to ensure high quality campaigns, strong surveillance and focus even more intensively on improving routine immunisation.

According to officials, advices given by very few paediatricians, especially working for private hospitals and private clinics, regarding the side effects of extra doses was also a growing cause of concern for the polio control authorities. In bigger cities particularly Lahore, Karachi, Islamabad and Peshawar, the officials said paediatricians working in private hospitals and clinics have been misguiding parents not to administer extra doses to their kids, which they felt was aggravating the problems for them.

?Doctors can play a vital role by removing misconception from the minds of parents related to extra doses. Their role is significant in making Pakistan?s stand in the row of polio free countries sooner than later,? they said.

Expressing concerns about the growing number of diarrhoea cases in the country the experts said that any vaccine gives only 60 to 80 per cent of assurance against any bacterial or viral disease.

?If a child has diarrhoea and he/she is administered polio drops, the drops will not help increase the desired immunity levels of the child. As the absorptive capacity for all substances in the GIT (Gastro Intestinal Tract) is reduced,? they opined.

Replying to a question regarding the efficacy of the vaccine being imported from abroad, the experts strongly dispelled the rumours, saying that the same vaccine was used throughout the world to get rid of polio, including Bangladesh, Indonesia and Cambodia, which have similar characteristics that the Pakistan programme is facing.

?It is a big disappointment to all of us that some of our irresponsible officials are using the vaccine being imported from various parts of the world as an excuse to hide from their inefficiency in the polio rounds, no matter where the vaccine is imported from, it?s the formula that matters and has got nothing to do with any country that manufactures the vaccine?, said the experts.

 

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Re: Pakistan - No let-up in polio cases

Source: http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2008/10/04/MNH212J3NS.DTL

Anti-U.S. views fuel polio growth in Pakistan
Ayesha Akram-Nasir, Chronicle Foreign Service
Saturday, October 4, 2008

(10-04) 17:49 PDT Lahore, --

Pakistan - With her face partly hidden behind a traditional black cloak, Salma Amir follows her daughter Farah's every movement while tightly gripping the 15-month-old toddler's back. Farah's sticklike legs fail to straighten as she clasps her mother's hands and laughs with glee.

"I didn't know what's wrong with her," said Amir, who lives with her husband in a squatter settlement. "She developed fever and the next day her legs refused to straighten out."

At a government hospital, doctors told Amir that her daughter had polio.

To date, Farah is the lone case of polio in this city of 10 million inhabitants. But health officials fear the polio virus is re-emerging across Pakistan. It is especially serious, they say, in the lawless tribal North West Frontier Province along the border with Afghanistan where the Islamic fundamentalist Taliban rule and many families have refused vaccinations on religious grounds.

"The situation is worrisome, very, very worrisome," said Dr. Whaeed Khan, health director for the city of Peshawar. "Even previously polio-free cities are becoming infected."

In 2007, the World Health Organization recorded 32 cases of polio in Pakistan, up from 28 in 2005. Between January and August, 31 more cases have been recorded, with one-third in the tribal areas.

Since a door-to-door immunization program began in 2001, tens of millions of children have been vaccinated or given polio drops, according to health authorities. But in tribal areas, radical Islamic clerics such as Maulana Fazlullah have convinced residents that U.S.-manufactured polio drops are designed to sterilize Pakistanis and reduce the Muslim population.

"If the Pakistani government wants to give our children these drops, then they have to manufacture them in this country," said Muslim Khan, a spokesman for Tehrik-e-Taliban, Fazlullah's militant organization.

Health authorities say polio vaccines used in Pakistan are produced in WHO-accredited laboratories not only in the United States but in Japan, Belgium and India. Pakistan has no such laboratory.

Kahn says recent air strikes in tribal areas have also contributed to residents refusing to allow vaccinations for their children. Since Aug. 13, there have been at least seven reported U.S. missile strikes, as well as a ground force operation, in tribal territories.

"Due to the security situation in these areas there is a lot of resentment against America," said Kahn. "The perception that this vaccine is a U.S. product holds strong in these areas, leading to refusals" to accept vaccinations.

Khan also noted that Fazlullah's sermons have stressed that those who become crippled or die from polio are martyrs. The vaccine is considered haram, or that which is forbidden for Muslims.

"There are other diseases also - like hepatitis, typhoid, etc. Why is everyone concentrating on polio?" asked Kahn. "See, this is an American conspiracy."

Tehrik-e-Taliban's opposition and a worsening security situation have caused government vaccination teams to stay out of tribal territories. In the Swat area alone, some 160,000 children have gone without immunizations, according to the state Expanded Program on Immunization, or EPI.

"It just wasn't possible to gain access to those areas," said Muqeem Khilji, an EPI spokesman.

Khilji says that aside from conspiracy theories, religious beliefs can also play a role in keeping children from being vaccinated. "Some parents say it's un-Islamic to vaccinate their children because it's akin to tampering with the will of Allah," said Wahaeed Khan, a former EPI official.

Other EPI officials say many tribal communities refuse to cooperate with vaccination programs until the state agrees to a road or sewer project in return.

To be sure, many religious leaders support the government vaccination campaign. The EPI team has obtained fatwas, or religious declarations, from such renowned Islamic scholars as Maulana Fazl-u-Rehman and Qazi Hussain Ahmed. But in such tribal areas as Swat, Bajaur Agency and Kurram Agency, militant clerics like Maulana Fazlullah are more influential in shaping local opinions, health workers say.

With the government rapidly losing control over tribal areas, EPI volunteers fear being beaten and kidnapped, says Khan. In 2006, two campaign workers were shot dead on their way back from trying to convince a local council to support the state vaccination drive.

"In June, four of our volunteers were kidnapped and kept for two days," said Kahn.

Joint Secretary of Health Azam Saleem predicts that Pakistan will be a polio-free country by 2012, a date some health workers suggest may be too optimistic.

"To end polio in this country, we need to change people's attitudes," said Whaeed Kahn.
KEY FACTS ABOUT POLIO

-- Polio is a highly infectious disease caused by a virus. It invades the nervous system and can cause total paralysis in a matter of hours. The virus enters the body through the mouth and multiplies in the intestine.

-- Initial symptoms are fever, fatigue, headache, vomiting, stiffness in the neck and pain in limbs.

-- The virus mainly affects children under 5.

-- One in 200 infections leads to irreversible paralysis usually in the legs.

-- In 2007, more than 400 million children were immunized in 27 countries.

-- Polio cases have decreased by more than 99 percent since 1988, from an estimated 350,000 cases in more than 125 endemic countries to 1,997 reported cases in 2006.

-- Between 2003 and 2005, 25 previously polio-free countries were reinfected.

-- Only four countries in the world remain endemic for the disease - Nigeria, Pakistan, India and Afghanistan - and Nigeria leads the world with 578 cases in 2008.

Source: World Health Organization

E-mail Ayesha Akram-Nasir at foreign@sfchronicle.com.

 

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Re: Pakistan - No let-up in polio cases

Source: http://www.thenews.com.pk/print1.asp?id=139313

Officials suspended for ?detecting polio cases?
By By Amer Malik
10/5/2008
LAHORE

THE fate of 117 School Health and Nutrition Supervisors, Sargodha district, hangs in the balance as Health Department suspended them after one year of their service on basis of not filling recruitment rules.

However, the affected officials alleged that they had been penalised for detecting polio cases during their health and nutrition campaign in schools in Sargodha district. The issue has raised warning that polio cases in Punjab may have been under-reported to hide failure to control the alarming spread of polio virus in Punjab this year.

The Punjab Health Department had recruited 117 School Health and Nutrition Supervisors in grade-17 on a three-year contract in Sargodha district under Health Sector Reforms Programme. They have completed their one year of service.

While lodging a complaint in Chief Minister?s Complaint Cell, officials (both male and female) rejected the government?s plea to remove them due to their recruitment against rules after one year of service, as they believed that, if at all, they were recruited against the rules, then it was government?s own fault. ?So why we are being punished for none of our fault?? they questioned.

They lambasted the bureaucracy for waking up about their recruitment against rules after one year of service.

They further said that they had been made a scapegoat for detecting some polio cases in schools in Sargodha, which caused their own suspension. ?The District Health Department, Sargodha, had warned us against making polio cases public, which ultimately became reason of their suspension,? they added.

The medical experts and officials of Health Department that Punjab?s health authorities were facing a challenge to control the spread of polio virus, which had emerged like an epidemic in different districts of Punjab during this year. Presently, there are 16 reported polio cases in Punjab out of total of 65 cases across Pakistan. Out of total of 65 polio cases, 50 cases are of P-I strain of polio and 15 cases of P-III strain of polio virus. All 16 cases in Punjab are detected as attacked with P-I strain of polio virus.

However, medical experts and officials of Health Department said there might have been many more cases of polio as against moderately reported 16 cases in Punjab, as reporting of greater number of polio cases reflected failure of Health Department?s anti-polio drives through low coverage of immunization of each and every child below five years of age or raised questions about the substandard or expired vaccines being used during the vaccination campaigns under Expanded Programme of Immunization or special three-day anti-polio campaigns under National Immunization Days (NIDs). ?It has prompted health authorities to under-report polio cases to conceal their own failure to control the spread of crippling polio disease among the children in the province,? they added.

When contacted, EDO Health, Sargodha, Firdous Shah said that School Health and Nutrition Supervisors, which recruited on a three-year contract under Punjab Devolved Social Services Programme (PDSSP), had been stopped from working as their case was pending for their recruitments through ?fake? recruitment committee constituted by the then district government. He clarified that the said officials were not removed as authority to remove grade-17 officials rests with DCO or Secretary Health.

However, he disapproved said officials claim that they had been penalized for detecting polio cases in schools of Sargodha. ?The polio cases can?t be concealed in Pakistan,? he asserted, and revealed that there were 41 polio cases detected so far in Punjab.

The EDO Health said that he had proposed to constitute a board or committee to review the case and decide the future of the said employees. ?It is in the interest of these officials to seek clearance of their recruitment to save their own careers and future,? he said, adding that many of them had been recruited against merit. However, he admitted that no committee or a board had been constituted so far.

Secretary Health Anwaar A Khan said that School Health and Nutrition Supervisors had been recruited on the basis of previous rules instead of prevalent/enforced rules of recruitment at the time of their recruitment. However, he refuted the affected officials? claim to have been punished for detecting polio cases in schools of Sargodha.

When asked about their future, the Secretary Health said that he had asked EDO Health Sargodha to re-advertise the posts and assess the suitability of the sacked officials for their recruitment on the basis of recruitment rules presently in vogue.

 

[Shiloh]

Re: Pakistan - No let-up in polio cases

Source: http://www.onlinenews.com.pk/details.php?id=134458

Polio cases increases up to 77

ISLAMABAD: Followed by confirmation with regard to presence of poliovirus in three more children by national institute of health, the number of polio affected children has been increased up to 77 during current year and likely to rise further in upcoming days.

On Friday, national institute of health has confirmed presence of poliovirus in Shahzia (13 months old) from Balochistan, Amjad (4) and Hansullah (13 months old) from Peshawar.

Sources told Online the polio-affected children could not get anti polio drops during anti polio drops campaign launched by health departments. Only 32 cases of polio were registered last year.

After adopting epidemic nature in Sindh, the virus is also increasingly spreading in NWFP. The virus instead of decreasing has registered sharp increase during current year, causing deep concern among responsible stakeholders.

 

[Shiloh]

Re: Pakistan - No let-up in polio cases

Source: http://www.dailytimes.com.pk/default.asp?page=2008\10\12\story_12-10-2008_pg7_42

Unrest deprives 39,000 NWFP kids of polio drops

* WHO, UNICEF set to launch three-day drive from 13th

By Daud Khattak

PESHAWAR: As many as 39,000 kids across NWFP are not getting anti-polio drops because of negative propaganda by some elements and unrest in some settled districts and the adjacent tribal agencies, officials have said.

In a bid to persuade people to administer polio drops to the children below five years of age, two separate ceremonies were held in the city on Saturday where officials administered polio drops to children.

The provincial health department, in collaboration with the World Health Organisation (WHO) and the United Nations Children Fund (UNICEF), is going to launch the three-day anti-polio drive from Monday.

Addressing a ceremony, Peshawar District Nazim Haji Ghulam Ali said that around 1,500 parents in the city were still reluctant to allow polio staff to administer anti-polio drops or vaccines to their children.

However, he said, the number of those averse to anti-polio campaign was 7,500 a few months back which was reduced to 1,500 with the help of elected representatives and local elders.

Speaking on the occasion, Executive District Officer (EDO) Health Mohammad Ali Chohan said 30 polio cases had been detected in NWFP during the first 10 months of the current year. Seven of them were children of Afghan refugees, he added.

He said 1,700 polio teams would administer anti-polio drops to around 0.7 million children in Peshawar during the three-day campaign. Of those 1,700 teams, 300 would visit areas where displaced people of Bajaur and Swat are living.

He said that some of the children affected by polio have P-3 virus and the free movement of Afghans across the border is the main reason behind that.

Another such ceremony was held at the Peshawar Press Club where Director General Health Dr Shaheen administered anti-polio drops to children to declare the launching of the drive from 13th.

Speaking on the occasion, Dr Shaheen said Pakistan was among the four countries where polio virus still existed. The other three countries are India, Nigeria and Afghanistan.

He said polio virus was detected among 70 children in the country during the current year. Thirty of those cases were found in NWFP, he added.

Among those 30 cases, 12 were reported from Peshawar, three each from Swat, Bajaur and Khyber Agency, two each from Nowshera and Upper Dir districts and one each from the districts of Kohat, Mardan, Charsadda, Battagram and Mohmand Agency, he informed.

He said the negative propaganda against polio campaigns by some elements was keeping around 39,000 children from anti-polio drops in NWFP. According to health officials, the number of children below five years of age in NWFP is 5,633,039. A total of 16,222 teams have been constituted to administer anti-polio drops to children in all the accessible and risk-free areas of the province.

Health officials said free movement across the Pak-Afghan border and security situation in some tribal agencies and settled districts like Swat as well as negative propaganda by some elements were the main reasons behind failure to root out the virus from NWFP.

Around 0.7 million children below five years of age could not get anti-polio drops in many parts of Swat, Bajaur Agency and Shabqadar area of Charsadda district because of the prevailing unrest and hold of some militant groups there during the previous campaign, officials said.

 

[Shiloh]

Re: Pakistan - No let-up in polio cases

Source: http://www.nation.com.pk/pakistan-n...forts-needed-for-eradication-of-polio-Shahbaz

Collective efforts needed for eradication of polio: Shahbaz
Source: OUR STAFF REPORTER submitted 7 hours 18 minutes ago

LAHORE - Punjab Chief Minister Mian Shahbaz Sharif has said that collective efforts are needed for the eradication of fatal disease like polio from the country and solid measures will have to be adopted to save the children from this menace. He added that life of every child was dear to him and had timely steps been taken for precious lives could have been saved. He said that the heinous trade of spurious medicines was growing like cancer and he would not be contented until it was rooted out from the society.
He was addressing a seminar on ?Eradication of Polio? arranged by the Health Department at Al-Hamra on Saturday, says a handout. Chairman Task Force Dr Asad Ashraf, members Provincial Assembly Dr Farrukh Javed, Dr Tahir Ali Javed, Advisor Saeed Mehdi, Chief Unicef Punjab Deepak Bhatachariya, WHO representative Dr Ahmad Darwesh, Secretary Health, senior doctors, commissioners, DCOs, police officers, EDOs (Education), district khateeb and ulema, district zakat officers and a large number of people representing various walks of life were present.
The CM said that polio had been eradicated from the world but Pakistan was among a few unfortunate countries from where this killer disease had not been completely rooted out. He said though we could not counter natural calamities but we could minimise the losses with a sense of responsibility. He said that the question was how far we had succeeded in curbing this disease. He said that it was the responsibility of local governments which were a gift of former dictator Pervez Musharraf to take effective measures for checking the outbreak of polio, dengue and other epidemics. He said that the district governments were to blame for the negligence in this regard. He said media had played an important role in promoting public awareness adding that he himself got guidance from newspapers clippings and did not rely on the reports of the agencies, which were always misleading. He said that he was thankful to media for playing a positive role in promoting awareness about dengue virus.
Shahbaz further said that he was ready to work round the clock for the provision of best healthcare facilities to children and there would be no dearth of resources. He said that only a few drops of polio vaccine were enough to save the lives of these children but due to the inefficiency of some individuals and departments concerned polio vaccination campaign was not being carried out properly. There was no paucity of resources, what we need was a sense of responsibility, he added. He said that effective measures were being taken for the improvement of health sector and 60 dialysis machines of best quality had been imported from Germany for the provision of free dialysis facilities to kidney patients. He said that these machines would be installed at district headquarters hospitals within a few days. He said though a huge amount had been spent on the import of dialysis machines but this money would not go waste if it helped in saving even one human life.
The CM told that few days ago when he visited the Mayo Hospital, the oldest hospital of Pakistan, he was shocked to see the poor state of affairs. He said that operation theaters were littered with empty glucose bottles, used cotton and bandages while the toilets were filthy. He said that water was not available in the bathrooms due to broken taps. He said that provision of free medicines in emergency and other wards would be useless if due attention was not paid to the principles of hygiene and sanitary conditions. He said that an extensive campaign had been launched against spurious medicines and special teams had been constituted in this regard. He said he would not be contented until this heinous trade was uprooted from the province. He said that there was also a need to check the activities of quakes. He said that there was need for sincerity and determination for improvement of health sector as well as condition of hospitals. He said if we could become a nuclear power, we could also work wonders in other sectors.
Earlier, Secretary Health Anwaar A Khan while highlighting the aim and objectives of the seminar, informed that the campaign against polio will have to be launched with a new vigor and zeal and all departments will have to make concerted efforts in this regard. Dr Asad Ashraf, Deepak Bhatachariya and Dr Ahmad Darwesh also addressed on the occasion.

 

[Shiloh]

Re: Pakistan - No let-up in polio cases

Source: http://www.thenews.com.pk/daily_detail.asp?id=156326

The polio challenge
Saturday, January 10, 2009

In terms of its efforts to eradicate polio and clamber off the list of the four countries in the world where polio remains endemic, the year 2009 has begun badly for Pakistan. The first case of the year has been confirmed in Punjab's Sahiwal district, which had been declared 'polio-free'. This discovery, with a five-year-old girl found infected, comes after the reporting of 118 cases of polio across the country in 2008. The figure is startling when compared with rates for previous years. In 2007, 32 cases were confirmed. For 2006 this number stood at 39 and for the year before that 28.

Clearly, something is not right. It is pointless to blame the resurgence of the sickness only on refusals by parents to have their children vaccinated. While this has been an issue in parts of NWFP, with some 30 cases uncovered in the province through 2008, it cannot explain the presence of cases in other provinces. Refusal is not, after all, an issue in Punjab or Sindh. It is important that problems pointed to over the past year be properly investigated. Apart from many loopholes in the coverage of children and administrative flaws in the anti-polio campaign, there have been more serious allegations. These include charges of corruption, embezzlement of funds intended for the drive against the disease and failure to maintain the cold chain necessary to keep the oral vaccine effective. There have also been stories about the use of substandard vaccinations. While officials have fervently denied this, and have blamed the number of cases on persons who bring in the virus from neighbouring Afghanistan or on its administration to children suffering diarrhoea, this explanation on its own is inadequate. Pakistan had hoped to be declared a polio-free nation by 2010. This goal now seems unlikely to be met. The challenge for Pakistan's health officials and for the new federal health minister is to uncover what is going wrong, so that we can move closer to a situation where no child is afflicted by a disease that has over the last decades left hundreds disabled.

 

[Shiloh]

Re: Pakistan - No let-up in polio cases

Source: http://www.thenews.com.pk/print1.asp?id=156423

Dr Gezairy for redoubling efforts to strengthen immunisation
Saturday, January 10, 2009
By Our correspondent
Islamabad

The Regional Director of the Eastern Mediterranean Region of the World Health Organisation Dr. Hussein A. Gezairy has called for redoubling of efforts to significantly enhance routine immunisation cover in Pakistan.

?We must begin the year with the resolve to hit the polio virus with full force because Pakistan has the capability and the capacity to eradicate the virus,? Dr. Gezairy said while speaking at a meeting of health ministers of all provinces alongside AJK and FANA here on Friday.

With federal minister for health Mir Aijaz Hussein Jakhrani in the chair, the meeting was convened to take stock of the polio eradication effort in the country and discuss steps to intensify the fight against it. Dr. Gezairy, who is currently visiting Pakistan, as well as international partner agencies also attended the meeting.

Addressing the meeting, Jakhrani emphasised the need for improving implementation at the district level. He said there was high level of political commitment and ownership of the initiative by the present government. ?Polio eradication was the dream of my leader Benazir Bhutto, who launched the campaign by administering polio vaccine to her own children,? remarked the minister.

The minister expressed gratitude to Dr. Gezairy for taking keen interest in improving the health status of the people of Pakistan.

In his welcome remarks, Secretary Health Suleman Ghani said inter-provincial collaboration would provide the inertia to focus energies better besides offering fresh input and insight to the Polio Eradication Initiative. He dwelt on the need for developing synergies and improved collaboration to achieve optimal results.

The health minister of Balochistan Ainullah Shams said he has personally written to members of the Balochistan Assembly to monitor the drive in their respective areas. A Polio Monitoring Cell is to be established soon in the office of the Provincial Health Minister at Quetta.

The health minister of Sindh Sagheer Ahmed said the Sindh government was up- scaling monitoring of the campaign to improve its overall quality and there was commitment at the highest level in this regard. ?DCOs in the province are fully engaged and efforts were being made to do away with frequent postings and transfers of EDOs to improve management of the initiative,? he said.

Secretary health NWFP said there were numerous challenges the province was facing with regard to containing the spread of the polio virus. The province experienced unprecedented upsurge in cases last year with 53 polio victims registered during the year. The major challenge was providing vaccination service in the security compromised areas. He called for observing ?Days of Tranquillity? with the help of tribal elders and ?ulema? in such areas. Cross-border movement on the Pak-Afghan border was a major challenge as unvaccinated children carry the polio virus across. In this connection cross border vaccination points are being fortified and monitoring enhanced, he claimed.

Secretary health AJK said the area is polio-free for the last eight years. He attributed success to strengthened routine immunization and public health education. Secretary Health Northern Areas informed that FANA was polio-free for over a decade.

The director general-health, Punjab, informed that the Chief Minister Mian Shahbaz Sharif was according personal leadership to the initiative and had formed a task force to monitor the campaign in the province. He said case response and mop-up were being strengthened and intensified social mobilization campaign is being undertaken.

The federal director General of Health, Dr. Rashid Jooma, spoke at length on the need for involvement of other sectors outside health. He said education sector, police and Railways were being increasingly involved to support the polio effort.

Earlier, Dr. Altaf Bosan gave a detailed presentation on the polio situation in Pakistan. He apprised the meeting of the spread of the virus, its causes and steps required for urgently addressing the challenges ahead.

 

[sharon sanders]

Re: Pakistan - No let-up in polio cases

Thank you Shiloh.

 

[Shiloh]

Re: Pakistan - No let-up in polio cases

Source: http://www.thenews.com.pk/print1.asp?id=158282

1.2 million children to be at the mercy of polio virus
Wednesday, January 21, 2009
By By Rauf Klasra

ISLAMABAD: Around 1.2 million Pakistani children of a lesser god, under the age of five years, is at the risk of becoming victim of the ongoing militancy and subsequent military operations in some areas of the country, as these kids are unlikely to get the polio drops during the first round of polio vaccination campaign in 2009 launched on Monday.

Even heavy snowfalls in some parts of the AJK and the Northern Areas are said to have added to the problems of health workers, planning to visit these areas to save the children from the looming threat of becoming handicapped for the rest of their lives.

What to talk of other violence-torn areas, 377,075 children in Swat district alone would not get polio vaccination during the current campaign, raising instant alarm bells in donor agencies, if not within the Pakistani society and the media that Pakistan might soon see a rising numbers of polio cases as the government had no idea about this shocking human tragedy in the making in the militancy-hit areas of the country.

Background interviews with several concerned officials revealed that the health authorities were trying to hush up the shocking issue amid the rising political temperature in Islamabad. Even the opposition parties were not interested in the sorry tale of these children.

?How can you control the spread of the deadly poliovirus when the government is not ready to halt the ongoing military operation in the NWFP and the Fata to give some space to workers to go and administer the vaccination?? an official source said. He also blamed the religious extremists who, he said, were also playing with the lives of innocent children by not allowing health workers to visit those areas. Neither the government nor the militants are ready to show any mercy to the future generations of these war-torn areas, lamented one source.

Talking to The News, National Programme Manager, Polio Eradication, Dr Altaf Bosan, said, of course, there were some problems in areas where the operation against militancy was under way, as health workers could not visit those areas. Bosan said, he had talked to the Fata officials on Monday, who reported that there was a problem in sending teams to certain areas.

He, however, said as the situation would improve, the teams would try to penetrate those areas to give polio drops. Likewise, Bosan also confirmed that there was some problem in the Neelam Valley where the teams could not visit because of heavy snowfall. But, he hoped as the snow would melt, the teams would be sent to those areas. ?During the last year, the health authorities had conducted five national and numerous special polio campaigns but due to the military operations, the authorities had missed more than 335,000 children due to inaccessibility in areas of Swat alone,? he disclosed.

The source said this time, almost 140,000 children of Kurram Agency, 335,000 of Swat district and almost 40,000 children in areas like Waziristan could be inaccessible during the upcoming campaign. However, the official figures put the number at Bajaur 189,593, Charsadda 59,024, Hangu 101,146, Kurram 135,965, Mohmand 55,138, Orakzai 85,350, Peshawar 1,687, Swat 377,075, North Wazirstan 16,302.

The number of children who won?t be able to get polio vaccination because of heavy snowfalls: Chitral 76,117, Kohistan 12,677, Mansehra 10,991, Neelam 26,160, AJK 26,160 and Upper Dir 61,603.

The source said the Swat district, just like other parts of the country, had remained polio free since 1993. One case, reported from Swat, was in 2007 which involved a Pakistani student living in Australia, who had come to Swat. However, during the last year, three polio cases were reported from Swat.

Sources in the Health Department said the poliovirus was still active in parts of the Fata but because of security concerns, it was impossible for them to report and diagnose the children suspected of having the disease in inaccessible areas.

According to a WHO source, who wished not to be named, ?It is extremely important that we achieve very high quality of campaigns in districts surrounding the inaccessible areas. Now that January to March is a low transmission season, we have to immunise as much children possible, to make sure that during the high transmission season which starts in April, chances of children getting the virus are minimum?.

According to the official, Pakistan, India, Nigeria and Afghanistan are still endemic and are responsible for transportation of the disease to areas which had been declared polio-free long ago.