Pakistan has been facing terrorism since long, way before 9/11 happened, only at that time it had a different avatar and wreaked havoc in a different manner. However, with the time, the terrorists have changed their tactics, what they haven’t changed is their mindset that is still etched in a misunderstanding that violence will help them win people’s favour. Centuries-old notion of what threatens their self-proclaimed pure form of Islam stands not only in the way of progress in terms of human resource and social development, but also as a stubborn obstacle in dealing with the social challenges of modern times. Anything that does not stand the test of their version of Islam is something they have to wage a war against. But they cannot be any more wrong as attacks on teams of anti-polio campaign have shown.

The militants were already against the idea of vaccination, but ever since the role Shakil Afridi played as member of an anti-polio team in gathering information about where Osama bin Laden lived in Abbottabad, they have made it one of their objectives not to let the anti-polio drive succeed at least in the areas where they can stop it with violence. Since then they have ramped up their attacks on these teams, mainly in the restive areas of Khyber Pakhtunkhwa and even in Karachi. Their recent attacks in Mardan city clearly show how twisted their understating of the teachings of Islam is, and that they would do anything in pursuance of their objective of total domination and subjugation of the innocent public. In one such attack three days ago, one policeman was killed while two were injured, whereas in the attack the other day while no one was hurt, the real victims are the children of these areas where this disease, the polio, has shown a considerable threat to resurface and infect kids of different age, crippling them for life. This while the developed and most of the developing world have been successful in eradicating this disease decades ago.

One of the social markers to gauge a country’s development status is its national healthcare system. But in our case, we won’t be able to improve it if we are unable to manage diseases that have lost their presence in other parts of the world years ago. One way to go about managing this situation is through increased security, but then that could give the militants other venues of venting their frustration. The other method would be to engage the terrorists and make them see the light, by making them understand that healthcare does in no way infringe upon their ideology of Islam or anyone else’s. Moreover, healthcare is a fundamental right of every citizen. Depriving them of this right is basically standing up against the state, something the state has to look into and check it before it creates further problems.

- See more at: http://www.pakistantoday.com.pk/2013....QWAz0Yp0.dpuf

April 16, 2013


Measles continues to take a heavy toll on children. With over 50 deaths occurring in the past weeks and months the plague devoured two more children on Sunday, while the number of children catching the disease is in thousands, as confirmed by Punjab Health Minister Salima Hashmi. The situation is clearly critical and calls for emergency health services.

However, the health minister candidly admitted that the health coverage in Punjab was as low as 57 percent, whereas it should be 90 percent. Her assurance that the ministry was trying to tackle the epidemic on a war-footing comes as a crumb of comfort, although the precious loss of life is regretted. The Health Secretary Punjab also confirmed that 30.3 million doses are being procured. It is obvious that these lives could have been saved had timely steps been taken. But in Pakistan, the tendency is to wake up only after the disaster has stuck and that goes for the Health Ministry as well. It has been also observed that people’s awareness regarding the immunisation is pathetic. When the children are not vaccinated on time it allows the disease to attack them freely. But at the end of the day, the government and the Health Ministry cannot escape the blame of letting the scourge spread so freely and kill on such a large scale.

http://www.nation.com.pk/pakistan-ne...ons/editorials

Yet another young resident of Shahdara died of consuming banned cough syrup Tyno in Mayo Hospital a couple days ago. During last few months, over 100 people have died of consuming the toxic Tyno Syrup across Punjab-33 of them died in Gujranwala and Kamoke areas--after which it was banned by the Lahore High Court but the killer Tyno syrup is still available in the market. Under the Drug Act, both federal and provincial governments, responsible to curb the sale of spurious medicines, failed to take notice of the deaths. The then Punjab government was to busy in the construction of its darling Rapid Transit Bus Service Project thus did not bother to comply with the court order to eliminate the killer syrup. Notwithstanding the inability and crude insensitivity of the political leadership both in the Centre and the province, the worth condemnation and the most worrisome aspect is that the Drug Regulation Mechanism in Pakistan is totally in-effective to put a firm control over the faulty medicines after so many causalities. In the absence of automated checks over the production of medicines, Tyno syrup is neither the first nor the last pharmaceutical product that is causing loss of human life. In another heart-rending development in Lahore, two more infants died of measles on Tuesday in hospital, taking the death count to four in only two days.

Total 56 children, suffering from measles, are being treated in various hospitals in the provincial capital. The irony is there is hardly a child who is not vaccinated against measles yet the disease is on the rise which, of course, is a matter of grave concern. Five years' callous rule has plunged the country into multiple crisis-the health issues are on the top of the list. In connivance with the corrupt bureaucrats in the health department, black sheep in pharmaceutical industry have flooded the market with spurious drugs and fake vaccinations of the fatal diseases for the human beings and animals alike. Greed and lust for money both in private and public sectors help flout the weak laws governing pharmaceutical industry. In the past, the use of fake and spurious life saving drugs was reported in the top hospitals including the Punjab Institute of Cardiology--the worst-scam of the living memory yet it failed to attract a severe action and crackdown against those involved in the making, supply and purchase of spurious drugs. Unfathomed sadness is; the heinous trade is compromised in the name of the fate; especially, this is what was witnessed when the heirs of the latest victim refused to conduct post-mortem analysis of the dead. Having no fear of crackdown by the authorities concerned, the black sheep involved in the heinous trade are continuously swelling their wealth at the cost of human life. Hopefully, the interim set-up too will not let it go unnoticed and unpunished rather give the devil what is due.

http://www.thefrontierpost.com/category/46/

Most people think of polio as something we used to worry about. We want to argue that it’s worth a considerable amount of our attention right now.

A quarter of a century ago, the countries of the world set the goal of wiping polio off the planet. Since then, the many partners in this eradication effort have decreased the number of cases by 99 per cent. With victory so close, it’s only natural to assume that the job’s basically done. But in global health, as in many areas of life, the last mile is the hardest mile.

That’s why it’s absolutely necessary to focus on polio. What happens in the immediate future will determine whether we take the giant leap from 99 per cent to 100 per cent or whether polio gradually spreads back into countries where it has been eliminated, infecting thousands of children annually for the foreseeable future.

In addition, winning the polio fight will have important consequences beyond ridding the world of this ancient, crippling disease. If we succeed in eradicating polio, we will prove that setting big goals leads to big victories. Furthermore, we will demonstrate once again that vaccines are the most powerful tool available in public health, giving a boost to the global effort to reach all children with all vaccines. Millions of children are currently dying from vaccine-preventable diseases. Getting to zero cases of polio will not only demonstrate the effectiveness of vaccines, it will leave behind an infrastructure that will help us reach more children with more vaccines in the future.

This week, we will both attend the historic Global Vaccine Summit in Abu Dhabi, one of us (Bill) as a host and one (Julian) as the representative of a leading participating country. The summit is bringing together leaders from many regions and walks of life to send the message that vaccines save lives, that polio eradication is possible and that success will require adequate funding and political commitment.

What separates polio from so many other diseases around the world is that the solution is clear. In 1988, when the world set the goal of total eradication, 350,000 children in 125 countries were paralyzed by this horrible disease every year. In 2012, there were 223 reported cases. This progress was made possible by a worldwide effort, including years of leadership from Canada. Finishing the job would make polio only the second disease, after smallpox, to be wiped out.

To meet this challenge, the organisations leading the fight against polio just put together a comprehensive six-year plan that lays out the steps toward eradication. We have never had a complete blueprint that uses all the available data to draw up the endgame. This plan also marks a significant improvement in our thinking about how to make sure the infrastructure developed for polio can be used to spur progress in other areas of health when the job is done. For example, the plan shows how staying the course on polio can improve routine immunization systems in many countries.

The plan says exactly how much it will cost to end polio: $5.5-billion over six years. That’s a considerable sum, especially in a tight economic environment. But if we don’t follow through on the plan, we will spend significantly more money in the long term trying to control the disease and treating people who get infected.

And while financial support is fundamental to the eradication of polio, we know dollars alone will not get the job done. Today, polio remains endemic in only three countries: Afghanistan, Nigeria and Pakistan. These are the last battlegrounds for the disease, with a majority of cases in remote and insecure areas. Despite recent violence, polio vaccinators continue to deliver life-saving vaccines to children who need them most. Leaders from the endemic countries are fully committed to ending polio in their countries, and it’s the responsibility of donors, civil society and government leaders to remain diligent in supporting eradication efforts to ensure that our children, no matter where they live, are protected for generations to come.

This is the time for a final push to end this disease forever. Support now, when it matters most, will show what humanity can do when we understand the stakes. As long as one polio case remains, millions of children continue to be at risk. Together, let’s make polio history.

Julian Fantino is Canada’s Minister of International Co-operation. Bill Gates is the chairman of Microsoft and the co-chair of the Bill & Melinda Gates Foundation.

http://www.thefrontierpost.com/category/40/

Elusive polio eradication

Fayyaz Ahmad Khan

The eradication of polio from Pakistan, which seemed a possibility eight years ago, is looking increasingly difficult with each passing day. The worsening security situation and recent attacks on vaccination teams notwithstanding, the failure to eradicate the poliovirus from the country has many policy and political dynamics.
Public health experts throughout the country had been warning about the dangers associated with a single-disease-focused approach towards fighting polio. The results of not paying heed to such voices have been devastating.
While polio remains a challenge, thousands of Pakistani children are exposed to five equally deadly infections including measles which has already claimed over 400 lives in the last few months. Our children could have been safer had Pakistan’s routine immunisation programmes had not been compromised.
Close to 80 percent of Pakistani children used to be fully vaccinated from six infectious diseases ten years ago. The immunisation programme in Pakistan, despite its challenges, was among the most organised in the country. The routine vaccination drives were part of daily life and parents would work with local vaccinators to ensure that their children were given all vaccines to be safe from deadly infections.
The situation changed when the government decided to declare a war on polio. Having successfully eradicated smallpox decades ago, Pakistani health authorities were confident about ending polio. The nature of the poliovirus fits into the parameters of eradicable disease and hence starting special immunisation campaigns made good sense.
The results of earlier polio campaigns were encouraging. From around 25,000 reported polio cases in 1994 when the campaign was formally started, the figure dropped to less than a hundred in 2002 and then to just 28 in 2005. This convinced the authorities that Pakistan was at the brink of eradicating polio and hence more resources were pumped into the system to reach the desired goal.
However, it soon emerged that the zeal to get rid of the poliovirus had badly affected the routine immunisation programme of the country. Repeated polio campaigns (at least four every year) were pumping in monetary incentives for health workers that trigged corruption at all levels. Each campaign would cost 8-10 days of district and field health workers during which all community health initiatives would come to a grinding halt.
Any reported polio case would be accounted for at the highest levels, making the district health authorities paranoid about a single disease. The fatigued workers would hardly feel motivated to work for routine immunisation, which by the mid-2000s was pushed to the backburner at every level. The percentage of children fully vaccinated against the six diseases dropped to just 47 percent in 2006 as reported by the Pakistan Demographic and Health Survey (2006-7).
Repeated campaigns also attracted the attention of conservative elements who got suspicious at the zeal of donor agencies in fighting only one disease while children remained vulnerable to many others equally deadly viruses.
The religious lobby, terming the polio eradication drive yet another design to render Muslim population infertile, launched a vicious propaganda campaign. In 2008 the number of reported polio cases rose to 117 and the figure jumped to 198 in 2011 — shattering the dream of making Pakistan polio-free.
Dr Shoaib Khan, who has supervised scores of polio campaigns as district health officer in Rawalpindi many years ago, says “Until and unless we improve routine immunisation programme, we cannot eradicate polio even in the next 100 years”.
Dr Khan has also highlighted the need for universal birth registration in Pakistan and for working with health authorities in Afghanistan since without ending polio in the neighbouring country its eradication in Pakistan is difficult owing to our porous borders. Another key step according to Dr Khan was vaccine safety.
With all other factors constant, 35 percent of the polio victims in 2012 had received more than seven doses of vaccine. This requires immediate attention to the quality as well as management of the cold chain. When a vaccinated child is hit by polio, the entire neighbourhood loses trust in the vaccine, says Dr Khan.
Polio eradication campaigns suffered a further setback in 2012 when vaccinators and volunteers were attacked by militants in Karachi, Punjab and Khyber Pakhtunkhwa.
The government has finally vowed to strengthen routine immunisation and combine polio vaccination with other mother-and-child health initiatives to ensure that Pakistani children were safe from polio as well as other deadly infections.
The saga of polio eradication in Pakistan has had mixed results. Millions of children who received polio drops during the last 20 years and can walk on their feet today thank the efforts of thousands of health workers who have been carrying out polio eradication campaigns. Scores of others, however, may still wish that the polio campaigns had not paralysed other primary health initiatives by taking the focus away from them. An integrated immunisation strategy could have saved millions more in Pakistan


http://images.thenews.com.pk/29-04-2...s/e-174179.htm

__________________
If you tremble with indignation at every injustice then you are a comrade of mine.(Che Guevara)

Pakistan is one of the three countries around the globe that failed to eradicate polio as yet. Polio drops means everything ranging from infertility drops to Western conspiracy against Muslims in Pakistan from a viewpoint of a common Pashtun or Panjabi far away from the city lights and illusion of awareness created by influx of private TV channels.

In the past three month the scribe has had a chance of going through some diverse research based data on issues of immunization including polio vaccination and catching some real life stories from Khyber Pukhtunkhwa known in the world for terrorism rather than its beautiful landscapes, culture of hospitality and rare gem stones.

The world has seen success in protecting children through vaccinations. But in Pakistan, immunization coverage that hovered at 90pc a decade ago now stands at an abysmal 20pc to 50pc in different parts of the country. Of the staggering 435,000 deaths of children under the age of five every year, approximately 20pc — or 100,000 deaths — are the result of illnesses such as pneumonia or measles, which can be easily prevented through available vaccines, Dawn newspaper reports.

Ms. Huma Khawar, a health education consultant who was formerly associated with UNICEF believes that lack of awareness with regard to the long term benefits of immunization is a challenge as large section of our population is either unaware of or careless about having children vaccinated” There are security issues and there are areas which are hard to reach but it should not be an excuse to let this endemic polio affect our children” she said.

Polio should be a target disease but we have to refocus our energies on routine immunization and the recent outbreak of measles must be an eye opener for us, she added.

Four major issues came up during my interaction with the community and parents to understand their concerns with regard to vaccinations. First, parents were skeptic about polio vaccination as they think it causes infertility, second, why the government focuses only on polio when people are dying of Hepatitis, third, parents believe that they were not given any drops but still they are fine physically and as if the above three were not enough, the way the case of Dr. Shakil Afridi was presented on media made every polio drops provider a suspect spy. (Dr. Shakil Afridi had been accused of launching fake vaccination campaign to help the US Central Intelligence Agency (CIA) in hunting down Osama Bin Laden in Pakistan. He was sentenced to 33 years in prison last year in May for his links to a banned militant group)
Director General Health Services Khyber Pakhtunkhwa, Dr. Janbaz Afridi who heads the Expanded Program on Immunization (EPI) in KP province agreed that security situation and community awareness are the biggest challenges in KPK and Federally Administered Tribal Areas (FATA) but dispelled the impression that vaccines causes infertility or drops for Hepatitis are not being delivered. “Pentavalent (DTP+HepB+Hib) vaccine helps in giving protection against five diseases; diphtheria, tetanus, pertussis, hepatitis B, and Haemophilus influenzae type b” Dr. Afridi added.

“I agree that we do not put too much emphasis on regular immunization as compared to polio but we need to understand that Pakistan has a commitment to meet and eradicate Polio from the country and when we achieve this target we will focus on routine immunization” he added.

The security situation is not in our control but for community and parents awareness we arrange seminars and publish brochures which we think is not enough and more needs to be done, he said.

“Three cases reported this year in Mardan, Malakand and Bannu while 25 cases were reported in Khyber Pukhtunkhwa in 2012” Dr. Afridi added.

But there is another side to the story and that is that in some cases even the vaccination does not help and there are reports of children affected by polio despite being given drops. What could be the possible explanations if not justification; mal nourished children, inadequacy of dosage or problems within vaccine including the plausible flawed storage mechanism and the culture of greed? While exploring the truth it was noted that mostly those who are associated with the EPI directly or indirectly refrain from sharing any personal opinion. Only a native medical doctor on the condition of anonymity divulged that since “Pakistan is among the three countries in the world which is not free of polio, in panic we give drops in excess which has counter effects and there are cases when children get affected despite having served polio drops”
A quick literature review cum analysis on the issues of polio immunization, followed by field observations revealed that since Pakistan is among the countries with a lowest national spending on health; it is not a priority issue for political parties and media. The "magic recipe" for most of the donor agencies and technical aid agencies in Pakistan (including UN Agencies and INGOs) is producing documentary or some TV advertisement by outsourcing to corporate media agencies and or expensive and well-connected individual consultants (who too often do not have any expertise in health related issues). This all is executed as time bound activity too hastily with the non-realization of certain facts like that in the remote mountainous areas, very few people have access to Television and more important how credible is the source as the fait accompli.

Interpersonal communication matters a lot in such cases. We also have this fatalistic approach in our TV ads showing a crippled child and his father is shown regretting not immunizing his child.

Dr.Rakhshinda Perveen, an activist and health communication practitioner opined that the communication strategies for the polio eradication are developed in comfort zones, mostly by those "experts' who are not in contact with the reality zones and lack the capacity to integrate or transfer empathy in such strategies. Consequently the products delivered no matter how refine they appear on papers not only lack the trust and credibility but do not appeal to the hearts and head as well- the absence of all these are a must for any ineffective communication. Therefore, it should not be a surprise that Pakistan could not get rid of a preventable disease like Polio.

When elections are round the corner and political parties are presenting their manifestoes, it was observed that not a single time the top TV anchors raise this important issue with the leaders that how they will make sure that the immunization coverage go up which currently is going down.

While witnessing real life tragedies in KP I happened to meet Marjan (Carol) a prized gem. Marjaan is a common name among Pashtun boys and girls. The word Marjan has Hebrew origin and Coral as a precious gem stone is known to be most effective for female or male for radiating powerful emotions through absorption of red radiation from visible light spectrum. Gem specialists believe that through the use of coral in gold several diseases can be warded off, particularly tropical fevers, chicken pox, jaundice, fistula, impotency and ailments pertaining to blood, particularly impure blood. Children suffering from malnutrition or inadequate / slow development may also improve-the myths say so.

The Marjaan I met was anything but hope. While sitting on her front door stairs in despair she was looking at other kids in the street playing hide and seek. Marjan cannot run like other girls of her age and is not part of the game as neither team is willing to include her in the team; she is a victim of polio.
Marjaan is an 11 old displaced girl from Khyber Agency and lives in a small town Chamkani, 20 miles to the north of Peshawar, the headquarters of Khyber Pukhtunkhwa province. Her father Rafiullah Khan passed away a year before Marjaan was hit by polio. “I know it’s too late and we regret what happened to Marjaan but then teams were not visiting each house like they do now or campaigns were run on media to create awareness with regard to polio vaccination. There is realization now and even those who are not educated, make sure that their children gets immunized” Sajid, Marjan brother said. I am not a believer in the powers of gem but after witnessing the predicament and plight of real gems I desperately wished if all said and believed about gems could be true in my homeland where health as a basic right has yet to be deciphered by the decision makers and make its appearance in political agendas.

There are many Marjaans not only in KP and FATA but in other parts of Pakistan as well who are affected by polio. World Health Organization reports that this year 1.8 million children have not been accessed for polio vaccination, the reason being bad security situation in the remote areas of KP, FATA and Baluchistan.

But why should we go too far and make excuses of security and communication gap, I came across Zar Khan, a 10 year old child who was collecting garbage in a street of Islamabad which also has the private residence of The President of Pakistan, Asif Ali Zardari. Have you been vaccinated for polio, I asked Zar Khan and his blank expression was enough to communicate the answer.

Last week when the world was marking the World Immunization Week and was gearing up in protecting children through vaccinations, I met some 53 victims of polio in different parts of KP and FATA who need to be helped through practical measures. The messages, opinions, verdicts, perceptions and prescriptions I came across were diverse and riddled with conflicts too. According to the right holders, the billion dollar initiative by world’s leading organization to eradicate polio appear crippled in Pakistan and the critical most question of reasons behind failure to reach the most in need and questionable efficacy of the vaccine remain camouflaged if not buried by one simple phrase by those who are responsible for materializing the effective immunization drive( the bearers) in the simple and short phrase “ complex terrorism and security situation in Pakistan.”

http://www.thefrontierpost.com/category/40/