What Pakistan can learn from the Indian Experience of fighting polio

Polio as a disease rendered many young lives in India very difficult to live forever, until 2011, when this disease was eradicated from India.

The last reported polio case – a young girl in West Bengal – was recorded on Jan. 13, 2011. In February 2012, the World Health Organization removed India from the list of polio-endemic countries, a historic achievement given that until very recently, India was considered the epicenter of the disease and had been predicted to be the last country to stop polio. (link)

Now around the world there are three countries which still face this disease – Afghanistan, Nigeria and Pakistan. Pakistan can eradicate it as well, but it has religious challenges as we saw recently with the killing of the polio workers.

During December’s sub-national immunization days in Pakistan, nine frontline health workers, six of them women, were shot and killed. The media have linked the violence to lingering suspicions within some segments of the Muslim community that polio eradication is some sort of Western conspiracy to sicken or sterilize Muslim children.

But can this issue be tackled? Yes, thinks Ashok Mahajan, who has worked in this area in India. There is a way to work with the Muslim population and bring them on-board given their religious straitjackets. Here is some useful advice.

At that time, Mumbai was at high risk for polio, especially in areas with large Muslim communities. I sought and was granted repeated meetings with the leading imam, who, finally convinced, went so far as to reprimand parents of children who were not immunized. At his request, we put up hundreds of pro-vaccination posters and banners around the periphery of the main shrine and mosque three days before a scheduled National Immunization Day. The posters at those religious places sent a message to his followers that if the imam approves polio immunization, they should also. Over time, community resistance declined and Mumbai became polio free.

We continued successfully along this path on a more-or-less informal basis as India made great gains against polio, recording only 66 cases in 2005. But in 2006, an alarming number of infections in western Uttar Pradesh and Bihar threatened to derail our progress. Of the 676 cases in India in 2006, 548 were in Uttar Pradesh and 59 percent of those were from the Muslim community.
Our response was to call for a meeting of the leading Muslim imams, ulemas, scholars, physicians, and educators in New Delhi in August 2006. Out of this came Rotary International’s State Level Committee of Muslim Ulemas in Uttar Pradesh. This, for us, was one of the biggest achievements in the effort to engage the Muslim community.

The state Muslim Ulema Committee thereafter played a significant role in bringing about a metamorphosis, successfully persuading hitherto resistant and unwilling sections of the community to accept the oral polio vaccine. Committee members issued appeals on behalf of polio eradication and walked with Rotarians, health workers, and vaccinators to booths and homes to ensure children received the vaccine. Several of them personally administered the vaccine drops to their own children to demonstrate to their followers that it was harmless.

The numbers soon demonstrated the effectiveness of this approach. In 2008, Muslim children accounted for 37 percent of polio infections in Uttar Pradesh, down from 70 percent the previous year. The concept was quickly expanded with the formation of district level ulema committees throughout the state. Rotarians in these regions continuously follow up to ensure that the campaign remains up to the mark. Last month, I met with a top administrator at Aligarh Muslim University to garner the support of doctors associated with the university to promote the campaign.

Ulema Committee members are now sought by the Health Ministry and other agencies to advocate not just for polio, but other health and sanitation needs in the Muslim community. Rotary is organizing free camps to reach the community with basic health care services. With the Ulema Committee, Rotary created a partnership that will endure and yield benefits far beyond the eradication of a single disease.

Source : NYTimes