Deadly attacks suspend UN polio program in Pakistan

Updated December 21, 2012 19:15:00

The United Nations suspended their polio program this week, after deadly attacks on health workers trying to immunise children. Health advocates says hundreds of thousands of children have missed out on the vaccine and they're worried that the process made towards eradicating polio could be setback.

Source: PM | Duration: 10min 21sec

Topics: bones-and-muscles, vaccines-and-immunity, pakistan


SALLY SARA: The campaign to eradicate polio has been disrupted by violence in Pakistan.

The United Nations suspended the program this week, after the deadly attacks on health workers trying to immunise children. Eight health workers were shot dead, while a wounded man died in hospital overnight.

Health advocates says hundreds of thousands of children have missed out on the vaccine and they're worried that the improvements made towards eradicating polio could be setback, as Lindy Kerin reports.

LINDY KERIN: The three day vaccination program run by Unicef and the World Health Organisation targets millions of children under five in Pakistan.

But the program has come to a halt after deadly attacks on nine health workers.

Unicef's spokesman is Peter Smerdon.

PETER SMERDON: Unicef and the World Health Organisation had to suspend all vaccination activities and the government also suspended vaccinations across Pakistan because of these attacks.

LINDY KERIN: Peter Smerdon says a large team of about 2,000 health workers, mostly volunteers, deliver the polio vaccine. He says they're devastated about the attacks, but are determined to continue the program, which he hopes will begin again soon.

PETER SMERDON: We would hope as soon as possible. The difficulty is of course that this is being investigated, these nine killings of health workers are being investigated and the government is trying to find out who is responsible, who is behind this. There have been no claims of responsibility so far.

The vaccination campaign will continue because it's so important and it's a commitment by the government, most importantly the people of Pakistan, and then it's the UN agencies that are simply helping. But it will continue, it's just a question of when it resumes.

LINDY KERIN: The vaccination program has made an impact.

In Pakistan this year, there were 56 cases of polio, compared with 190 last year. Pakistan, Nigeria and Afghanistan are the remaining three countries around the world where polio is still endemic.

Michael Sheldrick runs the End of Polio campaign with the Global Poverty Project.

He's worried tens of thousands of children are now missing out.

MICHAEL SHELDRICK: There's I think 300,000 children who can't be accessed as a result of this. In terms of the program as a whole, it really is, it stands on a knife edge.

On the one hand, 2012 has really been a year of unprecedented success. We've had the fewer number of cases in the fewest districts in the fewest countries than in any time in history. So on the one hand that's good, but if we can't reach every last child, there's a risk that the disease can spread again.

Polio spreads like wildfire. It only takes a couple of outbreaks here and there and quite quickly we can be up to case numbers that we had a couple of years ago. And it can spread, putting at risk the lives of thousands of children.

LINDY KERIN: The Pakistani Taliban has denied responsibility for the attacks. The insurgents have a history of threatening polio eradication programs, claiming they are a cover for US plots to sterilise Pakistani children.

Medecins Sans Frontieres operations coordinator Chris Lockyear says some suspicion of vaccination programs is still a problem.

CHRIS LOCKYEAR: There's a been a series of events where aid and medical action in particular has been manipulated for political or military reasons. And that creates a distrust of the action of delivering aid which is provided on a neutral basis because it creates suspicion.

And it goes back to the point of, in two directions, a) medical assistance needs to be given on a neutral, impartial basis. Not politicised, not in any way militarised, and b) those people delivering the assistance need to be guaranteed in terms of their safety and ability to carry out these actions.

LINDY KERIN: The international agency says acceptance from all communities, political and military groups is the only way medical organisations, including MSF, can work in Pakistan.

SALLY SARA: Lindy Kerin reporting.

The World Health Organization has condemned the attacks on the polio workers. It says children who could be immunised, will instead be at risk of contracting the deadly disease.

The WHO says it's vital for the eradication program to continue.

I spoke earlier with Dr Bruce Aylward, the assistant director-general for polio, emergencies and country collaboration.

BRUCE AYLWARD: These attacks are absolutely horrific. We need to be very clear: this is not an attack just on polio, this is an attack on health workers, on health services and the delivery of just the most basic health care to some of the most deprived children in the world and this is completely unacceptable under any circumstances.

SALLY SARA: Where have these rumours come from that the polio eradication scheme is part of a US plot? Is that because of the role that it played in the assassination of Osama bin Laden?

BRUCE AYLWARD: No, actually there's been rumours off and on for years and years. This program has been ongoing for 24 years and the rumours as to the nature of the vaccine and who's behind the vaccination go back many, many years.

And part of the reason for that is that many of the communities that we're trying to get to have never received any services whatsoever and when suddenly government services are showing up and people are showing up knocking on doors saying, "We're here to vaccinate your children and help against this disease," which many may never have seen, raises suspicions.

And when people aren't in a position sometimes to explain those, rumours very, very rapidly are fuelled. So the events in Pakistan of 18 months ago are really just one part of a much bigger and longer and deeper story.

SALLY SARA: The US decision to use a polio vaccination program as a cover for some of its intelligence work before it assassinated Osama bin Laden. What do you think about that approach?

BRUCE AYLWARD: Well first we need to be clear. What's referred to as the "Afridi Affair" was actually a different kind of campaign altogether, where they used an injectable vaccine and a hepatitis vaccine, from what we understand actually, we've never seen the official report on what actually happened, and in fact that is fundamentally different than what the polio program is all about.

The polio program is about giving vaccines, giving health to communities to be able to be involved with the delivery of the service and to vaccinate and care for their own kids.

That's very, very different to what happened in this event, as we understand it in that outsiders actually were brought in to conduct a campaign like this. And people often misuse it for other reasons.

In terms of what we think of that theory, for everybody it's completely unacceptable to use, again, health workers and put health workers at any kind of risk.

SALLY SARA: What does it mean for a child in Pakistan if they contract polio, what does it mean for their future prospects, with things like work and marriage in the long term?

BRUCE AYLWARD: Polio is an awful, devastating, debilitating and frequently deadly disease. It will leave a child, if it doesn't kill the child, paralysed for life and without the use of one or more limbs.

And it can be devastating, not just for the child and wipe out the child's prospects, but also those of the family and sometimes even the community in which he or she lives.

This is because obviously it leaves the child disfigured in some way and sometimes unable because of the lack of services or rehabilitative services to be able to get an education, to work as they might like to work, and even, as you have mentioned, to marry and to enjoy a full life, tragically.

SALLY SARA: Polio was a disease that ravaged generations, even here in Australia. How dramatic has the change been from those days to now, when there are only three countries that are still struggling to get rid of the disease?

BRUCE AYLWARD: Absolutely dramatic change in the situation since the eradication initiative was launched. Just 25 years ago, over 250,000, probably closer to half a million actually, children were being paralysed every single year by this disease in over 125 countries.

And as a result of this massive initiative, the number of cases has dropped now to just about 200 this year in corners of just three countries. So we're looking at a completely different picture and this disease now on the verge of eradication forever.

SALLY SARA: What do you think the prospects are of continuing this polio eradication campaign in Pakistan?

BRUCE AYLWARD: Well this has been an awful tragedy and a very, very black day for Pakistan and, not so much for the polio program, well for the program obviously, but really for health care in general.

But if something positive might come out of it, it's the fact that there's been a huge backlash from all sectors of Pakistani society as well as the religious institutions and the political institutions that this simply is not acceptable and we now have communities demanding vaccination in Pakistan that in the past have been quite complacent actually.

So I think as we've seen in many other areas where it's been necessary to suspend the vaccination, either due to conflict or civil unrest or other reasons, the prospects for eventually restarting, once the underlying issues are dealt with, and then completing eradication, they remain quite positive.

We've certainly seen situations like this before. The tragedy is that while campaigns are suspended, many more children in that country and possibly due to international spread, are at risk of being paralysed needlessly.

SALLY SARA: That's Dr Bruce Aylward, the assistant director-general for polio, emergencies and country collaboration with the World Health Organization.