The ghost of polio
By Basheer Ahmed Ijbari
Polio is known as poliomyelitis; it is infantile paralysis as well as it is an acute communicable disease caused by the poliovirus and ranges in severity from in apparent infection to fatal paralytic illness. First recognized in 1840, poliomyelitis became epidemic in Norway and Sweden in 1905. Outbreaks reached pandemic proportions in Europe, North America, Australia, and New Zealand during the first half of this century. Incidence peaked during the 1940s and early 1950s, and led to the development of the Salk vaccine.
Although polio can cause a paralytic disease and the result will be death, the stretched majority of people who have been affected by the poliovirus many people have developed symptoms from poliovirus contact no paralytic polio, it is type of polio that doesn’t lead to paralysis abortive polio, this usually causes in a same mild, flu-like sign and its symptoms are typical of other viral diseases.
Symptoms which generally last one to 10 days, include:
- Sore throat
- Back pain or stiffness
- Neck pain or stiffness
- Pain or stiffness in the arms or legs
- Muscle weakness or tenderness
Discovery of Polio Vaccine:
Two polio vaccines are used throughout the world to combat poliomyelitis (or polio). The first was developed by Jonas Salk and first tested in 1952. Announced to the world by Dr Thomas Francis Jr. on April 12, 1955, it consists of an injected dose of inactivated (dead) poliovirus. An oral vaccine was developed by Albert Sabin using attenuated poliovirus. Human trials of Sabin’s vaccine began in 1957, and it was licensed in 1962. There is no long term carrier state for poliovirus in immunocompetent individuals, polioviruses have no non-primate reservoir in nature (although they have been induced in transgenic mice), and survival of the virus in the environment for an extended period of time appears to be remote. Therefore, interruption of person to person transmission of the virus by vaccination is the critical step in global polio eradication. The two vaccines have eradicated polio from most countries in the world, and reduced the worldwide incidence from an estimated 350,000 cases in 1988 to just 223 cases in 2012.
In November 2013, the World Health Organization announced a polio outbreak in Syria. In response, the Armenian government put out a notice asking Syrian Armenians under age 15 to get the polio vaccine. It is on the World Health Organization’s List of Essential Medicines, a list of the most important medication needed in a basic health system.
Entire world through vaccination has got immunized from grim disease “the Polio” but unluckily Pakistan, Afghanistan and Nigeria are harboring the patients with virus on distressing level that in these mentioned countries and it can breakout then as epidemic on sudden time in told states.
The Pakistan caused transformation of virus to China, Egypt and Syria where it has incapacitated many children. This has persuaded that WHO declared the spread [PHEIC] Health Emergency of International Concern and recommends some points to constrain the rapid spread of virus and these will valid for three months, but in case of non-effectiveness the short-term sanctions can be extended on.
In current year, Pakistan is on top in the rank of polio cases with 83 totally affected children have been incapacitated by this viral disease of polio, while in Afghanistan 6 and in Nigeria 3 cases of polio have been reported so far.
The abysmal situation in Pakistan regarding polio has impelled the International World to take some dire steps because for safety of people and they are also obliged to take pre-emptive measures. The World Health Organization, WHO, has imposed travelling sanction on Pakistan in 5th May, 2014, in that vaccination certificate of polio is stapled with Pakistan travellers to abroad. The WHO restriction will effect ten countries of world; Pakistan, Syria, Cameroon, Eqvodore Genie, Ethiopia, Nigeria and Somalia. The WHO has recommended sanction on above mentioned states or that will be under sanctions, directly.
On international level some immediate initiatives are required to be taken:
• Emergency is to be called against Polio in effected countries.
• The polio virus-catering countries’ citizens who intended to travel other countries for one month or for more than one month for them it is compulsory to get vaccinated earlier four weeks or for injection time lasts a year. In case of dash, the citizen must be vaccinated for polio before the departure.
• The certificate of vaccination by departments concerned must be provided to the travelling citizens.
These 3 months scheduled sanction comprises the directive that vaccination is compulsory for all people irrespective of their age differences, the pregnant passengers also included in vaccination because the polio vaccine is not impair for them.
Polio in Pakistan:
Currently, Pakistan is the country which is catering polio virus in largest scale in the whole world. In addition to that, in Pakistan, polio disease has paralyzed 83 children beyond June 23, 2014, while 19 cases were reported in previous year. During 2014 in FATA 64, in Khyber Paktun Khuwa 12, and Sindh 6 children have been left disabled by polio. Commonly the polio virus communicates from November upto May due to cold weather and in this specified period its ratio remains very low and cases report fewer, but this year, ironically, from January upto now [June] the number of cases has increased five folds.
Pakistan is such a country where the majority of citizens are unaware of citizens’ rights but a layer is occupying all resources and country’s major portion economy goes in the regard of defensive expenditure, like missiles testing and war-equipment purchasing have pushed this country’s people in darkness of illiteracy and ignorance. These things have caused very low growth of cognizant and people don’t seem to care much for their health and they are unenthusiastic in participation of polio eradication campaigns.
In Nigeria, fanatic notions have been encouraged and in Pakistan for keeping hegemony on neighboring states the Jihadists were used, and aftermath these elements have got as challenged to the writ of state and denied to vaccinate their areas’ children by frothing illogical and irrational debates, and that is the reason, FATA, The Federally Administered Tribal Areas, has 64 incapacitated children disabled by polio. The similar monk also exists is Balochistan’s Pashtun belt. They believe the polio vaccine is taboo and a conspiracy of US and other European countries to reduce the number of Muslims in world. They believe that the polio vaccine is the cause of infertility of women; such irrational thoughts are hampering the Pakistan to be a polio free state.
The extremist thoughts badly affected the polio campaigns in the country, mostly, the FATA and its adjacent areas, where many polio workers in Peshawar and other towns of KPK and in Karachi have lost their precious lives during performing their duties by fatal attacks of discussed extremists. These attacks on polio workers got shape of a challenge to law-enforcement agencies of state.
Currently, State’s central command has launched an operation “Zarb-e-Azb” in FATA for the elimination of militants, which caused evacuation of local population from the area. The war affected population has been shifted to settled areas of country and they are dubbed IDPs and strength of these is in million as well as some of them also flown across the border to Afghanistan. This displacement of people has provided a magnification of chance vaccinate caused region children and got them immunized from polio who are communicating the virus whether inside and outside the country of Pakistan.
Polio in Balochistan:
Balochistan is the largest province of Pakistan area-wise, but the poorest in sectors of education and economics. Balochistan’s Pashtun religious elements create some problems in polio vaccination but Baloch moderate and progressive ever facilitated and welcomed polio teams in their localities. Presently, Balochistan is immunized from polio totally and luckily it is the sole province in entire country polio-free. The sustaining of this status to Balochistan is great challenge for it. Balochistan has to establish polio vaccination units on the transit points to other provinces. On the highways, railways and the IDPs who are migrating to other parts of country, similarly in Balochistan they are entering and creating hazardous environment for polio virus communication; hence this aspect is required vigilance to prevent the virus spread in the province.
In this regard the authorities concerned, without vaccination process, shouldn’t let the IDPs enter Balochistan. The parents also give drops to their children and cooperate with vaccination teams and must not miss any children from drops on this imperiled occasion. Balochistan is sole province that is polio-free since 18 months and here WHO and Government of Balochistan disbursing polio team workers in extra Rs.250 to each, the provincial government officials are monitoring personally the vaccination campaigns.
Challenges regarding Polio in Balochistan:
Low graded polio campaigns:
On district and union level due to no answerability, bad administration and insufficient teams of polio, challenges in Balochistan are against the eradication of virus totally.
Large scale migration of population:
Balochistan is province where large number of population migrates season to season to other provinces and neighboring country to Afghanistan. People migrate to Sindh, KPK and southern Afghanistan for sidestep from extreme weather and they live a nomadic life style. Average 15000 to 20000 children each month cross the Pak-Afghan border entrance “Bab-e-Dosti”.
Somehow the religious outlook is also akin to a hindrance that fundamental thinkers are misguided that imported polio vaccines are taboo or cause infertility to women. The Ghost of polio has gripped tightly to Pakistan and now here the governing bodies are also confused when WHO imposed travelling sanctions for tenure of three months on trial basis, although after vaccination process Pakistani citizens can travel abroad. Here it doesn’t seem that within three months Pakistan will be a polio-free country. In case of polio virus harboring the international world definitely will implement more tough sanctions, which will be more troublesome for Pakistanis.
Regarding the ground realities, it can be prognosticated that in a short-term of three months Pakistan will not be polio-free. During 65 years, from its creation, this has failed to provide clean drinking water to its citizen not talking of other rights and amenities, henceforward with such history no one can prognosticate for being Polio-Free State given the short span of three months, at least a far-fetched perception about Pakistan. And international world may cut-off relation or suspend air flight and world Health Organization recommends stern restrictions on it because these are unavoidable too, otherwise, polio virus will relocate, like it has transmitted to Syria, China and other countries get a drastic situation. The Pakistan’s topsy-turvy political structure, religious hysteria and corruption are impediments in the way of making the country polio free.
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