6/11/2015

The final war against polio


June 11, 2015


  • Donald McNeil
A Pakistani health worker in Bannu giving  the polio vaccine to children last year.
A Pakistani health worker in Bannu giving the polio vaccine to children last year. Photo: AFP
New York: In the documentary "Every Last Child",  a police commander says a few words to his men before they roll out into a hostile city. Their job is to protect polio teams going house to house in neighbourhoods where Taliban assassins cruise on motorbikes.
It is their jihad, he tells them.
A polio vaccinator giving a child the vaccine in northern Nigeria in 2013.
A polio vaccinator giving a child the vaccine in northern Nigeria in 2013. Photo: AFP
Everyone in "Every Last Child" is fighting a holy war - the vaccinators against the virus, the Taliban against the vaccinators, the police against the Taliban. Above them, outside the frame, is a dark tornado of greater forces fighting their own jihads: Islam versus Crusaders, the CIA versus the World Health Organisation, Western science versus Eastern faith. Every time it touches down in the slums of Karachi and Peshawar, it leaves behind new victims: dead vaccinators and paralyzed children.

If polio has disappeared from Africa - and on August 11, it will be a full year since a case has been found on that continent - then the Pakistan-Afghanistan strain will be the world's last.
But in many senses, the crisis remains inexplicable. Why would anyone decline a gift with no strings attached - a gift that, rejected, could consign one's own children to paralysis?
A newly arrived Somali refugee child given a polio vaccine in Kenya in 2011.
A newly arrived Somali refugee child given a polio vaccine in Kenya in 2011. Photo: Reuters
Even worse: Who would ruthlessly gun down women and girls - neighbors and clansmen, not strangers - who are the innocent bearers of that gift?
In the film, Zubair Rabi, a grocer, and his friends offer partial answers, repeating the tired but still potent rumours: That the vaccine is really birth control aimed at Muslims. That the same American works brewed up the virus that causes AIDS and shipped it to Africa.
The camera follows Rabi and his children to the beach. It is empathetic: He obviously loves them. No, he says, as they play fully clothed in the surf, they are not vaccinated, but they are healthy. He loves God, so God protects his children.
An Afghan in Kabul takes a child to be vaccinated against polio last year.
An Afghan in Kabul takes a child to be vaccinated against polio last year. Photo: AFP
Left unexplained is why this blind rejection stays nailed solidly into a few tiny pockets of the Islamic world while the vast majority of Muslims accept the vaccine - along with others, and antibiotics, drugs for AIDS and hepatitis C, cancer chemotherapy and other Western formulations, all of them more toxic than polio drops.
As polio has been driven back into its last redoubts, it has become more and more a disease of the aggrieved minority, of people so beaten down that they trust nothing offered by outsiders - and for whom almost everyone is an outsider.
That is not uncommon. In West Africa, Ebola first broke out among the rural Kissi people who live where Liberia, Sierra Leone and Guinea meet. They feel despised by the elites of the capital cities, descendants of freed slaves, and were so sure that the elites had sent Ebola that they killed medical teams venturing in to help them.
Polio health workers in Lagos, Nigeria, which has been polio free since last July.
Polio health workers in Lagos, Nigeria, which has been polio free since last July. Photo: AFP
For a decade, polio has been essentially a Muslim disease. The 2005 hajj season spread a Nigerian strain to Mecca and out from there. Most Muslim countries clamped down hard. Saudi Arabia, for example, vaccinates pilgrims on arrival.
Now the virus hits almost only Pakistanis and Afghans - and not all of them, but nearly only Pashtuns, the tribe originally from the mountainous border. And not even all Pashtuns, but mostly the Mehsuds and a few other conservative clans.
They are the people who fought the British at the Khyber Pass, the mujahedeen who fought the Soviet invasion of Afghanistan, and the source of the Taliban.
Empires have overrun their villages and butchered them but have never subsumed their culture, or even pacified their clan fighters for long. 
The Taliban is to the Pashtuns roughly what the Cosa Nostra once was to Italian-Americans: a mix of criminal gang and self-defence group, religiously conservative and quick to violence.
The CIA's use of vaccinators to hunt Osama bin Laden was a disaster for the polio campaign, and military drone strikes, virtually all in Pashtun territory, have increased Pashtuns' fear that the world - including a Pakistani elite dominated by descendants of Indian Muslims - is against them. They have grievances: Urbane Pakistanis talk about them the way American snobs refer to "hillbillies" and "trailer trash".
Now the Pakistan vaccination campaign - a disaster in early 2014, when the film was shot - is slowly turning around. Polio cases are dropping.
Some Pashtun complaints - like being offered nothing but polio vaccine - are being answered. The campaign now holds pop-up pediatric clinics where children receive checkups, vitamins, deworming drugs, antibiotics and several vaccines.
Crude violence is working, too. Last year, Pakistan's army invaded Waziristan, where vaccine resistance was strongest. They were re-establishing government control, not pushing the polio agenda, but vaccinators followed. Also, while on the road, the thousands fleeing the war are vaccinated at bus stops or in train stations.
Violence is part of the reason polio disappeared from Nigeria. Boko Haram, the Taliban equivalent there, sowed such terror by kidnapping girls and slaughtering villages that much of the population fled down roads and into refugee camps where vaccinators waited.
Polio has escaped before - to Syria, to Somalia and elsewhere - but its escapes are briefer and the number of children paralysed fewer. The day of the last child appears to be getting closer.
Post Polio Litaff, Association A.C _APPLAC Mexico

The Polio Crusade

THE POLIO CRUSADE IN AMERICAN EXPERIENCE A GOOD VIDEO THE STORY OF THE POLIO CRUSADE pays tribute to a time when Americans banded together to conquer a terrible disease. The medical breakthrough saved countless lives and had a pervasive impact on American philanthropy that ... Continue reading..http://www.pbs.org/wgbh/americanexperience/polio/

Erradicación de La poliomielitis

Polio Tricisilla Adaptada