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Polio vaccination, again?

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Mansour, Shah Maqsoud and Nadia work as a polio vaccinator team in Kabul. Photo: WHO/Tuuli Hongisto  Mansour, Shah Maqsoud and Nadia work as a polio vaccinator team in Kabul. Photo: WHO/Tuuli Hongisto

In Afghanistan, frontline health workers explain to parents why the polio vaccine must be delivered multiple times

Kabul 15 February 2018 – “It’s easy for the boys. They are young and strong,” laughs Nadia. She has just climbed hundreds of steps to the top of a long and steep staircase on the side of one of Kabul’s many hills. Together with her colleagues Mansour and Shah Maqsoud she works as a part of a polio vaccination team, who walk from house to house vaccinating children.

Today, the team started at 8 am, and they have been walking up and down the hill for 3 hours already. No wonder she is tired.

The group works in the Nadir Khan area in Kabul, and they have visited 50 houses and vaccinated 110 children so far today. They have 30 more houses to visit, and in the next 3 days, they will visit a total of 233 homes.

The team’s role is not only to vaccinate the children but to also to educate people about the life-saving vaccine and its importance. It is not always an easy job.

“Last time we visited the houses was only 2 weeks ago, so some parents have been asking why we are visiting again. I have explained to everyone that the vaccine is beneficial for the children and that children need to be vaccinated every time to be protected.”

It is the first day of a vaccination campaign, which aims to immunize over 6 million children against polio in Afghanistan.

Today, thankfully, no families have refused the vaccine from this team. 

Last push to eradicate polio in Afghanistan

Afghanistan is one of the last countries in which wild poliovirus is still circulating. It has the highest number of polio cases anywhere in the world.

In 2017, there were altogether 14 cases and so far in 2018, there have been 3 confirmed cases. In recent months, the virus has been found circulating in southern and eastern regions.

WHO Afghanistan polio programme manager, Dr Hemant Shukla is confident, that with stepped-up efforts, the circulation can be stopped. “Afghanistan has stopped transmission in the past in all areas, but not at the same time. We are confident, that by following correct strategies, focusing in the right areas and by coordinating our efforts with neighbouring Pakistan, we can stop the transmission”.  

To address the challenges, the polio eradication initiative has stepped up efforts by for example improving surveillance to detect any viruses in the environment, and is implementing special action plans in the eastern and southern regions to reach all children every time, as these are very high risk areas for polio transmission and have frequent population movement across the border with Pakistan.

The programme also works to reach and immunize the mobile populations, such as nomadic people, who are also at high risk for contracting polio.

The oral poliovirus vaccine is effective, as it not only protects the children from contracting poliovirus, but also prevents them from carrying the virus in their intestines − but it needs several rounds of vaccinations to build sufficient immunity, especially in areas where children’s immunity might be low due to poor nutrition.  

To quickly build up children’s immunity during the low transmission season, the Polio Eradication Initiative decided to conduct 2 campaigns to vaccinate children in the high-risk and very high-risk districts in quick succession in January and February, so that the vaccine would have a maximum effect.

Next month, the whole country will be covered by a campaign, in which 10 million children will receive the vaccination.

Yusef (3) was vaccinated by house visitors in KabulYusef (3) was vaccinated by house visitors in Kabul. Photo: WHO/Tuuli Hongisto

In Kabul, the February campaign is still ongoing. One by one the team marks their tally sheet with numbers and ages of the children and takes note, whether all the children of the household were present.

One of the children vaccinated today is 3-year-old Yusef, who stands outside his family’s home. His mother Pari peeks through the gate. She has 6 children, and Yusef is her youngest.

“Yousef was just vaccinated 2 weeks ago, but I know it is important to vaccinate children every time”.

The team marks this household vaccinated for now.

In 4 weeks, Pari can expect a knock on the door again.

Polio Eradication Initiative

Text and photos: Tuuli Hongisto / WHO Afghanistan 


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Key health-related statistics

Population (m) 29.7
Health expenditure (% of GDP) 9.5
Adult (15+) literacy rate (%) 34.8
Life expectancy at birth F/M (2010) 63.2-63.6

Sources: Central Statistics office, Afghanistan National health Accounts, Afghanistan Living Conditions Survey, Afghanistan mortality survey. 

Framework for health information systems and core indicators for monitoring health situation and health system performance, 2018

Afghanistan country health profile

Regional Health Observatory

WHO Afghanistan Programme Overview 

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