Afghanistan: Three P against Polio   

Polio eradication is a global priority. Its eradication demands three P: Persuasion, Participation and Peace.  

 “I have six children; all of them have been vaccinated today.” Tells Fatima proudly. She is only 25 years old and carries already the responsibility of a big family on her slim shoulders.  

1.2 million Children in high risk areas will be targeted by a 3-day polio eradication campaign launched on 13 September by the Representatives of WHO and UNICEF in the province of Ghor, Western Afghanistan. The immunization event comes shortly after a new case of polio was discovered in the province. Yet it is part of an ongoing effort to eradicate polio in Afghanistan - one of just four countries in the world still affected by the crippling disease.  

“Living conditions are not easy in my village. We have neither land for agriculture nor cattle. As my husband and oldest son have not the necessary knowledge to work outside, they are working as day labourers. When they are both employed we have 200 Afghanis (US 4$) per day. To go to the doctor each time when my children fall sick is too expensive” tells Fatima. Her living conditions are similar to the ones of many Afghan women. Health services and Education are a luxury in this environment.  

“My people do not have an incurable disease. They are jobless, poor and afraid– attention of the Government and donors can heal them. We are very grateful of the efforts that UNICEF and WHO have made in our region. Yet I ask you to carry my message with you, so much remains to be done.” Mr Sayed Mohammad Eqbal Munib, the Governor of Ghor tells during the launch of the 3-day vaccination campaign. Today’s vaccination drive is one proof amongst many, for the attention that WHO and UNICEF give to the children of Ghor. 156,000 kids under five years old are targeted by immunization efforts in this province.  

The campaign, which is organized in the countdown of UN Peace Day 2009, aims to reach 1.2 million children under five years old in conflict-affected districts. More than 15,000 health workers are traveling from door-to-door in eight provinces – Ghor, Farah, Uruzgan, Helmand, Kandarhar, Khost, Kunar and Nangarhar. Like Fatima, many families are unable to access health facilities, be it due to lack of financial means, large distances between their homes and the health centre or – for most of them - because they are afraid of attacks. A mobile approach is essential to ensure that every child in the target group is reached.  

Circulation of the wild polio virus continues in Afghanistan, though limited to few districts. A solid decrease has been achieved with 17 confirmed cases in 2007, down from 31 cases in 2006 and 63 in 1999. This containment of the virus and the prevention of its spread-out were possible thanks to continued collaboration of the Afghan Ministry of Public Health, UNICEF, WHO and generous donors. Yet, since 2008 the number of attacks has increased, creating an environment of fear and limited access for vaccination teams to children living in conflict-affected areas; by consequence the number of cases went up to 31 in 2008. 20 cases have been reported so far in 2009. Lack of community awareness and participation, limited female service providers, inadequate health infrastructure and population movement from polio free areas to polio endemic areas and vice-versa further enhance the before-mentioned factors.  

“Polio is an issue of common interest” declared Mr. Peter Graaff, WHO Representative in Afghanistan. “I appeal to the local leaders of Ghor to persuade all parents in their area to bring their children for the vaccination. Every member of the community must participate in this endeavor. We have a responsibility towards the children in Ghor, in Afghanistan and the whole world to eradicate polio. “ 

Four nation-wide house-to-house vaccination campaigns reached almost 7.5 million children until August 2009, in parallel routine immunization is ongoing in health facilities across the country to stop and prevent the virus from spreading. Yet, an average of 100,000 children can not be reached as lack of security hinders the access to numerous households. 

UNICEF Representative in Afghanistan Catherine Mbengue urges “Peace is necessary to access all children and vaccinate them against polio. It takes just a few seconds to immunize a child – but the results last for a lifetime. Unless we eradicate polio in Afghanistan, the virus will continue to disable children, placing even greater strains upon families. Peace and polio constitute a vital cycle for the future of Afghanistan.”