Of the 170 children identified as suffering from post-polio paralysis in the provinces of Punjab and Sindh since 2008 and in NWFP from 2003 to date, 137 have been assessed and provided with rehabilitative services under a project focusing on improving the quality of life of children suffering from polio-related disabilities in Pakistan, ‘The News’ learnt here on Tuesday. 

On a further positive note, 21 of the 35 children identified as falling in the school-going age in NWFP alone—after having received rehabilitative services—are now enrolled in formal schools and can be seen happily indulging in academics and a multitude of extra-curricular activities in an environment of inclusive education. The parents of 5 children refused to send their children to regular schools; these children were admitted in religious schools.    

A brainchild of the World Health Organization (WHO) in collaboration with Ministry of Health, Pakistan Institute of Prosthetic & Orthotic Sciences (PIPOS) and funded by International Islamic Relief Organization (IIRO), the project was initiated in 2007 to enhance the mobility and dignity of children suffering from polio-related disabilities; to prevent the onset of secondary disabilities ; and to enhance the physical mobility of school-going children through corrective surgery, orthosis, or physical rehabilitation. 

Of the 137 children who have benefited from rehabilitative services, 85(62%) were boys and 52 (38.3%) were girls. Their majority was in the age group of less than 3 years, followed by the 3 to 8 year age group. 

According to data, WHO-MoH Rehab team provided orthotic devices to 105 (77%) children, while 29 (21.8%) cases needed physiotherapy exercises for prevention of secondary deformities, and only one case (0.78%) underwent surgical intervention for release of fixed flexion deformity at the knee joint.  

The project adopted a combination of Institution as well as home based rehabilitation approach for provision of rehabilitative services. As such, Pakistan Institute of Prosthetic and Orthotic Sciences, served as the key facility for provision of orthotics to confirmed polio cases in NWFP, while the Department of Physical Medicine and Rehabilitation of Mayo Hospital, Lahore and the Orthotic and Prosthetic Workshop of Dow Medical College served cases in NWFP and Sindh, respectively. This unique model is now set for replication in other provinces requiring alleviation of the burden of polio-related disabilities. In the follow-up phase of the project, the orthotic devices provided to the children were replaced in view of their growing age, and in a few cases, minor fittings were made.  

The existence of an estimated 10 to 20 million polio survivors worldwide makes them one of the largest groups with physical disabilities in the world. In 1988, polio was endemic in more than 125 countries, paralyzing over 350,000 children every year. Today, it is endemic in four countries including Pakistan, which has failed to sustain the reduction in cases from 5,000 in 1993 to 32 in 2007. The country witnessed a sharp increase in polio cases in 2008, which ended with 118 confirmed cases. And the trend continues today, with 45 cases reported so far in 2009. 

Polio is a debilitating disease that mostly strikes children living in poor socio economic situation, leaving them crippled for the rest of their lives. Children in developing countries like Pakistan are the hardest hit due to lack of rehabilitative facilities, without which many of them are condemned to crawling and limping. The longer such children remain untreated, the more complicated it gets to have them upright and walking—even with appropriate assistance and interventions. Analyzed against this backdrop, the need for prevention of further disabilities in polio survivors can hardly be over-emphasized.  

At the same time, however, it must also be realized that any intervention for children with polio-related disabilities needs to look beyond physical rehabilitation and also cater to their education, livelihood and empowerment. According to the World Bank, 98 percent of the children with disabilities in developing countries do not go to school because of poverty, lack of resources, and low priority for education.  

With Rehabilitation Quality of life of polio victims can be improved remarkably but can never be back to normal. Vaccination against polio is the only way to protect the children from being victims to this crippling disease.