EOC COMMUNICATION UPDATE Issue XXXXVII

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EOC Communication update

WWW.ENDPOLIO.COM.PK ISSUE XXXXVII – NOVEMBER 27 , 2015

Polio vaccinators go after missed children in cotton fields in Punjab

By Wasif Mahmood

DeraGhazi Khan - As polio teams scurried house-to-house to vaccinate every child on day two of polio National Immunization Day, large number of women took to the fields to pick cotton, along-with their children as young as one, in this remote village of Dera Ghazi Khan, in south Punjab of Pakistan.

For the burdened health team in the district, who on average cover over 200 households a day including schools, the onset of cotton-picking season heralds challenges ahead as more and more children are reported no-show during house-to-house vaccination campaign.

The scale of polio teams’ efforts is more humongous in the village of Darkhast Jamal Khan, located some 16 kilometers from Dera Khan City, due to treacherous terrain and scattered nature of houses.

The district is located in one of the remotest areas of the province with dismally low literacy rates, history of polio cases, last reported in 2014, and the routine immunization coverage just above 25 per cent.

Dera Ghazi Khan shares border with polio-infected districts of Balochistan and Khyber Pakhtunkhwa which makes it more vulnerable, hence categorised in tier-2 in the list of polio-prone districts. Tier-1 districts being the ones in FATA, Khyber Pakhtunkhwa, Sindh and Balochistan.

“For us the cotton picking season is very tough,” says the team leader Rafiq Ahmad in village of Basti Saker Bagalani.

“We knock at the doors and find nobody. It is a continuous exercise… we go again and check in the evening and find a few children are still not available. Search and vaccination continues for days till the last child is vaccinated,” he adds. EOC COMMUNICATION UPDATE | Issue XXXXVII 2

With the vaccination of children in households, the job of health teams is not finished here. The season also spells problems for the health teams in vaccination of such children who have travelled with their families in search of livelihood from areas infected with polio virus. Such children are considered high risk populations due to their mobility, vulnerability to vaccine preventable diseases,including polio. Reaching out and vaccinating such children requires separate plans.

“We try to vaccinate these children on the first day of the campaign. Such on-the-move populations are marked red in our maps,” says health worker Muhammad Akhtar in Basti Ahmadani.

“Such children are very poor, mostly malnourished, they don’t have access to clean water and sanitation facilities as well as no educational opportunities,”Akhtar says.

“For Rafiq and 34,000 frontline health workers in the vast 36 districts of Punjab, the job is by no means easy. Children who are missed during the three-day campaign and two-day catch-up, another extended catch-up pursuit continues for 14 days.

“We maintain lists of such population with complete addresses incorporated in our daily plan along with the name of the head of the family,” Akhtar says.

“As they have scant livelihood resources they move from one place to another and live in unhygienic conditions thus making them more vulnerable to polio,” he says.

“The key is to establish ties with the elders of such groupsso that wherever they go they vaccinate their children at the health centres or from the teams”, he says.

Director of the Expanded Programme on Immunization in Punjab, Dr Munir Ahmad, is all praise for the health teams.

“Frontline health workers are the real force in elimination of polio; have pivotal role in defeating the virus once and for all. More than 200,000 motivated men and women across Pakistan have been selected from their local communities, and trained with state of the art tools to ensure every child is reached and every parent can trust vaccinators to protect their children from polio,” says Dr.Munir

In recent months, the Pakistan polio programme has refocused its efforts in tracking the virus to the remaining reservoirs and in finding and vaccinating the continuously missed children among the highest risk population to close the immunity gap.

The number of children paralyzed by polio has dropped by 80 per cent from last year. The immunity gap is now closing but the virus is still successfully seeking out unprotected children. Finding and vaccinating these persistently missed children will leave the virus nowhere to go.

“We have to track children and check their vaccination status and then administer them polio drops. This is the least we can do for them; we are working for a noble cause of protecting the future of children”, says Rafiq.

EOC COMMUNICATION UPDATE | Issue XXXXVII 3

“Mus Tak Bill”, a theatrical Performance of youth on Child health issues

The Rafi Peer Youth Performing Arts Festival concluded in Lahore last week. Youth group from across country participated in the Rafi Peer theatrical workshop to stage their performances.

In the Festival, a group of enthusiastic youth group staged a satirical play on child health issue and apathy of society towards the issue. "Mus Tak Bill" was a 40 minute comedy based on the issues of child health in Pakistan. It is an effort to create awareness about the nine communicable diseases, particularly polio. It aimed to provide a reality check to our society that compromises our future.

The initiative of engaging youth through a theatrical performance originated from the meeting of National Child Health Consortium held in Lahore on October 29, 2015 where an Arts teacher of University of the Punjab, who became member of NCHC volunteered himself to write a play on this issue. Secretariat of the NCHC, Mediations, extended its support in providing technical information to the writer about the program.

Polio case update

Pakistan is making significant progress in the fight against polio with 85% reduction in the number of cases in 2015, compared to the same time last year. The number of children paralyzed by polio have declined from 283 in November 2014 to 42 in November, 2015.

Despite this progress, Pakistan still accounts for 73% of the world’s polio cases. Many children in key high-risk areas of the country are still being missed by vaccinators and left unprotected against the virus Success in Pakistan means success worldwide.

There are 12 High Risk Districts that represent the final polio reservoirs in the country. These 12 districts are the focus of the 2015 low-transmission season, beginning with the September National Immunization Day (NID).

Almost half a million children who were previously missed have been reached, due to gradual improvements in programme quality and access since late 2014. Nine high quality campaigns have been planned from September 2015 to May 2016. If every child is vaccinated during every campaign, Pakistan will succeed in ending Polio by May 2016. ******************