PESHAWAR -- The Khyber Pakhtunkhwa (KP) government is changing its strategy on polio vaccinations after recent attacks on health workers and unfounded rumours that the vaccine hurts children.
"We have decided to take into consideration different options after the April 22 incident in Peshawar, in which an angry mob set fire to a Basic Health Unit," said KP Secretary of Health Dr. Syed Farooq Jamil.
The KP government on April 22 launched a three-day anti-polio campaign. The same day, various spurious videos and messages claiming that polio vaccines were making children sick sparked panic, with thousands of children brought to KP hospitals.
"Health workers are in a state of fear" after false rumours claimed that polio drops were making children sick, Jamil said. Now, "the door-to-door campaign is extremely difficult."
"We have decided to work in collaboration with stakeholders and devise a new policy to protect our workers," he added.
KP has recorded 10 of the 15 total cases of polio in Pakistan this year.
Changing campaign frequency
"We are now going to pursue a programme to reach all children and at the same time ensure our workers' safety," Jamil said.
Militants have killed five health workers in KP since the polio panic on April 22. That violence has health workers afraid to work in the field, he said.
The government is reducing the number of national immunisation and sub-immunisation campaigns against polio in view of the threats to vaccinators, said Prime Minister Imran Khan's focal person for the eradication of polio, Babar Bin Atta.
"Presently, nine national immunisation campaigns, six weeks apart, are being conducted in the province, while four sub-immunisation anti-polio campaigns took place in the selected districts, which means that the vaccination staff visit each household on average 10 times a month," he said.
Such frequency created doubts and enraged some residents, said he and other officials.
Sixty thousand workers and security staff were deployed in the campaign, creating a war-like situation and sowing doubts, said Dr. Akram Shah, head of KP's vaccination programme.
"Now, we plan to conduct the polio vaccination on a quarterly basis," he said.
'Scaling up' public awareness
The recent campaign has sparked fear among health workers and polio vaccine refusals will increase if the communication strategy does not change, said Dr. Saima Abid, president of the KP Public Health Association.
"The incident further endangered the lives of polio workers, and high-profile campaigns aren't possible," she said. "Fatigue and fear are increasing among the vaccinators, and they aren't ready to carry out their duties in this situation."
Members of the association have been working on a voluntary basis "to help the government eradicate the childhood ailment", said Abid.
"We should focus on scaling up public awareness about the efficacy of the oral polio vaccine instead of visiting houses, which has become a risky affair," she added.
Seventy health workers have been killed by militants since 2012 and more will die if the current vaccination approach continues, said Shaheen Begaum, a senior vaccinator.
"It is wise thinking to change the strategy," she said, adding that it is often female workers who face more problems when visiting houses.
Prof. Gohar Rehman, the president of the Pakistan Paediatrics Association, also called for a different strategy for the vaccination programme.
"We can't expect smooth sailing of the polio programme under the current strategy as we frequently visit houses," he said. "We should strengthen routine immunisation, where vaccination for 10 childhood diseases was done at the hospitals."
Pakistan, Afghanistan and Nigeria are the only countries where polio remains endemic, he said. All of these Muslim countries are facing threats from militants and are unable to conduct polio vaccination at the desired level.
Militants are opposed to vaccination and want to expose children to diseases, Rehman said.