The parents of 24Â 000 children in northern Pakistan refused to allow health workers to administer polio vaccinations last month, mostly due to rumours that the harmless vaccine was an American plot to sterilise innocent Muslim children.
The disinformation — spread by extremist clerics using mosque loudspeakers and illegal radio stations, and by word of mouth — has caused a sharp jump in polio cases in Pakistan and hit global efforts to eradicate the debilitating disease.
The World Health Organisation (WHO) recorded 39 cases of polio in Pakistan in 2006, up from 28 in 2005. The disease is concentrated in North-West Frontier Province, where 60% of the refusals were attributed to “religious reasons”.
“There was a lot of anti-American propaganda as well as some misconceptions about sterilisation,” said Dr Sarfaraz Afridi, a campaign manager with the WHO in Peshawar.
The scaremongering and appeals to Islam echoed a similar campaign in the Nigerian state of Kano in 2003, where the disease then spread to 12 polio-free countries. Pakistan is one of just four countries where polio remains endemic. The others are Nigeria, India and Afghanistan.
The North-West Frontier Province government made strenuous efforts to counter talk of an “infidel vaccine”. Health workers fanning across the province last month were equipped with copies of a fatwa, or religious order, endorsing the vaccinations and signed by Maulana Fazlur Rehman and Qazi Hussain Ahmed, the leaders of Pakistan’s most powerful religious parties.
The move reassured many doubters. More than 5,7-million children were vaccinated in January, with another three million targeted in a second round due to start next Tuesday. “The elephant is over. We are left with just the tail,” said Afridi.
But the tail has a deadly sting. Even though only 24Â 000 children missed the vaccine, the WHO officials said failure to vaccinate in small pockets of the country gave the virus a fresh toehold to spread.
The vaccination struggle is entangled with the confrontation between the government and powerful militants in the tribal areas. Refusals were highest in areas where conservative clerics and self-styled “Pakistani Taliban” fighters hold sway, flouting government authority and making their own strict laws.
Demands for “assistance” from local officials and elders was the other major factor behind the refusals. In the Mohmand tribal agency, policemen demanded their salaries before allowing vaccination to proceed.
Aid workers fear they are being pushed into the frontline of the struggle between the government and tribal militants. Last weekend a grenade was lobbed into a Red Crescent compound in Peshawar, damaging vehicles but killing nobody. Some linked the attack to a fatwa issued in Dara Adam Khel, a lawless town famous for its gunsmiths, in December. A cleric named Mufti Khalid Shah declared a fatwa on employees of the United Nations, WHO and all other foreign organisations. “Killing their employees is in line with the teachings of jihad in Islam,” said a notice. — Â