Despite security risks, health volunteers vaccinate children against polio in Afghanistan

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Door-to-door immunization campaign

By Rajat Madhok

JALALABAD, Afghanistan, 8 April 2011 – During afternoon prayers, religious leader Abdul Wakil Mowlavzada speaks passionately to the men who have gathered at one of Jalalabad’s largest mosques. They listen intently as he talks about the importance of polio eradication.

VIDEO: 16 March 2011 - UNICEF's Rajat Madhok reports on health volunteers and religious leaders working with UNICEF and its partners to help make Afghanistan polio-free. Watch in RealPlayer

The cleric is one of the most vocal and powerful advocates of polio immunization in eastern Afghanistan, and his message is clear: Two drops of polio vaccine can save a child from paralysis and, potentially, save that child’s life.

“Ours is an Islamic community where we respect religious leaders,” he says. “When the message of polio eradication comes from the religious leaders, people will accept it and follow instructions from the mosque. The religious leaders have a great role to play in eradicating polio.”

Agents of change

At the same time, in a slum district across town, a volunteer health worker named Leema goes door to door, looking for children who haven’t yet been immunized. She also enthusiastically talks with parents of young children about the benefits of polio vaccination.

When Leema finds a child who needs the life-saving two drops of oral polio vaccine, her dedication is unmatched. She promptly opens her thermos and administers the vaccine, while her companion maintains a list of all the children they have reached in the neighbourhood.

Leema, Abdul Wakil Mowlavzada and hundreds more like them are agents of change, trying their best to rid Afghanistan of the polio virus, which cripples children and can result in death.

Security concerns

Over a short break later in the afternoon, Leema talks about the challenges, concerns and excitement that come with her work as a health volunteer.

“Our job is to visit homes and families, and after introducing ourselves, we ask the elders how many people live in the house and to show us all children under five years of age,” she explains. “We then give two drops of polio vaccine to all children, then mark their fingers with a permanent marker. And for children between the ages of two and five, we give them a de-worming tablet.”

Asked about the prevalence of polio in the region, Leema seems relieved. “Three years ago, there was a positive case of polio in this area, but after that we haven’t had any,” she says.

One major issue Leema and other health volunteers face, however, is security. “Communities are aware of our work, and the moment they see us they bring their children to us for vaccination,” she notes. “But security in the region remains our biggest concern, as there are many suicide attacks and bomb blasts.”

Training for health workers

UNICEF and its partners – including the World Health Organization (WHO) and the Government of Afghanistan – have organized frequent National Immunization Days, when hundreds of health volunteers such as Leema go from house to house vaccinating children.

“Each coordinator has to undergo training, which is facilitated by UNICEF, WHO and the government doctor,” says Leema. “Coordinators train supervisors and volunteers. During the campaign, volunteers collect the polio drops and then are sent to their respective locations to vaccinate children.”

UNICEF provides vaccines, supplies and other equipment used in the campaigns, besides paying daily wages for the coordinators and supervisors.

Need to sustain gains

And this work has reaped results. In 2010, Afghanistan reported 25 cases of polio, while neighbouring Pakistan and Tajikistan reported 144 and 458 cases, respectively. Since the beginning of 2011, some 10 million Afghan children have been vaccinated against the virus, and the process is ongoing.

Leema is committed to the cause and feels confident that polio will soon be eradicated from her country.

At Torkham, an open border point between Afghanistan and Pakistan where thousands of people cross annually, UNICEF and its partners have set up counters to monitor the movement of children and vaccinate those who need the two drops. On a visit to the border, UNICEF Communication for Development Officer Kshitij Joshi concurs that eradication efforts are going well.

“Along with the partners, UNICEF has been able to make significant gains into polio eradication in Afghanistan,” he says. “We need to sustain those gains and intensify our efforts in the next few years to ensure that polio is eradicated from Afghanistan forever.”