By Gulistan Mirzaei
In February 2014, a young girl in Kabul was found to be infected with the polio virus, the first case in the Afghan capital since 2002. As an immediate response, UNICEF and its partners launched an emergency campaign to stop the virus from spreading, sending volunteers door-to-door to provide oral polio vaccine and stepping up vaccinations at entry points into Kabul.
Afghanistan is one of only three countries, along with Nigeria and Pakistan, where polio remains endemic.
KABUL, Afghanistan, 24 April 2014 – The sounds of car horns and the jingle of colourfully decorated trucks fill the dusty air as Afghan soldiers stand guard at the busy Pul-e-Charkhi checkpoint into Kabul city. Tens of thousands of vehicles pass through this checkpoint every day as they enter Kabul from the eastern provinces of Nangarhar, Logar, Kunar, Laghman and as far as Pakistan.
Nikzad, 18, is a volunteer vaccinator for a three-day emergency polio vaccination campaign, a combined effort of the Afghan Ministry of Public Health, the World Health Organization (WHO) and UNICEF. The campaign was launched after a young Afghan girl contracted the deadly virus, the first diagnosed case of polio in Kabul since 2002.
The young volunteer surveys every car that passes through the checkpoint, looking for children aged 10 and under. Most vaccination campaigns target children under 5, but in light of the recent case, UNICEF and its partners are taking all precautions to ensure that the virus doesn't enter the city.
Nikzad waves down a small truck with three children in the back. “How old are your children?” he asks the driver. Two of them look like they could be under 10 years old. The family has been travelling from the eastern city of Jalalabad, capital of Nangarhar province, which remains at risk due to population movement across the border with Pakistan.
Nikzad beckons the children down from the truck and examines their little fingers. Children who have been vaccinated within the past few days will have a purple ink mark on their finger. Seeing that these children haven't been vaccinated, he opens a cold box and takes out the polio vaccine, which is kept at 2°–8°C at all times.
“This vaccine will prevent child paralysis,” he explains to the family. They understand immediately and agree to get the children vaccinated. After giving the children two drops of vaccine, Nikzad marks their little fingers.
Dr. Gholam Raziq Siddiqi, an official with the WHO polio programme, is supervising the volunteer vaccinators today. He says that every day about 700 to 800 children are expected to be vaccinated at this checkpoint during the campaign.
“Anyone can carry the polio virus, even adults, which is why we need to vaccinate children up to 10 years of age here.”
Dr. Siddiqi has worked with WHO on polio eradication efforts since 2000, and he has seen a significant change in peoples’ perceptions about the vaccine. “In the beginning, people didn't have sufficient information about the disease and its implications on a child’s health,” he says. “But now, through the media, television, radio, posters and even speeches by religious leaders in mosques, people have a greater awareness about polio and now allow their children to be vaccinated.”
Across Kabul, 53 teams of two volunteers each go door-to-door to vaccinate children 5 and under. Dr. Sakhi, a coordinator in one district, says that most families are receptive to the polio vaccine. “We do have some people who are against the vaccinations, and if a family refuses to vaccinate their child, the volunteer will make a note and let their supervisors know,” he explains. “Then we approach the house and explain to the family that the polio vaccine doesn't have any negative consequences, and that if one child doesn't get vaccinated, it's a risk for all other Afghan children. Then the families usually come around.”
The door-to-door teams typically vaccinate anywhere from 100 to 300 children a day during the campaign, depending on the accessibility of the area. “Our job is to reach every house and give every child two drops of the polio vaccine so that, in the future, we'll be like the other countries and will successfully get rid of this deadly disease,” Dr. Sakhi says. “Then we can really celebrate.”