Social Mobilizers Combat Polio In Pakistan's Slums

Some 34 million children need to be inoculated against polio in Pakistan, if the country is going to be part of a worldwide effort to eradicate the disease. And it has to be done against a pervasive insurgency, religious extremism, a highly mobile population and no shortage of rumors.

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And let's turn now to Pakistan, where an international effort is underway to eradicate polio. Some 34 million children need to be inoculated multiple times in order to wipe out the virus, and making that happen in Pakistan is daunting. Here's why. There's a Taliban insurgency and religious extremism. The population of Pakistan is highly mobile and there is no shortage of rumors. For our series Chasing Down Polio, NPR's Jackie Northam travelled to the eastern city of Lahore.

JACKIE NORTHAM, BYLINE: In Pakistan's battle against polio, this is one of the front lines. Every day, 37-year-old Omer Feroz travels narrow, uneven dirt tracks that serve as roads in one of Lahore's worst slums, often sharing the way with buffalos and stray dogs. On this day the path was slick with several inches of mud from the previous night's monsoon rain.

OMER FEROZ: From here on, we have to be on the foot because it won't be nice for you to ride the bike.

NORTHAM: Feroz is one a thousand so-called social mobilizers recruited by UNICEF to go into places like this slum to try to educate Pakistanis about the polio virus and to promote vaccinating children. This slum of about 200,000 people has no government offices, no public schools, no medical facilities, certainly no planning commission. The children are filthy. Donkeys and stray dogs roam the area and there are rivers of sewage.

Feroz says these are perfect conditions for the polio virus to breed.

FEROZ: There is no sanitation. There are not roads and they are living in tents. They collect rag and rubbish. So they live in rubbish, their business is with rubbish, and as you can see, there's water standing everywhere. There's mud and a lot of filth in this area.

NORTHAM: Feroz says it was not easy the first few months on the job. Many of the residents are Pashtun and come from Pakistan's volatile tribal areas near the Afghanistan border. Social mobilizers and vaccinators simply cannot get into many parts of the region because of the danger from the Taliban and other Islamist groups. In a slum in the southern city of Karachi, a vaccinator was gunned down this summer.

Feroz says more often than not, the Pashtun are trying to escape the violence or are looking for work and end up in a slum like this. But he says they bring with them rumors that are difficult to dispel, that the people vaccinating their children are CIA agents and that the polio vaccine will make their children sterile.

FEROZ: And other concern was it contains germs of AIDS and hepatitis C and probably America is spreading hepatitis and AIDS into our kids through the vaccination.

UNIDENTIFIED CHILD: (Speaking foreign language)

NORTHAM: A young girl recites a poem about a bird that dances and sings at one of the makeshift schools here. The social mobilizers visit every school in the area once a week, checking with the teachers about any new students, especially those under five. They also appeal to students and women's groups, but by far the most important visit is the mosque. The local mosque provides meals and classes in computer skills, math and science.

Qari Abdul Rasool Attari is the cleric. A small man with a large turban and a wizened face, he too had heard all the rumors about the polio vaccine. It took many meetings, but Feroz and his two colleagues were able to convince the imam to give his blessing for the polio vaccine. Attari says he now includes it in all his sermons.

QARI ABDUL RASOOL ATTARI: (Through translator) My word is final. I've been here 40 years and nobody would say no to me. What I do, people follow.

NORTHAM: Feroz says as a result no one refuses the polio vaccine in the slum. The bigger problem here is the constantly shifting population. Feroz looks out over the slum at a family erecting a cloth tent.

FEROZ: They just moved in. And previously, three days ago, there was another tent, another family. They just moved out and they just moved in.

NORTHAM: Feroz says compounding the challenge is the birth rate. About 40 children are born in this slum every month. Feroz and his team step into a large tent, where a woman, her 10 children and others are scattered. All the children are checked for the polio vaccine. Feroz says they need to reach every last child if they want to eradicate polio in Pakistan. Jackie Northam, NPR News.

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