Beyond ethnicity: Experts call for refined strategies to tackle polio in Sindh

By Mukhtar Alam

KARACHI: As thousands of polio managers and field workers in Sindh prepare to launch another mass OPV plus vitamin-A campaign on October 28, a data study suggests that authorities in Sindh need to reassess and refine their strategies to combat polio, moving beyond the notion that the Pakhtoon migratory population is solely responsible for the spread of the virus in the province.

“The situation requires a more nuanced approach, addressing the root causes of the spread effectively, rather than attributing the problem to a specific ethnic group,” experts said.

Startling facts and alarming trends have emerged in Sindh's 12 new human polio cases this year, according to experts working on the subject.

- Urdu speaking families: Two cases were reported in Urdu speaking families living in Hyderabad's UC 50 and UC 12, with the virus linked to environmental samples (ES) found positive in Hyderabad (May 2024).

- Sindhi ethnic children: Four Sindhi children were detected with the virus in Shikarpur, Sujawal, Sanghar, and Mirpurkhas, with the virus scientifically linked to two ESs in Karachi South (May 2024) and Hyderabad (May 2024). The genomic sequencing of the remaining two children is said to be in progress.

- Balochi speaking families: Two Balochi speaking families' children were detected with the virus in Karachi-Keamari (June 2024) and Jacobabad (September 2024), linked to ESs of Keamari (May 2024) and Kandhar (December 2023) respectively.

- Pushto speaking families: Two Pushto speaking families' children were detected with the virus in Karachi-Keamari (August 2024) and Karachi-East (September 2024), linked to ESs of Keamari (May 2024) and Tank (July 2024) respectively.

- Other cases: A child from a Burmi origin family in Ibrahi Hyderi, Malir district, contracted the poliovirus in August 2024, linked to ES of Kandhar (August 2024). A Seraiki speaking family in Jacobabad also contracted the virus in September, linked to ES of Kandhar (August 2024).

Experts sound the alarm

Health experts warn that attributing polio spread to a single ethnic group is misleading, and that a comprehensive approach is needed to tackle the disease in Sindh.

Experts approached by this reporter on the condition of privacy remarked further that data and findings reflected very bad on the ongoing officialdom and filed workers policies and actions, calling for improving vaccination coverage and access to healthcare services; enhancing sanitation and hygiene infrastructure; promoting awareness and education among all communities; strengthening surveillance and monitoring systems; encouraging community engagement and participation in polio prevention efforts.

According to the salient particulars recorded in chart format by technical experts concerned, the ages of the 12 polio cases in question ranged between 12 months to 96 months, with six boys and six girls.

Three of the infected children had no history of getting polio preventive vaccines in the course of routine immunisation; one got the vaccine only once. Among them eight received IPV while eight got supplementary OPV drops for 7 times or more.

In regard to medical history, it was learnt that four were malnourished or underweight, while two suffered illnesses including chronic diarrhea frequently. Medical history of six of the children could not be recorded by experts. Of these, eight were index cases, while four were declared polio-positive based on their positive contact cases.

When contacted for a comment, veteran expert in child diseases and infections in the country, Prof Dr Iqbal H Memon, stated that the current scenario supports the notion that it is incorrect to term any particular cluster of population as inaccessible or hesitant to receive OPV and routine polio immunisation.

Dr Memon, also the president of the Asia Pacific Pediatric Association, noted that there are widespread areas in different localities where vaccination has not been done, offered, or refused."

New campaign: The Sindh Health department is launching a polio vaccination campaign from October 28 to November 3, targeting 10.6 million children under the age of five across 30 districts of Sindh, to provide oral polio vaccine to eligible children.

In addition, 9.5 million children aged 6 months to 5 years who receive OPV will also receive Vitamin A supplements to boost their immunity.

“The urgency of this campaign cannot be overstated,” the department said. “The presence of positive environmental samples in Karachi and other areas continues to indicate active virus circulation, making this vaccination drive essential to halting the spread of polio.”

As many as 81,000 frontline workers will be mobilised to go door-to-door, while about 19,000 security personnel will also be deployed to safeguard the polio workers and ensure a smooth campaign, the official statement highlighted, urging the parents to welcome the vaccination teams and ensure their wards are duly vaccinated during the campaign.

With an uninterrupted 23-year career in daily journalism (1991-2013), the author/editor of this blog currently serves as Editor of Social Track, a weekly newspaper focused on social sectors, based in Karachi. Holding a master's degree in Mass Communications from the University of Karachi (1990), his professional experience includes roles as senior reporter at Daily Dawn, Karachi (May 2001-August 2013) and Chief Reporter at The News International, Karachi (April 1991-May 2001). He has a strong background in development journalism, he has an extensive portfolio of news stories, analytical reports and features covering a wide range of sectors. He has had the privilege of covering numerous high-profile figures, including Pakistani presidents, prime ministers, army chiefs, foreign dignitaries, and VVIPs and attending conferences and workshops abroad. He began his journalism career in the early 1980s. Throughout his career, he has received several national awards from government and private organisations. He has contributed to various radio and TV/channel broadcasts and has also served as a trainer at workshops in Karachi, Lahore, and Islamabad, focused on training journalists.

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