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Eradicating polio in Afghanistan takes persuasion, participation and peace

© UNICEF Afghanistan/2009/Walther
A child receives oral polio vaccine during the recent immunization drive in Afghanistan.

By Cornelia Walther

GHOR, Afghanistan, 17 September 2009 – A three-day polio eradication campaign, organized by the World Health Organization and UNICEF, reached children across Afghanistan this month. The immunization drive was part of the ongoing effort to eradicate polio in Afghanistan, which is one of just four remaining polio-endemic countries. 

Polio eradication is a global priority, and its eradication demands a 'Three P' approach: persuasion, participation and peace.
This particular campaign, which was organized in tandem with the countdown of UN Peace Day 2009, targeted 1.2 million children under age five in conflict-affected districts. More than 15,000 health workers  went door-to-door in eight provinces: Ghor, Farah, Uruzgan, Helmand, Kandahar, Khost, Kunar  and Nangarhar.

A mobile approach to participation

"I have six children. All of them have been vaccinated today," said Fatima Farzad after a visit from health workers.

© UNICEF Afghanistan/2009/Walther
Afghan mother Fatima Farzad, with one of her six children, was thankful that the mobile immunization team reached her family.

Many Afghan families, like Ms. Farzad's, are unable to reach health facilities. They face various obstacles – including lack of financial means, long distances to travel to health centres, or fear of attacks. That's why a mobile approach is essential to ensure that every child in the target group is reached.

"My people do not have an incurable disease," the Governor of Ghor, Sayed Mohammad Eqbal Munib, told a visitor. "They are jobless, poor and afraid [but] the attention of the government and donors can heal them. We are very grateful for the efforts that UNICEF and WHO have made in our region. Yet I ask you to carry my message with you: So much remains to be done."

To date, some 156,000 children under the age of five have been reached by immunization efforts in Ghor province.

Persuading parents to be responsible

Circulation of the wild poliovirus continues in Afghanistan, though it is limited to a few districts. A solid decrease in polio cases had previously been achieved – with 17 confirmed cases in 2007, down from 31 cases in 2006  and 63 in 1999.

© UNICEF Afghanistan/2009/Walther
World Health Organization Representative in Afghanistan Peter Graaff and UNICEF Representative Catherine Mbengue administer the polio vaccine to a child.

This containment of the virus and the prevention of its spread were possible due to the continued collaboration of the Afghan Ministry of Public Health with the Global Polio Eradication Initiative partners, including UNICEF, WHO, Rotary International and the US Centers for Disease Control and Prevention.

Since 2008, however, the number of armed attacks in Afghanistan has increased, creating an environment of fear and limiting access for vaccination teams in conflict-affected areas. Against this backdrop, the number of polio cases has climbed back up; 20 cases have been reported so far in 2009.

Parental and community awareness and involvement are essential to reversing this trend.

"Polio is an issue of common interest," said WHO Representative in Afghanistan Peter Graaff. "I appeal to the local leaders of Ghor to persuade all parents in their area to bring their children for the vaccination. Every member of the community must participate in this endeavour. We have a responsibility towards the children in Ghor, in Afghanistan and the whole world to eradicate polio."

'Peace is necessary'

Overall, four nationwide house-to-house vaccination campaigns have reached almost 7.5 million children through August 2009. In parallel, routine immunization is ongoing in health facilities across the country to prevent the virus from spreading.

Still, roughly 100,000 Afghan children cannot be reached with vaccinations due to security concerns.

"Peace is necessary to access all children and vaccinate them against polio," said UNICEF Representative in Afghanistan Catherine Mbengue. "It takes just a few seconds to immunize a child – but the results last for a lifetime."



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