Women on a mission: Eradicating polio in Afghanistan

In an area of Afghanistan where women are often forbidden to work, Afia leads a team of polio vaccinators going door-to-door to reach every last child.

By Celeste Hibbert
A woman in a niqab, Afghanistan

24 October 2018

SOUTHERN AFGHANISTAN, 24 October 2018“Where I live, it is not safe for a woman to show her face. It is not easy to be a woman or child here. My cousin is just 11 years old and she is already engaged to be married soon. I am lucky… [my father] let me go to school and I have no pressure to get married, because I support my three unemployed brothers. However, if I wasn’t working I would also be forced to marry. My job is not just saving children’s lives, it is saving my own.”

"My job is not just saving children’s lives, it is saving my own."

Southern Afghanistan is barren and stunning – a sweeping desert landscape enveloped by mountains. The area has a rich and proud history but it remains a key battleground in the ongoing conflict. This year, southern Afghanistan also has the highest number of polio cases in the world. Teams of polio vaccinators traverse the country on an almost monthly basis to try to reach every child,  but inaccessible areas and distrust hamper immunization efforts. Many of these immunization campaigns are focused in Afghanistan’s most conservative areas, where female polio workers are essential to eradicate polio once and for all.

Afia* is one of 70,000 committed polio workers supported by UNICEF and WHO. This is her story.

A woman in a burka walks down an alley, Afghanistan

“I will call myself Afia. But, forgive me – it is not my real name. I have been working to eradicate polio for seven years. I am only 19 years old, and yet I manage a team of four women. In my community, there are many families that do not allow their daughters to work. I am an exception.”

In southern Afghanistan, most women are forbidden from working outside the home. But a national team fighting polio is a special case: it is one of the biggest female workforces in the country. Afia fearlessly travels throughout her community to educate families about polio and encourage vaccination, because she believes that no child should be paralyzed from polio.

A woman vaccinates a boy, Afghanistan

Afia vaccinates a child in an old military barrack surrounded by sewage, a pervasive problem across Afghanistan where poor sanitation provides fertile ground for the polio virus to spread. Afghanistan is one of only three countries in the world –  including Nigeria and Pakistan  – where polio remains endemic.

“In my country, guns and tanks are common. We don’t even think about it. I come [to the barracks] to speak to parents about vaccinating their children. One of the biggest challenges I face is families that refuse the polio vaccine. They say it is unsafe, or haram [forbidden by Islamic law].”

A woman holds a sleeping baby, Afghanistan

This little boy is sleeping when vaccinators arrive at his house, and he is lucky they are female, otherwise he might have missed the vaccine. Men are not allowed inside a private house unless they are immediate family members. This is why female polio workers are so critical. Over 35% of community mobilizers working on polio campaigns are female – a huge number, given the context.

“The home is a woman’s place in my society. Women are not allowed to leave the house without their father or husband’s permission. [But at the same time] we need more women polio vaccinators and educators, because they can enter the house and check that every child has been vaccinated. Even if one child misses the vaccine, it could put the entire community at risk.”

A boy laughs while holding a balloon, Afghanistan

“This boy is happy because I gave him a balloon. It may seem like nothing to you, but these children don’t have toys to play with. Children make kites out of plastic bags, or play in the sand. They love the balloons, and all the children run towards the vaccinators so they can get one. We give out 1.2 million balloons during each national polio vaccination campaign.”

One of the biggest problems is children who miss out on getting the vaccine because they are sleeping or not at home when the vaccinators come by, so by creating excitement during the campaign, more children are vaccinated.

A woman walks holding hands with a boy, Afghanistan

After a 10-hour day of vaccinating, Afia walks home holding hands with a young boy she just immunized. But her day isn’t actually over yet – she will go straight to classes at school. Polio eradication is not just saving children’s lives, it is transforming society.

“Working to eradicate polio has encouraged me to stay in the health sector. My dream is to become a midwife. I just hope my future husband will allow me to work. Those men are hard to find, but this programme is showing what women can do.”

Every year, UNICEF- and WHO-supported polio workers vaccinate nearly 10 million children during each of the three National Immunization Days across Afghanistan, in addition to smaller campaigns in priority districts.

UNICEF Afghanistan would like to acknowledge the generous support of the Bill & Melinda Gates Foundation, Canada, Estonia, the European Union, Italy, Japan, KfW (German Development Bank) and Rotary for supporting its efforts to end polio.

*name changed to protect identity