Updated Jan. 21, 2014 3:47 p.m. ETPESHAWAR, Pakistan—Baseerat was just 40 days old when her father couldn’t take the family’s poverty any longer and committed suicide. Now, at the age of 10 months, she has been diagnosed with polio, the paralyzing disease that has already crippled her right foot.
The dreaded virus has been almost wiped out globally in recent years. But its resurgence in Pakistan—partially because of Taliban attacks on polio vaccinators—is threatening children globally, officials at the World Health Organization warn. The Pakistani strain of polio was found in Syria in recent months, possibly carried by militants joining the civil war there.
Pakistanis could face travel restrictions this year when health experts convene at the WHO to consider how to deal with the disease’s outbreak, said Sana Bari, a spokeswoman for the WHO in Geneva. There are only two other nations where health experts classify polio as “endemic”: Afghanistan and Nigeria.
A major cause of the outbreak is connected with the U.S., Pakistani officials say. The Central Intelligence Agency used a fake vaccination campaign as cover for its hunt for Osama bin Laden in northern Pakistan in 2011. Pakistani health workers across the country are now suspected of being spies, and targeted by the militants.
In mid-2012, as Pakistan was close to eliminating the disease, militants banned the vaccinations in tribal areas they control and unleashed a campaign of assassinations against the health workers, who go door to door to administer polio drops.
In the latest such attack on Tuesday, in a central district of Pakistan’s biggest city, Karachi, gunmen on motorbikes shot and killed three members of a vaccination team—two of them women—and injured two others.
Many of the vaccinators are women. Their trade union, the Lady Health Workers Association, said it would go on strike to protest the lack of security. Polio workers are paid 250 rupees a day, or less than $2.50, for what has become one of the most dangerous jobs in Pakistan.
Since mid-2012, 32 polio health workers have been killed, according to Unicef, the United Nations children’s organization helping lead the vaccination effort in Pakistan.
While Nigeria cut the number of polio cases in 2013, the number of children paralyzed by the disease in Pakistan almost doubled.
Pakistani rescue workers stand beside the bodies of polio vaccination workers at a hospital in Karachi. European Pressphoto Agency
“As long as any country is endemic, it represents a threat to all countries in the world,” said Ms. Bari.
Peshawar, the main city in the country’s troubled northwest where Baseerat lives in a ramshackle little house, has become home to the world’s largest reservoir of the polio virus, the WHO warned last week.
In Baseerat’s case, health workers suspect that the suspension of the polio campaign in her area of Peshawar last year, after a female polio worker was killed, could have meant she missed some rounds of drops.
Najibullah, the girl’s uncle, a laborer who took the family into his three-room house after Baseerat’s father’s death, said: “I have my own children to look after, too. Only God is keeping us going now.”
The Pakistani Taliban’s main umbrella group, known as Tehreek-e-Taliban Pakistan, hasn’t claimed responsibility for the killings of vaccinators. Security experts say they believe, however, that it is the work of the TTP and allied militant groups.
“We are against these polio vaccinations,” said Ehsanullah Ehsan, a TTP spokesman. “It is against Islam and our traditions. These foreign nongovernmental organizations can easily use polio as cover for spying.”
At the crowded bus stands in Peshawar, a good place for health workers to reach children, the impact of the militant attacks is obvious. The polio workers don’t wear identifying clothing or badges. They gingerly approach families with children, offering the drops, which are carried in ordinary plastic shopping bags. Most parents readily agree.
However, at the main bus stop serving North Waziristan on the city’s Kohat Road, the situation is different. As many as 80% of parents going to Miranshah, the main town in North Waziristan, refused the drops, said Ateeq ur Rehman, who supervises 10 polio workers at the Kohat Road bus stand, which serves all parts of the tribal areas.
“They won’t give their reasons for refusing,” said Mr. Rehman. “We try to reason with these parents but they get angry.”
With some 300,000 children unreachable because of the militants’ ban on vaccinations in the North and South Waziristan tribal areas, and the violence elsewhere, a major outbreak of the disease is now feared.
The CIA had recruited a Pakistani doctor, Shakil Afridi, who ran a fake door-to-door vaccination campaign in 2011 in Abbottabad, a town in north Pakistan, in an attempt to get DNA samples from the house where it was suspected the al Qaeda leader lived.
Although Dr. Afridi, who is in jail in Pakistan after a conviction on an unrelated case that his lawyers insist is trumped up, was providing vaccinations for hepatitis B, not polio, the CIA’s use of a doctor for spying has cast suspicion on all health workers, said Pakistani officials and international aid professionals.
“It is because of Shakil Afridi that militants have taken up this issue,” said Zaheer ul Islam, a senior Peshawar city administration official. “The whole polio-vaccination program has been sabotaged by this Shakil Afridi.”
Washington has been pressing for the release of Dr. Afridi. Congress decided last week to hold back $33 million of aid in protest—$1 million for every year of his prison sentence.
Defending the jailing of Dr. Afridi, Pakistan’s Ministry of Foreign Affairs said Monday: “His action also caused immense damage to the polio campaign in the country.”
Pakistan diagnosed 91 children who had been paralyzed by the polio virus in 2013, up from 58 cases in the previous year, said health officials. For every paralyzed child, 200 more are estimated to have contracted the infection. Foreign donors largely fund the vaccination drive.
Peshawar, the tribal areas, and Karachi are the three main pockets left of the disease, health officials said.
“The government of Pakistan is trying its best,” said Safdar Rana, a senior health official in Islamabad dealing with polio. “But we need to be supported by all means possible.”
—Safdar Dawarcontributed to this article.
Write to Saeed Shah at saeed.shah@wsj.com
Excerpt from: Polio Workers Killed in Pakistan
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