MARY LOUISE KELLY, HOST:
Last week, Pakistan held its first countrywide polio vaccination drive of the year, sending workers door to door to vaccinate 45 million children. Pakistan is 1 of 2 countries in the world where polio still has a foothold, and a spike in cases last year was a setback for the eradication of the disease. Betsy Joles has more.
(SOUNDBITE OF KNOCKING ON DOOR)
BETSY JOLES, BYLINE: In a working-class neighborhood in Lahore's Old City, polio workers start knocking on doors at 8 a.m.
UNIDENTIFIED PERSON: (Non-English language spoken).
JOLES: Health worker Nabila Almana calls out from doorsteps to ask whether there are any children under 5 years old inside.
NABILA ALMANA: (Speaking Urdu).
JOLES: She also checks to see if any kids are visiting or still asleep.
ALMANA: (Speaking Urdu).
JOLES: Here, people mostly know the drill. Polio campaigns happen regularly, and during their rounds, workers are instructed to give an oral vaccine to every child under 5, including those who've received it before. According to Pakistan's polio program, kids should receive one dose of an injectable vaccine and multiple doses of the oral one to be considered fully immunized. There's no cure for polio. That's why eradicating the disease is so crucial.
ANAM MUNIR: (Non-English language spoken).
ALMANA: (Non-English language spoken).
MUNIR: (Non-English language spoken).
JOLES: Upstairs in one home, Anam Munir, a 25-year-old mother of three, tells NPR she's accustomed to polio workers coming again and again.
MUNIR: (Through interpreter) My nieces and my younger siblings have done this from the beginning, so obviously we have never missed the doses of vaccination for our kids. By God's will, they are all complete.
JOLES: This subdivision in Lahore is considered especially high-risk for polio because, for the past six months, the virus has shown up in its sewage samples. Medical workers say this means the virus is circulating in Punjab province, where Lahore is located, and kids can get paralyzed by it.
ZULFIQAR BHUTTA: The way we look at polio control is to look at surveillance as to how much virus is there in your sewage or in your sampling site?
JOLES: This is Zulfiqar Bhutta. He's the founding director of the Institute for Global Health and Development at the Aga Khan University in Karachi. He says the current situation is particularly concerning because most of Pakistan's children live in Punjab.
BHUTTA: And this virus is like a guided missile, you know? It will find an unprotected child before you know it.
JOLES: So here in the provincial capital of Lahore, the authorities are on high alert, says Uzma Kardar, the government liaison for Punjab's polio program.
UZMA KARDAR: We are firefighting now. It is so challenging for us. I mean, like, you know, we were so proud of being polio-free.
JOLES: She says mobile populations and people who've crossed over from neighboring Afghanistan are especially high-risk. Punjab is still better equipped to contain the spread of polio than other provinces. In regions bordering Afghanistan, conflict and distrust of vaccines make these campaigns harder. Polio workers have also become the target of militant attacks in recent years. Low rates of routine immunization in most parts of Pakistan mean children are vulnerable to polio despite door-to-door campaigns.
UNIDENTIFIED CHILD: (Non-English language spoken).
JOLES: Back in the narrow streets of Lahore's Old Town, polio communications officer Qaiser Subhani says an additional challenge is gaining the trust of vaccine-hesitant newcomers to the city.
QAISER SUBHANI: This is a commercial hub. People came from out of the province. They have a lot of misconceptions.
JOLES: Subhani says one commonly held myth is that the vaccine will affect fertility, so it's not always easy to persuade people, he says. His colleague, Arooj Akram, couldn't agree more. She says people also complain that health workers show up too early, when their kids are still asleep. But despite occasional clashes with community members, she sticks with it.
AROOJ AKRAM: (Through interpreter) This is our job, and we have to do it at all costs. Whether someone speaks to us rudely or with love, we have to do it.
JOLES: She hopes hundreds of thousands of polio workers across the country share her resolve.
For NPR News, I'm Betsy Joles in Lahore, Pakistan. Transcript provided by NPR, Copyright NPR.
NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.
