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Jirga opens doors for polio vaccinators in Pakistan

10 February, 2014

Mianwali: "Glowing faces, bright complexion, a traditional cap and most of them wearing identical shalwar qameez; Afghan children look so similar that it is difficult to count them in cluster", jokes polio team member Raees Gul as he vaccinates an Afghan child in a small compound in one of the biggest Afghan refugee camps in Chandana Union Council, Mianwali.

Two polio cases have been reported from Mianwali in the past three years. Both cases were from Afghan refugee camp and separate and new introductions due to their close demographic association with Khyber Pakhtunkhwa's active circulation areas.

The has a strategic significance for polio eradication in Punjab due to its geographical location – bordering with Khyber Pakhtunkhwa's two high risk districts of Lakki Marwat and Dera Ismail Khan. The district is also home for a large number of Afghan refugees, migrant and mobile groups as well as seasonal nomadic agricultural workers.

Over 25,000 refugees live in the camp set up by the government to host Afghans who fled war. Most of them have set up Afghan and FATA trademark residential compounds made of rock stone and mud in the camp.

The population in the camp has now decreased to merely a quarter from its original strength of over 100,000 refugees but the polio threat has not diminished at all.

"We were not allowed to vaccinate more children here after 12 noon because all male members of the family were unavailable. But as a result of the Afghan Jirga gathering few days back, teams can move here freely now even till late in the afternoon", he says as he sips warm qahwa served in the carpeted hujra (guest room) of Malik Abdul Jabbar, an Afghan refugee.

The continuous movement of population in and out of the camp has been a source of big concern for the government and polio eradication partners. The main residential area starts right after the central fruit and vegetable market at the entrance of the camp.

Hundreds of people and children under five years of age, who are most vulnerable to polio, travel every day all the way to Afghanistan to visit their relatives and extended family members there.

"This journey take them across high risk and inaccessible tribal agencies which are off limits for polio vaccination well as Khyber Pakhtunkhwa's provincial capital of Peshawar", says Raees Gul.

"The Afghans need to be sensitised regularly about the lurking threat. A recent gathering helped polio vaccination teams to break new grounds with refugees and allowed them space to work freely in their neighbourhoods", he says alluding to Jirga in the camp.

A large number of Afghans and Pashtuns who have settled in Mianwali attended the Jirga, fourth in the series of such awareness raising effort initiatives organised by the government in the camp.

"The biggest hurdle in communication is language barrier. None of them speaks Urdu or Seraiki and the polio teams have limited Pashtu knowledge. This complicates trivial issues when the government teams visit the camp. But it's a firm commitment from our side that Afghans will cooperate with government polio teams and volunteers", says Hayat Ahmad Zai, the representative of the Afghan refugees camp at jirga.

Thousands of Pashtun tribesmen travel to the district in search of livelihood with the onset of tough winters in tribal agencies. They find shelters in the warmer plains and jungles of Mianwali away from the population centres and it is difficult to locate and vaccinate them.

Most Pashutn communities are guided by strong traditional values, making outreach to them rather challenging especially from ousiders. Dominant social norms and conservative religious orientation requires special, contextually acceptable communication approaches.

"We need to find innovative ways to reach out to Afghans and remove misconceptions about vaccine so that refugees cooperate with polio teams", says Jirga participant Ibrahim Khan, UNICEF Communication Specialist.

Polio partners employ different strategies to seek support of elders and religious leaders that are engaged by social mobilizers to support the polio eradication programme.

"There is a constant need to engage all high risk populations. Jirga played a key role in sensitising the public", says Mian Ibrar Ahmad, district communication officer in Mianwali. "Our doors are open for polio teams.

Warm reception accorded to the polio teams today is an evidence that all the refugees will vaccinate their children against polio in order to fulfil their promise made at the Jirga", says Malik Abdul Jabbar Khan.


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