Shafiullah’s left arm and leg were paralysed when he was 5 years old. Photo: WHO Afghanistan/Y.Khan13 October 2016 – "I will never forgive myself or any people in my district if they allow the suffering I went through to happen to other children here,” says 25-year-old Shafiullah, leaning on his blue crutches in a remote village in Kandahar province, Afghanistan, the midday sun pressing on his head.
Shafiullah’s left leg and arm were paralysed when he was 5 years old. Shafiullah and his 3 sisters and 2 brothers had never received any doses of the polio vaccine and his family had never heard about the disease.
“Polio is my personal enemy”
Shafiullah is now working as an active volunteer advocate for polio vaccination in villages around his community. He knows there is no treatment for polio but it could easily be prevented through vaccination. Still, many parents refuse to give their children the vaccine due to misbeliefs and lack of knowledge about its safety and benefits.
Through his persistent interaction with communities, Shafiullah has convinced 30 households to give 2 drops of the oral polio vaccine to their children in the past 4 months. This means that over 150 children have been immunized against polio because of his tireless efforts.
“The poliovirus is my personal enemy,” says Shafiullah. “During polio campaigns, I am going around with the vaccination teams to convince parents to give their children the vaccine. Many people don’t understand how serious polio is and that it cannot be cured, but when I show them my paralysed limbs and talk to them about the safety of the vaccine, they change their attitude and ask for the vaccine.”
Shafiullah is a father of a 2-year-old girl and a 4-year-old boy and he makes sure his children are immunized during every polio campaign. “If for some reason the vaccinators don’t visit our home, I will go after them to find them and make sure my two children get the vaccine,” he says.
People living in this remote part of Kandahar province rely on the polio frontline workers to deliver the vaccines to their front doors. The nearest accessible health facility is more than 20 kilometres away in Sangin, Helmand province. The security situation is extremely volatile with active fighting in many areas.
Shafiullah looks on as a polio worker checks his childrens' finger mark after they have received the vaccine. Photo: WHO Afghanistan/Y.KhanReducing the number of children missed during polio campaigns is Shafiullah’s main goal as he travels with frontline polio workers on Kandahar’s remote dirt roads.
Abdul Jabbar and Nematullah used to always refuse the polio vaccine when a team of vaccinators would knock on their door. After discussions with Shafiullah, they have both changed their minds. Abdul and Nematullah vaccinated their children for the first time ever in July this year. “We will never risk the life and health of our children again by denying vaccination,” says Nematullah, resting his hand on Shafiullah’s shoulder.
Gains in challenging environment
8 polio cases have been reported in Afghanistan so far in 2016. The transmission of the poliovirus is contained to geographically small areas in eastern, southern and southeastern Afghanistan, forming one epidemiological block with Pakistan. Most of Afghanistan remains polio-free.
When Shafiullah is not going around his district with the polio teams he sews clothes for sale at the local bazaar. Photo: WHO Afghanistan.Y.Khan“We want to make sure that vaccines reach every single child and that nobody is left unvaccinated,” says Dr Yassin Khan, WHO’s provincial polio officer, who has worked for the polio programme for 2 years. “This work is very challenging but we have been able to make many gains in this difficult environment – more and more children are getting the vaccine in remote areas. I want to see polio eradicated from my country.”
Improvements in vaccination campaigns have enabled the polio eradication programme to reach an increasing number of children in the past year.
Recent innovations include specific plans for the 47 most high-risk districts in the country, the re-training of all frontline health workers with a new curriculum to enhance their skills and communication with communities and a new revisit strategy to reduce the number of children missed during campaigns. The revision of micro-plans and detailed mapping of areas ensure that vaccination teams are able to find and vaccinate all children in the community.
Around 300 000 children are not receiving the polio vaccine during national immunization days campaigns. Many children are missed because they are absent, sick or sleeping when the teams visit the households or because families refuse to vaccinate; in other areas active conflict and insecurity pose challenges for vaccination teams to move freely to immunize all children.
Over 65 000 vaccinators, social mobilizers, campaign coordinators, supervisors and monitors work in extremely challenging circumstances to ensure that all Afghan children are protected from polio.
“Afghanistan is on track to stop the circulation of the wild poliovirus and we are closer than ever to eradicating this debilitating disease for good,” says Dr Richard Peeperkorn, WHO Country Representative. “Our focus is now on reaching every child missed for any reason. Ending polio is our top priority and it is everyone’s responsibility.”
