MULTAN/RAHIM YAR KHAN - WASIF MAHMOOD - Heaps of garbage, children in rags, tattered shanties, plastic bags, foul smell and a pond of stagnant water turned green due to thick layer of algae – welcome to a nomadic neighbourhood in Peer Punj Faiz – a polio high risk union council in Multan.
A loud cheer from the participants including women, children and men welcomed the Communication Network (ComNet) staff as it walked to the shanties in a session organised to raise awareness ahead of the polio National Immunisation Drive.
Multan has one of the largest nomadic populations belonging to all backgrounds, including Pashtuns with their numbers reaching 12,000. Brick kiln workers and seasonal migrants also form a sizable portion of the population. The size of their population is constantly changing making it difficult for government and partners to provide healthcare facilities to such communities.
“What is polio”?, asks District Health Communication Support Officer (DHCSO) Zulekha Anwar from the men assembled outside a shanty. “Polio is a disease”, replies a man in his mid-forties.
“How does it affect children?”, the DHCSO asks. “It affects the body of a child”, replies an old man as he squats on a charpoy along with other members of his extended family. “What is the best time for children to be administered polio drops?”, asks Zulekha. “Every child is required to be given drops”, says the oldest man Muhammad Boota. “All children up to five years of age are most vulnerable to polio virus”, Zulekha adds. “How many polio drops every time”?, she asks. “Two drops every child every time”, the participants reply.
According to Multan social profile prepared by the ComNet in cooperation with the local influencers and social mobilizers, eight families, with at least 38 target children, reside in the neighbourhood in deplorable conditions who fend for themselves by collecting mango seeds, plastic bags and pieces of disposed of clothes.
The nomads move in flocks from one district to another in search of livelihood and are vaccinated at entry or exit points by the teams posted there.
Frequent and wide scale movement of seasonal workers and other travellers makes the task of health workers difficult at transit points.
During the harvesting season, due to large scale movement, there is a possibility that we miss a few target children every now and then due to lack of cooperation,” says Naib Qasid Shahid Hussain, who has been deployed at Khan Bela, UC Liaquat Pur, Rahim Yar Khan transit point.
“But still we manage to vaccinate hundreds of children during the three-day NID,” he says. Several team posted at the entry and exit points in Khan Bela vaccinate children coming to the city from Multan and other districts. Locating and mapping the nomad communities remains critical for polio eradication partners in their endgame to wipe out the virus.
After the nomads have settled down in various colonies, ComNet staff, in collaboration with influencers, brings them into the notice of government so that they are vaccinated in their neighbourhoods.
“The influencers in the communities share details of any new settlements in their area with us. After learning about nomads’ community, ComNet staff brings it into the notice of vaccinator. The UC Communication Officers share data with government teams. The nomads’ data then becomes permanent part of social district profile,” explains Zulekha. “The immunity system is weak because of the low immunization rate among the migrant population. Nomads have high chances of carrying polio virus, sometimes refuse polio vaccination due to misconceptions and have very poor awareness level due to mobility,” Punjab team leader, Health Officer Dr Tahir Manzoor says.
After the last polio case in Oct 2009 in Multan, the health DG warned district authorities to improve immunisation status. According to official data, over 7,500 zero doze children were reported in October 2012 NID in Multan alone. Whereas over 125,000 zero doze cases were reported in Punjab in the same year. In April 2013, that number was brought down to 393 – thanks to hectic efforts by all partners.