By Aarushi Gupta
Behind all the media attention from the Syrian Civil war, another issue has emerged from the shadows. Previously thought to be globally eradicated as of 1999, polio is making a comeback among the war-ravaged Syrian population. The World Health Organization (WHO) says that polio has been eradicated from the entire world except for the nations of Pakistan, Nigeria and Afghanistan, where it has been slowly on the decline. However, polio has been on the rise in Syria and other Middle Eastern countries. As of November 26, 2013, 17 cases of polio have been confirmed in the region; by December 2, 2013, the number of cases had increased to over 60. A decrease in vaccine coverage in Pakistan lead to the conception of the Polio Eradication Campaign by the WHO in December 2012. The goal? To vaccinate all children in the region under the age of five against polio. In Syria specifically, this noble undertaking was executed with the help of the UN Children’s Fund and the Syrian Ministry of Health. The Global Polio Eradication Initiative is currently an all-encompassing movement that is operational in 200 countries with the help of national governments and various service organizations. Without the help of the Syrian Ministry of Health, the 4,000 workers would not have been able to mobilize themselves in Syria to help the 2.5 million children in 13 Syrian provinces.
However, the WHO stated in October 2013 that there have been 15 confirmed cases of polio in Syria, despite the efforts of the “Eradicate Polio Campaign” (EPC). Coincidentally, all 15 cases (now more than 60 cases) are all in the Deir Azzor province of Syria. This region was also excluded from the EPC vaccinations earlier this year, because the Syrian Ministry of Health claimed that “the majority of residents have relocated to other areas in the country” due to the ongoing civil war in the area. However, a local health official associated with the ACU (Assistance Coordination Unit; an organization that provides assistance to victims of humanitarian crises) says that, contrary to the WHO contention of 15 cases, there are actually a shocking 52 cases of polio among children in the region alone. In addition, there has been no Ministry of Health presence in the Deir Azzor province at all. It should come as no surprise then that the Deir Azzor province has been under rebel control since 2012, which is why there has been no Syrian-controlled polio aid, resulting in the apparent concealment of the true extent of the polio endemic. In essence, Bashar al-Assad, the Syrian dictator, can be accused of using polio to help suppress the civil war ravaging his country.
The WHO has stated that the strain of polio present in Syria can be genetically linked to the active Pakistani strain. However, the WHO also claims that it is not the migrating Pakistani militants who brought the disease to Syria, but the nomadic tribal groups that have allowed the disease to fester and grow in Pakistan. The virus has been dormant in the Deir Azzor province of Syria for the past 18 months, but the current instability from the civil war has yielded favorable biological conditions for the virus and prompted it to reemerge and infect local children. Similar conditions are present in the Khyber valley where the virus remains prominent in Pakistan.
It is interesting to note that the Taliban, through their extensive presence in the Pakistani region, has implemented a “jihad against Polio vaccinations,” and has taken to attacking various human rights groups administering polio vaccinations, which is why several polio aid workers in Pakistan have been attacked. This Jihad is mainly directed against polio vaccinators and other health workers, but is intended to lessen the number of U.S. drone strikes and attacks in the region. The Taliban is essentially holding its own children hostage to call for a ceasefire from the United States. Another reason that the Taliban is targeting public health groups (like the Global Eradication Initiative) is the death of Osama bin Laden. To confirm bin Laden’s location when he was in hiding, CIA operatives staged fake vaccination drives in 2011 to validate the presence of the family in the region. They compared blood samples from the vaccination drive with a blood sample from bin Laden’s sister, who had died previously in a Boston hospital. Obviously, the samples from Abbottabad came back positive and confirmed his presence in the area. However, this led the Taliban and native Pakistanis to harbor a massive distrust of health care professionals in the region, especially toward western health care organizations, which are now essentially disallowed. However, in a state that is predominantly Muslim as Pakistan is, polio vaccinations are bound to be required, as now all pilgrims to Saudi Arabia (location of both Islamic holy sites, Mecca and Medina) are required to have their polio vaccination shots before entering the country, according to the Saudi Arabian Embassy. This may pose a problem for any Pakistani citizens wishing to complete the hajj, or holy pilgrimage, which is a requirement for Muslims everywhere.
Without more aid and extended reach from the Eradicate Polio Campaign, the possibility that polio could further migrate from Syria and other areas of unrest to the developed world will become a very realistic one. Vaccinations are imperative for travelers and workers in affected regions, as well as unexposed children, though in the Deir Azzor province, the children might be hard to find. We can only hope that the WHO’s “Eradicate Polio Campaign” will prevent this highly contagious disease from taking further lives. This currently regional issue could become an international concern if not controlled.
Image by the Gates Foundation