Zofeen Ebrahim

KARACHI, Nov 12 2008 (IPS) – As the first batches of Haj pilgrims from Pakistan arrived at Saudi Arabia s Jeddah airport for the current pilgrimage season they were, regardless of age, administered oral polio vaccine (OPV).

Finger markings prove that this child has received oral polio vaccine. Credit: Zofeen Ebrahim/IPS

Saudi Arabia, a polio-free country, is taking every precaution to prevent transmission of the crippling, paediatric disease from visitors belonging to four countries Pakistan, Nigeria, India and Afghanistan where the wild polio virus is still circulating.

Pakistanis will be administered OPV, regardless of age and vaccination status, on their arrival in Saudi Arabia, the national manager for the Expanded Programme on Immunisation (EPI), Dr Hussain Bux Memon, told media.

Terming it a good policy to prevent the international spread of polio, Dr Ni ma Abid, polio team leader for the World Health Organisation (WHO), in Pakistan, told IPS: It might be useful to show that a leading Muslim country is asking for polio drops to be administered as a prerequisite for Haj which means that the vaccine doesn t contain haram (forbidden) ingredients, he said.

He averred that polio can occur in adults and thus OPV should be administered to adults as well. Adults can also transmit the infection without being affected by the disease.

Dr. Yehya Mostafah WHO team leader for polio eradication in Sindh province told IPS that it was not without reason that Saudi Arabia has called for the administration of OPV to adult Haj pilgrims.
Related IPS Articles

An adult coming from an endemic country may be immune to polio but may still be a carrier and be able to transmit the virus to others, Mostafah said.

Also, he said, there may be many pilgrims coming from developed countries with good sanitation and where, generally, the immune systems of people are not as strong as in Pakistan and other endemic countries. They may be susceptible to the polio virus especially if they (adult or child pilgrims) have not been immunized.

I think this is an effective strategy to combat the virus, said Dr Rumina Hasan, who heads the departments of pathology and microbiology at Karachi s Aga Khan University Hospital.

What the Saudi government is doing is to give a booster since it has also made it mandatory for intending Hajis from endemic countries to be inoculated at the time of seeking visa, explained Hasan.

According to her it was alright for the pilgrims to be administered a booster to enhance their immunity against the disease as well as to prevent transmission . She dismissed the notion that OPV must be administered to a herd on the same day in a given geographical area.

That is not possible as not everyone will land in Saudi Arabia at the same time.

Further, she said, OPV administration on arrival protects pilgrims from re-infection and bringing the virus back home. It takes time for the vaccine to become effective in immunizing the vacinee. Dismissing the perception that this policy was directed by the World Health Organisation (WHO) or the United Nations, Dr Abid said: The decision by Saudia Arabia is to avoid a disaster like what happened after the 2003 Haj season when more than 20 countries were re-infected by viruses imported from Nigeria.

This year the number of polio victims has risen to 81 compared to 32 last year and 40 in 2006. A large majority of cases hailed from the North West Frontier Province (NWFP) and the war-stricken Federally Administered Tribal Area(FATA) that border Afghanistan.

Interestingly, some 27 religious scholars, planning to perform Haj this year, will literally have to swallow not just the OPV but their own decree against the polio vaccine.

The decree convinced many parents to avoid the door-to-door campaign by the health department to save children against the crippling disease. In 2007, parents of some 24,000 children in the NWFP refused to allow health workers to administer polio drops, as they were convinced it was part of a plot by the United States to sterilise innocent Muslim children.

At times it has been reported that the various polio field teams were threatened by the militants in parts of the NWFP and FATA with the result that the anti-polio campaigns have failed.

The leniency on the part of the scholars began six months ago when Saudi Arabia announced that children under 15 will have to produce a certificate of vaccination administrated six weeks before applying for the Haj visa.

In another development, radical leader Baitullah Mehsud s Tehrik-e-Taliban (TTP) has said his movement will soon announce support for the upcoming national polio campaign.

If that happens, polio campaigners can no longer blame militants and religious scholars for alleged slackness in the past.

A recent international review comprising the WHO and the U.N. Children s Fund (UNICEF) had dismissed refusals by parents as an unacceptable excuse behind the deteriorating quality of anti-polio campaigns carried out in the NWFP and FATA.

Developed countries have high stakes in eradicating polio from the world since they can then shut down their own immunisation programmes. Britain s Department for International Development (DFID) recently announced an additional 13.5 million US dollars to support the anti-polio campaign.

International experts are also emphasising that attention must be given to the main reasons why children are being missed during polio days.

In the last National Polio Campaign (October 13-15), a large number of children were missed in a small town outside Islamabad, not because parents refused to let them be vaccinated but because the teams falsely made chalk markings on the main doors.

These ghost polio teams, which have been known to exist previously in Sindh, were caught after a startling disclosure by a team of private consultants confirmed what was earlier suspected by international experts.