Friday, January 14, 2011

Pakistani militant fight leads to polio spike

Tiny Shamsa is a victim of the war against Islamist militants in northwest Pakistan, but it wasn't bullets or bombs that paralyzed her right leg. The 18-month-old contracted polio after fighting blocked vaccination teams from reaching her village.
In a country with no shortage of alarming statistics, here is another: Pakistan was the only country in 2010 to record an increase in cases of the crippling disease — 138, up from 89 in the previous year, according to World Health Organization figures. That made it the nation with the highest incidence of polio in the world.
Most cases were in the northwest close to the Afghan border, where battles between the U.S.-supported Pakistani army and Taliban fighters make many areas too dangerous to visit. The army bans travel to parts of the region, citing the security situation, and territory under militant control is highly dangerous for outsiders, even Pakistani aid workers.
Last year, one Pakistan Taliban commander declared the vaccine un-Islamic, echoing a few conservative clerics in other Muslim countries. But others have not publicly stated any objections. In Afghanistan, the Taliban cooperate with health workers administering the vaccine, in part because doing so adds to the movement's legitimacy.
Polio was eradicated generations ago from the Western world, but remains endemic in Pakistan, neighboring Afghanistan and India, as well as Nigeria. Sometimes fatal and highly contagious, it can be prevented with a few drops of bitter vaccine on a child's tongue.
Eradication needs a comprehensive vaccination campaign. Missing even a single child can mean the disease reappearing. In 2010, India recorded 41 cases, Afghanistan 24 and Nigeria 18, according to WHO. A WHO-backed campaign, which began in 1988, aims to eradicate polio from Pakistan by the end of 2011. But some doctors say privately that the target will not be met.
"It is upsetting to know that our only child could not get vaccine because of the troubles," said Shamsa's mother, Majeeda Ali, at a hospital in the main northwestern city of Peshawar recently where she took her daughter for treatment recently. "Yes, I am angry."
Workers from the United Nation's children's agency, which is helping administer the vaccine, say they have not been able to access Shamsa's village in the Khyber region for almost two years because of intensified Pakistan military efforts to rid the region of al-Qaida and Taliban militants. Shamsa caught polio last year.
WHO director general Margaret Chan raised the effect of the conflict on the worsening polio rate in October last year during a meeting with Pakistani President Asif Ali Zardari. She complained that health workers could only reach two in every three children in the northwest tribal border region due to the security situation, WHO said. Zardari pledged the government's support to eradicate polio.
"The number one reason (for the increase in cases) is that the majority of the cases are originating from those areas which are not accessible due to the war going on, or are cordoned off by the army which is not allowing any civilians or any WHO or UNICEF personnel to go there," said Aziz Memon, national chairman of the Polio Plus Pakistan Committee.
Army spokesman Maj. Gen. Athar Abbas said he was unaware of many areas where health organizations are not able to deliver necessary vaccinations. The army helps facilitate access in certain areas where the security threat is high, he said.
Vaccination in war zones is possible, but difficult and often politically sensitive.
UNICEF helped broker a truce between Sri Lanka and separatist rebels in Tamil Tiger-held territory during the 1990s that enabled families to travel safely to polio vaccinations centers on so-called "Days of Tranquility" when warring sides agreed to lay their weapons down. Polio has not been reported in Sri Lanka for well over a decade.
In Afghanistan, the Taliban fighting U.S. and Afghan forces allow vaccine teams to move around.
"All of the time, we are cooperating with the health workers," said Taliban spokesman Zabiullah Mujahid. "In the past and now, there is no problem because it is useful for the Afghan children."
Memon said organizing such a cease-fire was a far more complex proposition in Pakistan, where Pakistani fighter jets, helicopter gunships and CIA drone-fired missiles regularly pound targets. It would also rely on the support of the Pakistani state, which may well be reluctant to agree to something that could legitimize the militants.
"The Tamil Tigers were one group," Memon said. "Here, there are the Pakistani Taliban, Afghani Taliban, there are this man's group and that man's group — it's a totally messy affair."
Janbaz Afridi, director of the Pakistani government's polio program in the northwest, said vaccination teams were determined to reach all children in the northwest. New strategies include enlisting villagers to persuade militants to support vaccination, he said.
Other Muslim countries have also encountered some resistance from conservative clerics, which have spread false rumors that the vaccine was part of a sterilization campaign or derived from pig products. A few clerics have even argued that vaccination in general is un-Islamic because it tampers with the will of God.
"We will definitely reach each and every child even in those areas which are in conflict and where there are military operations," Afridi said. "There were some inaccessibly problems due to militancy, but these have been removed for the future."
Haris Ahmed, an expert on public health administration, said access to the tribal belt and gaining the trust of its inhabitants would be essential to eradicating polio in 2011. "If these two areas are addressed and you see 100 percent coverage and you see the trust coming back to the people, then anything is possible," Ahmed said.

Clerics on the march

The News
Ayaz Amir

This is not about blasphemy or the honour of the Holy Prophet. This is now all about politics, about the forces of the clergy, routed in the last elections, discovering a cause on whose bandwagon they have mounted with a vengeance.

The blasphemy issue ignited by Aasia Bibi’s conviction was virtually over in November, the government making it plain that it had not the slightest intention of amending the blasphemy law, and no government figure of any consequence stepping forward to support Salmaan Taseer on the stand he had taken.

There the matter should have rested if Pakistan’s clerical armies were not masters of manipulation and cold-blooded calculation. They whipped up a storm in December, when the issue was no longer an issue, and fanned such an atmosphere of intolerance and hatred that it would have been strange if nothing terrible had happened.

There’s a danger of moaning too much. But what with the lionising of Salmaan Taseer’s killer and hailing him as a ghazi and defender of the faith, the impression is hard to shake off that what we are witnessing are the last burial rites of what remains of sanity in a Republic not particularly famous for any striking monuments to reason.

No cleric worth the name has refrained from adding fuel to the fires thus lit across the country. But if a prize has to be given to anyone, the honours will go to Pakistan’s path-breaking contributor to political gymnastics, Maulana Fazlur Rehman, and the Amir of the Jamaat-e-Islami, Professor Munawar Hasan (professor of what? is tempted to ask).

The Professor is a study in contrasts: soft-spoken, even beguilingly so, and possessing a keen sense of humour but, at the same time, a master of virulence and of confusion spread in the name of the faith. The 2008 elections had laid the Jamaat low. It had made the mistake of boycotting those elections and its performance in bye-elections since then has furnished further proof of its dwindling political relevance. The Jamaat’s exploitation of the blasphemy issue is an attempt to engineer a political comeback, although there’s no altering the fact that its vote-getting ability comes nowhere near its high nuisance value.

But the issue has to be faced squarely. The clerics are on the march not because they are strong but because those on the other side of the divide – the non-clerical forces – are weak, directionless and devoid of vision...without any strategy and plan of battle.

Zardari’s vision is to stay in power and further enrich his person and his family. End of story. The common belief is he has enough but, by all accounts, we are dealing with insatiable appetites. Prime Minister Yousuf Raza Gilani’s vision is to enrich his family. If a tenth of the stories doing the rounds are to be even tentatively believed, they are doing pretty well for themselves. Names close to the army high command are also the subject of lurid rumours.

But the problem is greater than a few names. Pakistan’s governing class as a whole has earned the distinction of being rotten and corrupt. Everyone rightly-placed is on the take. Those not so fortunate are less emblems of virtue than martyrs to opportunities absent or lost.

A leadership thus tainted, compromised by ineptitude and greed, can neither initiate reform nor reverse the tide of obscurantism now washing against the walls of the Republic.

Lest we forget, the armies of the faithful – with their fearsome beards and shaven moustaches, shalwars pulled up over ankles – have never been in power in Pakistan (the MMA’s stint as Musharraf’s co-travellers in the Frontier not really counting in this equation). What Pakistan is today, the depths it has plumbed, the failures courted, the follies assiduously pursued, have been the handiwork of its English-speaking elite classes – who wouldn’t be caught dead calling themselves secular but who, for all practical purposes, represent a secularist point of view.

The mullahs have not been responsible for our various alliances with the United States; our entry into Cento and Seato; our militarist adventures vis-à-vis India; and the honing of ‘jihad’ as an instrument of strategic fallacies. This last piece of brilliance came from the army as commanded by Gen Ziaul Haq. Religious elements became willing accessories in this game but were not its inventors.

If the first Constituent Assembly lavished attention on a piece of rhetoric of no practical benefit to anyone, the Objectives Resolution, instead of writing a constitution which was its chief duty, the fault lay not so much with the clerical fathers as with the Muslim League leadership. The phrase ‘ideology of Pakistan’ was an invention of Gen Yahya Khan’s information minister, Maj Gen Nawabzada Sher Ali Khan. The central tenet of our security doctrine which sees India as an implacable foe out to undo Pakistan was woven in no madrassah or mosque but in General Headquarters, and a mindset which has been a distinguishing feature of the Punjabi elite.

Our fractured education system is a gift, paradoxically, of our English-speaking classes which have never felt the slightest need for framing a common education policy – the same books and curriculum, the same medium of education – for the entire country.

The army, a secular institution to begin with, has ruled Pakistan. The mainstream parties have been in power. Pakistan’s failures are their failures. The religious parties have been the hyenas and jackals of the hunt, yelping from the sides and helping themselves to the morsels that came their way. Lords of the hunt, lions of the pack, have been Pakistan’s generals and politicians, assisted ably at all times by a powerful and equally short-sighted mandarin class.

If the misuse of religion, the exploitation of religion for less-than-holy ends, the yoking of religion to unworthy causes – such as our never-ending adventures in Afghanistan – has poisoned the national atmosphere and narrowed the space for reasoned debate, the principal responsibility for that too lies with those who have held the reins of power in their hands. Why could they not have reversed the course of events, especially when it lay in their power to do so?

True, Gen Zia’s rule amounted to a visitation from the outer reaches of purgatory. We say he distorted Pakistan, which of course he did. But it is 22 years since his departure, time enough to have healed the wounds he caused and dismantle his legacy. But if the many temples to hypocrisy he erected survive, who is to blame? The Pakistan of today is Zia’s Pakistan not Jinnah’s. But if we have been unable to go back to our founding principles the fault lies not with the zealous armies of the bearded but Pakistan’s secular rulers, in mufti and khaki.

It is not the mullahs who frighten the ruling classes. These classes are afraid of their own shadows. And they have lost the ability, if they ever had it in the first place, to think for themselves. They live on imported ideas and the power of their own fantasies.

It is not a question of the English-speaking classes – our so-called civil society with its small candle-light vigils, usually in some upscale market – standing up to the clerical armies. This is to get the whole picture wrong. It is a question of the Pakistani state – its various institutions, its defence establishment and the creeds and fallacies held dear as articles of faith by this establishment – getting its direction right and then creating a new consensus enabling it to retreat from the paths of folly.

If the Pakistani establishment continues to see India as the enemy, keeps pouring money into an arms race it cannot afford, is afflicted by delusions of grandeur relative to Afghanistan, and remains unmindful of the economic disaster into which the country is fast slipping, we will never get a grip on the challenges we face.

The raging cleric, frothing at the mouth, is thus not the problem. He is merely a symptom of something larger. Pakistan’s problem is the delusional general and the incompetent politician and as long as this is not fixed, the holy armies of bigotry will remain on the march.

A Rescue, Under Fire