Can the Taliban vaccinate a nation in turmoil?

On the heels of major geo-strategic upheavals in Afghanistan that resulted in the Taliban's rise to power, a nationwide polio immunization campaign was launched in early November by The World Health Organization (WHO) and the United Nations children agency (UNICEF) and the backing of the Taliban. 

Faced with sanctions and freeze of state funds, the country faces an array of grim uncertainties in regard to its ability to deliver basic health services to citizens. Under such circumstances, spearheading a major, nationwide vaccination campaign for millions of the vulnerable children under the age of 5 years becomes a serious challenge, health officials and observers admit.

Threats remain despite Taliban’s soft stance

One of the vaccination team members, Hikmat Ullah, a resident of eastern Nangarhar province which borders the restive tribal belt, told FairPlanet that his task was never easy in the wake of eminent threats from the extremists; now, he says, the added constraints such as unpaid wages and subsequent poverty, have made the situation worse.

The province has seen a horrifying surge in targeted assassinations, public executions and bomb blasts despite the end of the Taliban-led insurgency.

"Our duty stations in Jalalabad [capital of Nangarhar] have recently seen such a worrying rise in targeted assassinations," he said. "When I leave home for work, I am never sure about safe return to home."   

Security analyst Zia Rehman told FairPlanet that the Taliban’s stance regarding the polio immunization driver has changed over the years, but many extremist groups continue to seriously oppose it. “The Taliban are not against [immunization], but other armed groups such as Daesh [Islamic State] and Lashkar-e-Tayaba, Jaish Mohammad are still sternly opposing [it]," he said. 

Deadly attacks on health workers here claimed many lives thus far despite the Taliban’s apparent soft stance towards the polio vaccination in Afghanistan, as other extremist groups continue to oppose the immunization campaign

Four members of the polio vaccination team were gunned down and three more were wounded by unknown assailants here in June. Back in March, three members of the polio vaccination team - all females - were shot dead by unknown assailants in the same province. 

On condition of anonymity, officials at the Ministry of Public Health in Kabul said that the nexus of financial woes and security concerns are not limited to one part of the country, even after the end of the Taliban-led insurgency and establishment of their Islamic Emirate here.

"We have sacrificed immensely in the past many years, and we continue to do so. Be it serving and treating the war victims (during the 20 years of insurgency), or the coronavirus patients or the poor and needy from the remote corners of the country," said a provincial health officer who was not authorised by the Taliban to speak to the media. "In return, we do not seek anything extraordinary but respect and recognition of our service and our due salaries so that we can feed our family." 

Frontline health workers continue to put themselves on the line 

Doctors and staff at the 200-bed public hospital in Taloqan, the capital of Takhar province, took to the streets last month and protested against the failure to pay their salaries and wages.

Mohammad Saber, a health worker at the Taloqan hospital, told FairPlanet that he had not been paid for three months and that he was facing many economic problems as winter approached and food and fuel prices were rising.

“We have shared this problem with the Takhar Department of Public Health and through it with the Ministry of Public Health in Kabul, and we desperately hope that this issue gets resolved," he said.

A female nurse said on the occasion that she and her colleagues always came to their duty, defying terrorists’ threats against polio vaccinations. “We are ready and willing to serve during the forthcoming polio vaccination drive, but the winter is coming and we do not have firewood or stocks of food," she said. "We call on the government of the Islamic Emirate to pay attention to our remaining livelihood."

At the end of the demonstration, Hafizullah Safi, chief physician at Takhar Provincial Hospital, issued a statement warning that health services will be suspended if doctors and other staff at the hospital are not paid. "It is clear to everyone that the hospital is a public institution that serves the needy citizens 24 hours a day, but we too are human and have families to feed."

The situation was similar in the 100-bed public hospital in Parwan province next to the capital Kabul. 

An official at Parwan's civilian hospital, who did not want to be named, said that in addition to the fact that employees have not been paid for five months, their sick and annuals leaves have been canceled.

"We have a lot of economic problems, not just me, but all public health workers," said one doctor, adding that the hospital's food supplies for both health workers and patients are running low.

Meanwhile, the head of the ministry’s immunization program, Dr. Gula Khan, told FairPlanet that the four-day immunization program was well-planned. "This is going to be the first polio vaccination campaign since the Islamic Emirate [Taliban] came to power in the country, and it is expected that there will be no problem in implementing it," he said.

He said that about four million children under the age of five missed the polio vaccine last year due to the spread of coronavirus in the country and the increase in instability during the previous three rounds of the vaccine.

"In this campaign, we will be vaccinating about 10 million children under the age of five."

Afghanistan is one of the three countries in the world, along with Pakistan and Nigeria, still grappling with the polio virus.

According to UNICEF, 16 out of 34 provinces have been infected with 56 cases of world polio virus type 1 (WPV1, while the virus’ circulation remains high in the southern region, which "has contributed to 66 percent of the total national cases in 2020."

Image by © EU - photo by EC/ECHO/Pierre Prakash.