Pakistan is currently at the center of the global effort to eradicate polio. Although the country has reported only about a hundred cases this year, that’s more cases than in all other nations combined.
Eliminating the paralyzing disease is a major logistical operation in Pakistan. More than 200,000 vaccinators fan out across the country, several times a year, to inoculate millions of children. The government also deploys tens of thousands of armed security forces to guard the workers.
All this is happening while Pakistan is fighting against the Taliban — and that militant group continues to threaten polio vaccinators and parents who immunize their children.
The polio campaign is costing Pakistani lives, national pride and precious health resources. Some health leaders are starting to question whether the focus on polio is worth it.
"All the immunization workers have been redirected into the polio campaign, which has resulted in another disaster: Our routine immunization has gone down to as low as 30 percent or less," says Dr. Raza Jamal, of the National Institute of Child Health in Karachi. "So that has resulted in epidemics of measles, diphtheria, cases of pertussis — which we had stopped seeing for a long time."
Jamal supports the polio eradication effort. But, he says, it has become a national obsession and has taken a huge toll on Pakistan’s already overstretched health system.
Polio is only one of many challenges facing the poor country. People lack access to jobs, sanitation, decent housing, clean water and electricity. Criminal gangs terrorize the slums of Karachi. Pakistan has a major terrorism problem.
Photo: During nationwide polio campaigns, hundreds of thousands of health workers go door to door, giving children two drops of the polio vaccine. (Anadolu Agency/Getty Images)
Last January Salma Jaffar was shot while she was going door-to-door in Karachi, giving children drops of the polio vaccine.
"Even when they took out the pistol, I couldn’t understand why he was taking out the gun," Jaffar says of the two men who pulled up on a motorcycle and started shooting at the vaccination team.
"But when he opened fire, that is when I thought it was the end of the life," she says. "My first thought was that I won’t be able to see my children again."
Jaffar was shot four times: twice in her arm and twice in her chest. She spent the next three weeks in an intensive care unit.
Three of her colleagues weren’t as fortunate and died in the attack. They are among the more than 60 polio workers who have been killed since the Pakistani Taliban banned polio immunization in 2012.
Today the militant group continues to threaten to kill not only vaccinators, but also parents who get their children immunized. That threat has had a chilling effect on anti-polio efforts nationwide. And it completely halted vaccination drives in some Taliban-controlled areas. It’s in these places that the crippling virus has come roaring back — and threatened to stymie global efforts to wipe out polio.
The worldwide campaign to eradicate polio has been going on for more than two decades. It has cost more than $10 billion. Now the success of the campaign hinges on whether Pakistan can control the virus.
At its peak in the 1950s, polio paralyzed about 350,000 people a year around the world. This year, so far, there have been only 128 cases recorded. Ninety-nine of them have been in Pakistan. And the South Asian nation is the only country in the world where the number of polio cases is rising significantly.
Photo: A health worker gives a child the polio vaccine in Bannu, Pakistan, June 25. More than a quarter million children in Taliban-controlled areas are likely to miss their immunizations. (A Majeed/AFP/Getty Images)
Ebola since 1976
Most border crossings in Liberia have been closed and communities hit by an Ebola outbreak face quarantine to try to halt the spread of the virus.
Screening centres are also being set up at the few major entry points that will remain open, such as the main airport.
Meanwhile, Nigeria largest’s airline, Arik Air, has suspended all flights to Liberia and Sierra Leone after a man with Ebola flew to Nigeria last week.
The virus has killed at least 660 people in West Africa since February.
The outbreak began in southern Guinea and spread to Liberia and Sierra Leone. It is the world’s deadliest so far.
Nigeria has put all its entry points on red alert after confirming that a Liberian man died of Ebola after arriving at Lagos airport on Tuesday.
Ebola kills up to 90% of those infected, but patients have a better chance of survival if they receive early treatment.
It spreads through contact with an infected person’s bodily fluids.
Arik Air said it took the decision to halt flights as a precautionary measure and called for all inbound flights to Nigeria from Ebola-affected countries to be suspended.
"We feel especially compelled to take the business decision to immediately suspend flight services into the two Ebola affected countries due to our interest in the well-being of Nigerians," the airline, which operates routes across West Africa, said in a statement.
Dionna Fry, a 2014 graduate from Emory University, spent last summer in Ethiopia devoting herself to toiletry. For six weeks, she worked with nonprofit organization Catholic Relief Services, going door to door to interview village leaders and families in different communities about how they liked Arborloos, low-cost and ecologically-friendly pit latrines with a concrete slab to squat over. The waste falls into the pit.
Introduced over the past 10 years in Ethiopia, the latrines protect families from diseases spread by open defecation and also turn human waste into an agricultural resource — the food to feed a plant tree that could eventually becomes a source of food and income for the family.
She says families, for most part liked it, and have grown trees that are taller than people.
Fry’s mind was on the toilet for most of the trip, but here’s a peek at her overall experience.
Did you try the toilet? What was it like?
All the Arborloos I used provided privacy [with lightweight walls] and had little odor. Users apply a mix of ash and soil to the pit after use. This decreases odor and the prevalence of flies.
Local habit you liked?
In Ethiopia they tear off a piece of injera [a spongy flatbread], wrap it around some food on the plate, mush it together and feed it to somebody. It’s a sign of respect and love, and the larger the piece the stronger the bond.
The hand that you clean yourself with after defecation, in many cultures, is the left hand, and so that’s considered the dirty hand. The thing is I’m left-handed, and you’re supposed to eat with your right hand. Sometimes I would forget and eat with my left hand, and I would think, “Oh shoot, people are going to think I’m gross.”
About 30 to 40 Gelada baboons, whole families with babies, were sitting on the road just hanging out, which caused a huge traffic jam.
Photo: An Ethiopian woman and her child stand next to an Arborloo latrine. (Courtesy of Dionna Fry)
Women and girls are less likely to undergo female genital mutilation, or FGM, than 30 years ago. That’s the encouraging news from a UNICEF report on the controversial practice, presented this week at London’s first Girl Summit.
The rate has dropped in many of the 29 countries across Africa and the Middle East where FGM is practiced. In Kenya, for example, nearly half the girls age 15 to 19 were circumcised in 1980; in 2010 the rate was just under 20 percent.
But there’s a sobering side to the report. In countries like Somalia the rate has gone down slightly but is still over 90 percent.
And because the population is growing in parts of the world where the practice takes place, total numbers are on the rise. Unless the rate of decline picks up, another 63 million girls and women could be cut by 2050.
The report is “exciting and worrying,” says Susan Bissell, the chief of child protection at UNICEF. “The population growth will far surpass the gain we’ve been seeing if we don’t step it up.”
The report shows that more than 130 million girls and women have experienced some form of genital cutting or mutilation in 29 countries across Africa and the Middle East.
The practice involves removing, partially or completely, the female genitalia — sometimes just the clitoris, other times also the labia or “lips” that surround the vagina. In extreme cases, the vaginal opening is narrowed by sewing up the outer labia.
In many communities, the custom has long been perceived as a rite of passage into womanhood. Because sexual contact is painful, the practice is also seen as a way to prevent a woman from losing her virginity before marriage. Some see it as ensuring fidelity during marriage, as the procedure eliminates sexual pleasure.
Graph: This chart tracks the changing rates of female genital mutilation in a sampling of countries — and projects the rate needed to end FGM by 2030. (via UNICEF)
The doctor leading the fight against the world’s deadliest Ebola outbreak in Sierra Leone has contracted the virus, according to government officials.
Sheik Umar Khan has been admitted to a hospital in the Eastern province of Sierra Leone and is undergoing treatment.
The 39-year-old doctor is considered a national hero and is credited for treating scores of people suffering from the virus.
Health Minister Miatta Kargbo said she would “do anything and everything in my power to ensure he survives.”
Ebola is spread by a virus that is initially transmitted from wild animals; it has a high fatality rate and no cure. The virus kills up to 90 percent of those infected, however patients have a better chance of survival if the virus is detected early on.
According to the United Nations, 630 people have died since the virus was detected in Guinea in February and the virus has spread across borders and into several West African countries like Liberia. Symptoms of Ebola include high fever, vomiting, internal and external bleeding as well as diarrhea.
Khan seemed aware of the risks involved with dealing with Ebola, telling Reuters late last month “I am afraid for my life, I must say, because I cherish my life.”
He also said “Health workers are prone to the disease because we are the first port of call for somebody who is sickened by disease.”
(From PBS NewsHour)
NPR’s Jason Beaubien is in Sierra Leone, covering the Ebola outbreak that began in March in Guinea and has spread to neighboring countries. When we spoke Thursday, he had just toured the treatment center built by Doctors Without Borders in the town of Kailahun. With 64 beds, it’s the largest Ebola isolation ward ever built. Currently there are 31 patients.
How’s it going?
Never a dull day here.
Can you describe the treatment center?
It’s basically a compound with a series of different tents. There are tents where people get suited up to go in. Another tent seems to be for storage, and one of the tents contains a lab. Then there’s a double fence about 3 1/2 feet high, made of orange plastic mesh. They designed the fence so people can see where the patients are, so it wouldn’t seem as if the patients are completely walled off.
Why a double fence?
So no one can get within 6 feet of someone who has Ebola. In case a patient from the isolation area reaches out or vomits, [Doctors Without Borders] wants to make sure there won’t be any accidental contamination.
How do the doctors record information on the patients?
Doctors go into the isolation area completely suited up, do their rounds and write down what’s happening with patients. Then they stand next to the fence and shout out to people on the other side of the fence [information about each patient]. Say, for patient 105, the doctor says, “diarrhea, vomiting.” Then the doctor’s notes [made inside the isolation area] are burned.
Where do they burn the notes?
They have a big pit in the back.
What else do they burn?
They burn everything. They say nothing comes out of isolation — although obviously they’re taking blood samples out. People come out. They strip off their protective gear, the Tyvek suits they put over their entire body and shoes.
Top: Construction workers repair the roof inside the isolation area at the Doctors Without Borders treatment center in Kailahun.
Bottom: All workers in the isolation area must wear a head-to-toe protective suit.
Photos by Tommy Trenchard for NPR
Desmond D’Sa helped shut down a toxic landfill.
The landfill was located in South Durban — an industrialized city teeming with petrochemical plants, paper mills and oil refineries. D’Sa and his family had been forcibly relocated to the area by the apartheid government in the 1970s, together with thousands of other Indian and black South Africans. The apartheid government was notorious for forcing nonwhite laborers to live in the industrial areas where they worked.
In 2009, the landfill — which had operated for nearly 20 years — was looking to extend its lease. That’s when D’Sa, the coordinator of the South Durban Community Environmental Alliance, began fighting back. Earlier this year, he was awarded the prestigious Goldman Environmental Prize for his efforts. We asked D’Sa about his quest to keep his community clean.
Why did you become an environmental activist?
In the early 1990s, I was working for the state oil corporation. I worked in a chemical plant, and I had done safety and risk [assessment], so I saw the damage to workers and that made me realize that the work we were doing was quite toxic and dangerous, and could affect our community as well.
At night I started to go to the [safety research] lab to get documents, and I would read up and try to understand what was going on [with hazardous waste disposal]. When I confronted management, they said, “We don’t need people like you here.” In 1998, I was fired while I was on holiday. That’s when I began working full-time as an environmental activist. They unleashed a monster.
What was the key to your campaign against the landfill?
Carefully documenting everything. We brought in health experts and researchers from the Durban University of Technology and from the U.S. We got people in the community to write down the problems they were experiencing. We took photos and videos, and collected [water and air] samples and worked with researchers to analyze them.
Beyond that, the key is very simple: Work all the time and talk a lot. Get up early in the morning, and get on the road. Talk to people in communities and churches. Leave your cellphone on.
Photo: Desmond D’Sa stands by the landfill he helped shut down in Durban. (Goldman Environmental Prize)
Last call. Game over. Polio ends with us.
When Rotary set out to end polio more than 25 years ago, there were over 350,000 cases of this crippling disease every year. Children in 125 countries lost their ability to run, walk and play–forever. Since then, we’ve eradicated 99% of this devastating disease. The end is so close we can see it. Our generation will be the last to see the crippling effects of polio. What else will your generation be the last to see?