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[PESHAWAR] An outbreak of acute watery diarrhoea (AWD) among people displaced by the Pakistan army’s campaign against Taliban militants in the North Waziristan Agency has highlighted the sore need for an immunisation programme against vaccine-preventable childhood diseases in the region.

Following the launch of the military crackdown on 15 June, at least one million internally displaced people (IDP) have had to be accommodated in temporary shelters, most of them in the Bannu district of Khyber Pakhtunkhwa (KP), one of Pakistan’s four provinces.

WHO officials, blaming poor sanitation in the camps, say that more than 40 per cent of the refugees have been hit by AWD attributable to the rotavirus bug that spreads through contaminated water and food and mostly afflicts infants and young children.  

Fawad Khan, a doctor with WHO, tells SciDev.Net that the afflicted are being treated for symptoms since no anti-viral medication is available.

“We are taking special measures to save women and children who form 29 and 45 per cent respectively of the displaced population,” Khan says. "While the danger from rotavirus has been dealt with, we are carrying out immunisation measures against other vaccine-preventable childhood diseases such as measles and polio.”

By the end of June measles had claimed at least 115 lives. Jan Baz Afridi, head of the government’s vaccination programme in KP, says that a special immunisation programme is currently underway in KP and Sindh provinces. Pakistan recorded 9,000 cases of measles in 2013.

As for polio, with two cases, one each in KP and the Khyber Agency, surfacing in the first week of August, the number of polio cases reported in Pakistan this year has risen to 108, defying vaccination drives. 

Rotavirus is yet another threat to refugee children and, according to a study published in Vaccine in December 2013, a national rotavirus vaccination programme could decrease the health and economic burden from the disease by more than 40 per cent.

The arrival in Bannu of about 200,000 unvaccinated children from the embattled North Waziristan Agency has stretched the public health resources of the small town beyond its limit, local authorities say.

“These children have not been vaccinated against polio since June 2012 when the Taliban first imposed a ban on vaccinations,” says Pervez Kamal, senior government health officer.  “Following WHO guidelines we are now administering oral polio vaccine to all IDP, regardless of age.”

Fayaz Khan, a public health administrator, tells SciDev.Net that the government lacks the infrastructure to cope with the massive influx of IDP into KP. “The UN central emergency response fund has provided US$ 680,000 so far against a requested amount of US$ 99 million.”

This article has been produced by SciDev.Net's South Asia desk.


Cost-effectiveness of a new rotavirus vaccination program in Pakistan: A decision tree model, Vaccine, December 2013

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