Public Health, Polio and Pakistan

Photo of newspaper headlines about polio vacci...

In less than three decades the goal to eradicate polio had become a public health success story.

Polio is a disease that comes on suddenly, cripples quickly and kills indiscriminately. There is no cure and at the peak of the polio epidemic millions were affected and killed in every country. The disease brought fear to people and public health workers alike. In a document that tells the story of the work to eradicate polio, UNICEF says ”

“Unlike most infectious diseases, which normally take their greatest toll on
the poor, polio knocked on the door of every level of society. Rich and poor, adults and children – no-one was safe.”

In the 1950’s Dr. Jonas Salk came on the scene and developed the world’s first ever polio vaccine. This discovery was followed in the 1960’s with Dr. Albert Sabin’s development of an oral polio vaccine. Going from a shot to drops made giving the vaccine simple and allowed for more wide-spread use of the drug.

And so in 1988 world leaders decided to embark on a world-wide campaign to eradicate the disease.

This campaign has been extremely successful. Last year less than 300 cases were reported world-wide, and many countries have eradicated the disease completely.

Anyone in the field of public health is well aware that when you embark on health campaigns in a community the first step is earning the trust of that community. You plan with, not for, the community. And part of planning with a community means connecting with trusted leaders.

Enter the CIA and a fake Hepatitis B vaccination campaign in 2011 in Abbotabad, Pakistan. I’m sure in the archives of CIA projects there are notes as to who came up with this idea, but whoever did surely did not take into account  the long-term public health impact on Pakistan.

Because when word got out that this was a fake campaign designed to gather intelligence, intelligence that ultimately led to the finding of Osama Bin Laden, every single vaccination program in Pakistan had the potential to become suspect.

In December of this past year, nine vaccination workers were killed in the city of Karachi, accused of being a part of a plot to hurt Pakistan. Taliban religious leaders in the Pakhtunkhwa area of Pakistan have warned people against vaccine programs saying they are foreign sponsored and designed to hurt, not help. Leaders in the area report 11 cases so far this year, and it hasn’t yet reached the peak of the season which occurs after the summer monsoon rains.

Even before the CIA ran its fake vaccination camp, vaccination workers had to convince people that they were legitimate, convince people that they were not part of a bigger scheme to identify drone targets. Once the word spread that indeed, there was one camp that was fake – it became a battle, the vaccinators the warriors.

When governments use healthcare and public health campaigns to advance their agendas, no matter how “noble” or “ignoble” those agendas are, it is wrong. It is pathetic. It is unconscionable.

I don’t care who the government is. The idea and the execution of the idea are indefensible.

The effort to kill one man will potentially result in thousands that are killed from polio, I believe in war it’s known as collateral damage.

So I ask myself – was there really no other way to get the intelligence needed? Were the minds of those devising this scheme so uncreative as to have no other options?

Americans know well the deception of fake health projects. The Tuskegee Syphilis Experiment was not very long ago and still results in suspicion from African-American communities when they are asked to take part in research projects. And it should.

The experiment was barbaric.

Barbaric –  just like the setting up of a fake vaccination program for intelligence purposes. There are no excuses. There is no defense.

It is no secret that I love Pakistan. When the owner of a Pakistani restaurant near our home recently introduced me as “a daughter of our nation” I was speechless and deeply moved. I long to communicate across the extreme boundaries that divide my two worlds – Pakistan and the U.S; Muslim and Christian. As a nurse, I have in the past been able to do some of that through health care, through health clinics.

But health care has been compromised as a vehicle of communication and care. 

So in a time when we desperately need bridges between worlds, between world views, between nations and religions, the nails in the coffin of US-Pakistan relations are pounded in harder every day.

An article in The New Inquiry called “Prescription Strike” says it far better than I ever could in the closing paragraph:

“Identity is the primary resource in a war against an idea. The distrust “they” in Pakistan have for “us” reflects the distrust “we” have for “them.” How many drone attacks, CIA scandals, and covert operations does it take to cast vaccine workers as foreign threats? How many terrorist attacks did it take to warrant the search of every brown man at the airport, the spying on Muslim Americans, the launching of  two separate wars? We conflate large swaths of Asia into a single Muslim enemy that lurks in deserts and caves; we retroactively label every “military age” male killed by drone a militant. They conflate all Western initiatives into a single operation bent on their demise, every health worker a potential spy. Meanwhile, Pakistani children die of polio and Americans ask, “Why do Pakistanis hate us? We’re only trying to save them.”