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Pakistan’s health workers fight the spread of polio

Despite demanding working conditions and even targeted killings, field workers continue to battle the disease.

Pakistan polio
Pakistan administers at least 300 million doses of oral vaccine annually with the help of more than 350,000 vaccinators across the country. The target population - children aged five and below - numbers about 43 million [Faras Ghani/Al Jazeera]
By Faras Ghani
Published On 18 Jun 2024

Pakistan is one of only two countries in the world where poliovirus is still endemic – the other being neighbours Afghanistan.

To counter the spread of the disease, Pakistan launched an eradication campaign in 1994. The country used to report 20,000 cases annually, according to government health officials. While the figure has come down significantly (five so far this year), the spread continues.

Pakistan administers more than 300 million doses of oral vaccine annually with the help of at least 350,000 vaccinators, according to the Pakistan Polio Eradication Programme.

Health workers, as well as accompanying security officials, are often harassed, ridiculed, taunted, threatened and targeted physically. At least 102 have been killed in the field, government officials say, including during campaigns carried out this year.

In addition to these attacks and refusals of vaccination, health workers also face other issues, including low pay, salary delays, and tough working conditions. Some told Al Jazeera they are paid as little as 1,360 rupees (approx $5) for an eight-hour day.

Some polio survivors working on the eradication campaign said they receive no transport or health benefits despite their condition, leaving them to walk through tough terrain and demanding weather conditions when carrying out their work.

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Pakistan polio
Security officials accompany polio workers in the field. At least 102 vaccination workers, officials and security personnel have been killed in the field, including in campaigns this year. Field workers are often harassed, taunted, and verbally and physically abused as they go door to door administering vaccines. [Faras Ghani/Al Jazeera]
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Pakistan polio
Field workers often experience vaccine refusals at the end of journeys through tough terrain and demanding weather conditions. In this area on the outskirts of Karachi, temperatures reach 40C as the health workers went door to door in the campaign. [Faras Ghani/Al Jazeera]
Pakistan polio
Since 2015, Pakistan has reported 357 polio cases, including five this year. A two-year-old boy died in May. In addition to human cases, wild poliovirus type 1 (WPV1) has frequently been detected in environmental samples taken across the country. This year, WPV1 has been found in 44 out of 159 districts across the country. [Faras Ghani/Al Jazeera]
Pakistan polio workers
Polio survivor Ayesha Raza is now part of the eradication campaign. She goes door to door handing out vaccines in the eastern city of Lahore. 'I try to convince parents who refuse vaccines for their kids by telling them my own story,' Raza said. [Courtesy: Pakistan Polio Eradication Initiative]
Pakistan polio
In addition to the door-to-door administering of oral polio vaccines during campaigns, the service is also provided at government-run health centres across the country. [Faras Ghani/Al Jazeera]
Pakistan polio
In addition to polio vaccines, these health centres carry out routine immunisation for the children brought to them. [Faras Ghani/Al Jazeera]
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Pakistan polio
Aamir Ali has had polio since he was four years old. After his studies and a job at a call centre, Ali decided to join the polio eradication campaign in 2020. Amid the hardships and demanding conditions, he says his aim is not to look back at what happened to him but to ensure 'no kid is left behind'. [Faras Ghani/Al Jazeera]
Pakistan polio
A mural, partially obstructed, reminding parents of the polio campaign at a health centre in the Landhi area of Karachi. [Faras Ghani/Al Jazeera]
Pakistan polio
A health worker in the northwestern city of Peshawar marks the door of a house at which she has administered polio vaccinations. [Faras Ghani/Al Jazeera]
Pakistan polio
Polio workers go from door to door in the Sohrab Goth area of Karachi as the temperature touches the 40C mark. The workers say the area does not have a lot of houses but has a high number of children under the age of five. [Faras Ghani/Al Jazeera]
Pakistan polio
Officials say they aim to reach more than 43 million children aged five and below in every campaign they carry out. [Faras Ghani/Al Jazeera]
Pakistan polio
A field worker, communication officer and local influencer during a campaign in Karachi's Sohrab Goth area. Officials secure the help of local influencers to reduce refusals and help spread awareness. [Faras Ghani/Al Jazeera]