More polio workers are killed in Pakistan

BMJ 2013; 346 doi: (Published 03 January 2013) Cite this as: BMJ 2013;346:f15
  1. Anne Gulland
  1. 1London

Seven more aid workers have been shot and killed in Pakistan, just two weeks after the murder of six people working on polio vaccination programmes in the country.1

The workers, six of whom were women, were killed on New Year’s Day near a community centre in the Swabi district in the north west of Pakistan. It is believed that the seven, of whom two were health workers and the rest teachers, were targeted because the community centre where they were working provided polio vaccinations. They might also have been targeted because the centre was educating girls.

The workers were ambushed in their car as they returned to the centre, run by a non-governmental organisation called Support with Working Solutions. The driver was shot but not killed.

Javed Akhtar, the head of the organisation, told Newshour on the BBC World Service that, as well as providing education, his charity ran a maternal health centre and also provided vaccinations, including polio.

He said that the work of his centre “must continue” and that he was looking to the government to ensure the security of his staff. He added that it would be a challenge now to hire more staff.

He said, “The staff killed were providing education and health facilities and services in an area where there are no government facilities available . . . This small element who is opposing these services—we will try to combat them.”

Maryam Yunus, a communications officer for the World Health Organization in Pakistan, said that investigations into the shootings were still at a very early stage and that the police were not sure who was responsible for the attacks, nor why they were carried out, although it was believed that the polio vaccination campaign was the main target.

The campaign is regarded with suspicion by some in Pakistan, being seen as a Western plot to either gather intelligence or sterilise Muslim children.

The latest weekly information published by the Global Polio Eradication Initiative, a project spearheaded by WHO, shows that there were 57 cases of polio in Pakistan in 2012, down from 198 in 2011. Alongside Nigeria and Afghanistan, Pakistan is just one of three countries in the world where the disease is still endemic.

A vaccination campaign was suspended in December after the shooting of six workers in Karachi, Sindh province, and Peshawar. At the time, WHO said that such attacks deprived “Pakistan’s most vulnerable populations—especially children—of basic lifesaving health interventions.”

WHO’s statement added, “We call on the leaders of the affected communities and everyone concerned to do their utmost to protect health workers and create a secure environment so that we can meet the health needs of the children of Pakistan.”

Polio vaccination workers were also killed in Pakistan in the summer and in the autumn.2

Heidi Larson, an anthropologist who leads a team studying public trust in vaccines at the London School of Hygiene and Tropical Medicine, said that the reasons for the shootings were complex and could include that the killers did not like the fact that women, the main victims in the latest shootings and those in December, were working. One of the things learnt from the polio eradication programme in India was that mothers wanted women to vaccinate their children, and this had been applied to the Pakistan programme.

“The trouble is that you try to fix one problem and then another one comes up,” said Larson. “We need to not only be socially and culturally sensitive but also politically sensitive.”

She added that carrying out countrywide programmes could also be a problem in a volatile country such as Pakistan. “I’m not against mass campaigns, and there are times when they’re appropriate in a stable situation. But it’s a bit like putting a flag out at a time when there have been explicit threats,” she said.


Cite this as: BMJ 2013;346:f15