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The South Asia Channel

Into the Abyss: The Escalating Violence Against Pakistan’s Polio Workers

This year has been a disastrous one for Pakistan’s campaign to eradicate polio, and 2014 isn’t even over yet. According to the Global Polio Eradication Initiative (GPEI), there have been 220 cases of polio in Pakistan in the past 10 months, a number far greater than the 93 cases in all of 2013. The last ...

AAMIR QURESHI/AFP/Getty Images
AAMIR QURESHI/AFP/Getty Images

This year has been a disastrous one for Pakistan’s campaign to eradicate polio, and 2014 isn’t even over yet. According to the Global Polio Eradication Initiative (GPEI), there have been 220 cases of polio in Pakistan in the past 10 months, a number far greater than the 93 cases in all of 2013. The last time Pakistan saw numbers this high was 15 years ago, in 1999, when 558 cases were recorded. One of the central reasons for this increase is that extremists are successfully targeting polio workers in violent attacks.

So far in 2014, there have been 20 attacks on polio workers in Pakistan that have killed 32 people, according to data I collected using news reports; and the attacks are only escalating in lethality and violence. In 2013, there were 29 attacks against polio workers, killing 22 people; and in 2012, there were only nine attacks that resulted in the deaths of 10 people.

The current war by Pakistani extremists on the country’s polio workers began on June 16, 2012, when Taliban leaders in both North and South Waziristan banned the vaccination campaign until the United States ceased drone strikes in the region. The first incidents occurred in July 2012, when on July 17, a U.N. doctor from Ghana and his driver were shot and injured in the Gadap Town section of Karachi. Three days later, another polio worker involved in the same campaign was killed in another shooting in the same area. The violence reached new heights in December 2012, when in the span of just two days, eight people were killed in six separate attacks.

The violence drew much of its initial strength from the revelation that the CIA had used a fake Hepatitis vaccination campaign in March and April 2011 in its hunt for Osama bin Laden. The operation was widely blamed among Pakistani public health workers for fueling the violence and decreasing trust in vaccinators. As Zulfiqar A. Bhutta, a vaccine specialist at Aga Khan University in Karachi, told the New York Times in July 2012: "There could hardly have been a more stupid venture, and there was bound to be a backlash, especially for polio."

While Pakistan’s polio workers suffered increasing violence through 2012 and 2013, 2014 has taken it to another level. A key factor driving the lethality of this year’s attacks has been the increased use of bombs to target polio workers. In January, a bomb killed six police guards who were on their way to protect a polio team in Peshawar’s Charsadda district. In March, a roadside bomb that targeted two vans carrying polio teams killed 11 people in Pakistan’s northern Khyber Agency. Of the five bombings involving polio workers this year — including one in October that killed three people at the home of a polio worker in Mohmand Agency — these two incidents were by far the most lethal.

In 2013, four out of the 29 attacks involved bombs, none of which came close to the lethality of the bombings in January and March of this year. And in 2012, there were no bombings: all nine of the incidents that year were shootings.

To be sure, Pakistan has taken action against those plotting attacks on polio workers on a number of fronts. In July, Pakistani security forces killed Javed Mehsud, a Taliban commander in Karachi, as well as four of his accomplices, who had reportedly been involved in one of the December 2012 attacks. Pakistani law enforcement officials have also arrested the perpetrators of acts of violence against polio workers. In May 2013, 14 suspects were arrested after an attack on a polio team in Peshawar.

Pakistan has also sought to undercut public distrust of the polio campaign, recruiting Muslim scholars to voice support for its vaccination efforts. Pakistan has even received assistance for this from the United States, which publicly forbade the CIA from using vaccination programs as covers in May 2014. Pakistan has also sought to respond to the increasing number of reported polio cases. Earlier this month, Prime Minister Nawaz Sharif’s Polio Monitoring Cell released new recommendations aimed at halting the virus’s spread.

Yet despite Pakistan’s efforts, the violence is climbing. Worrisomely, the violence is becoming intertwined with the larger unresolved challenges of militancy in Pakistan. Syed Asad Ali, a professor of children’s health at Aga Khan University, told the Los Angeles Times in October 2013: "I also feel the real target isn’t so much polio as the international press the militants get when they attack polio workers. They’ve realized, if you want to be in the news, it’s a good way to do it." Aziz Memon, who works with Rotary International’s effort to eradicate polio, told PBS that same month: "Polio workers, they love to target them, not just because of polio, but because touching a polio worker makes news. They know that."

At the same time, Pakistani efforts to slow the spread of polio appear to have had little success. GPEI’s Independent Monitoring Board (IMB) released a report in October stating: "Pakistan’s polio programme is a disaster. It continues to flounder hopelessly, as its virus flourishes," and continued to call Pakistan’s polio situation "a real and present danger to people in neighbouring countries and further afield." Indeed, Afghanistan already has reported eight polio cases linked to Pakistan.

The human costs for Pakistanis both in terms of lives lost and people diagnosed with polio are readily apparent. The costs in terms of international norms that recognize the neutrality of health services are also becoming clear as the violence shifts health policy into the realm of warfare and vaccination campaigns become increasingly dependent on government-provided security that is itself a target. Finally, if the international community and Pakistan’s security and health agencies fail to reverse the current state of affairs, the costs will be borne by more than just Pakistanis. As the IMB’s report states: "Something big has to change in Pakistan. Otherwise, hundreds of millions of dollars will be wasted in the years ahead solely to try to keep the Pakistan polio virus out of other countries."

David Sterman is a research associate with New America’s International Security Program and holds a master’s degree from Georgetown University’s Center for Security Studies. He tweets at @Dsterms.

 Twitter: @Dsterms

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