{"id":757,"date":"2014-12-17T16:51:12","date_gmt":"2014-12-17T15:51:12","guid":{"rendered":"http:\/\/blogs.lshtm.ac.uk\/hppdebated\/?p=757"},"modified":"2014-12-17T16:51:12","modified_gmt":"2014-12-17T15:51:12","slug":"door-door-vaccinators-risking-lives-help-stop-spread-polio-pakistan","status":"publish","type":"post","link":"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2014\/12\/17\/door-door-vaccinators-risking-lives-help-stop-spread-polio-pakistan\/","title":{"rendered":"Door-to-door vaccinators: risking their lives to help stop the spread of polio in Pakistan"},"content":{"rendered":"<p>By Svea Closser, Middlebury College<\/p>\n<p>In the last two years, more than 60 people have been murdered delivering polio vaccine door-to-door to children in Pakistan. These workers are part of a <a href=\"http:\/\/www.polioeradication.org\/\">global effort to eradicate polio<\/a>; they\u2019re working to create a firewall of vaccinated children that would stop poliovirus forever. But tragically, they\u2019re being targeted with lethal violence, <a href=\"http:\/\/www.theguardian.com\/world\/2014\/nov\/26\/gunmen-kill-polio-workers-pakistan\">gunned down<\/a> as they deliver vaccine to kids.<\/p>\n<p>Anti-government <a href=\"http:\/\/newsweekpakistan.com\/polio-vaccinator-shot-near-peshawar\/\">militant groups<\/a> have <a href=\"http:\/\/www.dawn.com\/news\/1149769\">claimed responsibility<\/a> for these attacks. These groups are not anti-vaccination per se: some <a href=\"http:\/\/www.wsj.com\/news\/articles\/SB126298998237022117?mg=reno64-wsj&amp;url=http%3A%2F%2Fonline.wsj.com%2Farticle%2FSB126298998237022117.html\">support door-to-door polio vaccination<\/a> when it suits their political interests. But because polio vaccination is pushed and supported by outside interests, and because it\u2019s one of the most visible activities of an <a href=\"http:\/\/www.sciencedirect.com\/science\/article\/pii\/S0140673613600197\">underfunded government health system<\/a>, it has become an attractive target for anti-government militants. The <a href=\"http:\/\/www.gq.com\/news-politics\/newsmakers\/201301\/doctor-cia-blood-of-bin-laden-january-2013\">CIA\u2019s use of fake vaccination campaigns<\/a> to collect information also contributes to distrust in these workers.<\/p>\n<p>Despite the fact that frontline workers are being murdered in the course of their jobs, though, neither the Pakistani government nor the international organizations that support polio eradication have been willing to pay them a living wage for their work. Frontline polio workers make just a few dollars a day, less than unskilled laborers in many parts of Pakistan.<\/p>\n<p>I\u2019ve interviewed about 100 of these workers, most of them women, over the past 10 years. Most of them take up polio work because they have no choice: their husbands and fathers\u2014the usual sources of support for women in Pakistan\u2014are dead or unable to support their families. Few jobs for women are available in Pakistan, but the polio eradication effort values female workers for their ability to go inside houses where men can\u2019t.<\/p>\n<p><a href=\"http:\/\/www.plosmedicine.org\/article\/info%3Adoi%2F10.1371%2Fjournal.pmed.1001528\">\u201cI get paid for my blood and my sweat, but there\u2019s relief in the work too,\u201d<\/a> one woman told me, explaining that she was able to use the small amount of money she made to support herself and her young son. But nearly every single worker I\u2019ve talked to notes that the pay is not enough to live on. Some women talked about working in temperatures of over 40 degrees Celsius and denying themselves bottled water because it would cut into the small amount of money they take home.<\/p>\n<p>In the wake of the killings in Pakistan, cases of polio have increased. Pakistan is now the world\u2019s <a href=\"http:\/\/www.polioeradication.org\/Portals\/0\/Document\/Aboutus\/Governance\/IMB\/11IMBMeeting\/11IMB_Report_EN.pdf\">most significant reservoir of poliovirus<\/a>. Supporting frontline vaccination staff in their important work should be a priority not just for Pakistan but for those across the world who want to stop the <a href=\"http:\/\/www.who.int\/mediacentre\/news\/statements\/2014\/polio-20141114\/en\/\">global spread of polio<\/a>.<\/p>\n<p>Sufficient support for frontline health staff should always be a priority. But in dangerous situations\u2014like the ones faced by the Pakistani polio workers, and <a href=\"http:\/\/blogs.lshtm.ac.uk\/hppdebated\/2014\/11\/12\/ebola-suppporting-health-workers-front-line\/\">Ebola workers in West Africa<\/a>\u2014living wages and strong benefits packages take on even greater importance. When health staff are asked to risk their lives to protect the lives of others, they certainly deserve job security, and enough take-home pay to feed their children.<\/p>\n<p>In Pakistan, polio workers have been <a href=\"http:\/\/www.dawn.com\/news\/1151020\/we-are-protecting-children-from-polio-at-the-cost-of-our-lives\">taking to the streets<\/a> to demand better working conditions. Helping to meet their reasonable demands\u2014which include better, timely wages; <a href=\"http:\/\/www.brecorder.com\/pakistan\/politics-a-policy\/207317-sc-expresses-annoyance-over-non-regularization-of-lhw.html\">job security<\/a>; and physical security as they work\u2014should be a priority. For years, planners have provided these women with the smallest amount possible. It\u2019s time for generous wages and benefits to attract, motivate, and retain the best people for this very dangerous and very important work.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Svea Closser, Middlebury College In the last two years, more than 60 people have&#8230;<\/p>\n","protected":false},"author":151,"featured_media":763,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[16247,24205,24213],"tags":[16256,24221,24220,24252,24284,16685,24233],"class_list":["post-757","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-policy","category-health-systems","category-low-income-countries","tag-child-health","tag-conflict","tag-fragile-states","tag-human-resources-for-health","tag-pakistan","tag-polio","tag-politics","odd"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Door-to-door vaccinators: risking their lives to help stop the spread of polio in Pakistan - Health Policy and Planning Debated<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2014\/12\/17\/door-door-vaccinators-risking-lives-help-stop-spread-polio-pakistan\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Door-to-door vaccinators: risking their lives to help stop the spread of polio in Pakistan - Health Policy and Planning Debated\" \/>\n<meta property=\"og:description\" content=\"By Svea Closser, Middlebury College In the last two years, more than 60 people have...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2014\/12\/17\/door-door-vaccinators-risking-lives-help-stop-spread-polio-pakistan\/\" \/>\n<meta property=\"og:site_name\" content=\"Health Policy and Planning Debated\" \/>\n<meta property=\"article:published_time\" content=\"2014-12-17T15:51:12+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/files\/2014\/12\/shutterstock2.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"500\" \/>\n\t<meta property=\"og:image:height\" content=\"328\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"\" \/>\n\t<meta name=\"twitter:label2\" content=\"Estimated reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2014\/12\/17\/door-door-vaccinators-risking-lives-help-stop-spread-polio-pakistan\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2014\/12\/17\/door-door-vaccinators-risking-lives-help-stop-spread-polio-pakistan\/\"},\"author\":{\"name\":\"\",\"@id\":\"\"},\"headline\":\"Door-to-door vaccinators: risking their lives to help stop the spread of polio in Pakistan\",\"datePublished\":\"2014-12-17T15:51:12+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2014\/12\/17\/door-door-vaccinators-risking-lives-help-stop-spread-polio-pakistan\/\"},\"wordCount\":584,\"commentCount\":0,\"image\":{\"@id\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2014\/12\/17\/door-door-vaccinators-risking-lives-help-stop-spread-polio-pakistan\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/files\/2014\/12\/shutterstock2.jpg\",\"keywords\":[\"Child health\",\"conflict\",\"fragile states\",\"Human resources for health\",\"Pakistan\",\"Polio\",\"politics\"],\"articleSection\":[\"health policy\",\"health systems\",\"low-income countries\"],\"inLanguage\":\"en-GB\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2014\/12\/17\/door-door-vaccinators-risking-lives-help-stop-spread-polio-pakistan\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2014\/12\/17\/door-door-vaccinators-risking-lives-help-stop-spread-polio-pakistan\/\",\"url\":\"https:\/\/blogs.lshtm.ac.uk\/hppdebated\/2014\/12\/17\/door-door-vaccinators-risking-lives-help-stop-spread-polio-pakistan\/\",\"name\":\"Door-to-door vaccinators: risking their lives to help stop the spread of polio in Pakistan - 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