Tracing Returnees for Polio Immunization
Polio eradication as one of the global priority has remained challenging and emergency program in Afghanistan, being one of the polio endemic countries Afghanistan reported 21 polio cases in 2018 mainly from south part of the country (15 cases in the Southern region and 6 cases from Eastern region) though the virus is geographically restricted, with particular emphasis on the Southern region where access and insecurity continue to hamper campaigns, yet there are number of other challenges such as ongoing conflict, political instability, poverty, socio-economic issues, cultural, trust and beliefs and constant population movement that makes it difficult for country program to access hard-to-reach children, migration and population movement both internally and internationally along the porous and rugged border between Afghanistan and Pakistan further complicates the vaccination efforts and makes children vulnerable in both side to contract the debilitating disease as well as that can put the country at risk of transmitting virus from infected parts to clean parts of country.
The twentieth meeting of the Emergency Committee under the International Health Regulations (2005) (IHR) regarding the international spread of polio virus, unanimously agreed that the risk of international spread of polio virus as a Public Health Emergency of International Concern (PHEIC) and noted that it is more than four years since there has been international spread outside of Afghanistan and Pakistan epidemiological linked countries.
Population movement between two countries whether for family, social, economic, cultural reasons, or in the context of populations displaced by insecurity and returning refugees remained one of the risk that needs to be addressed , taking in consideration the importance of risk management and urgency of polio eradication in county , mid-2016 Afghanistan PEI initiated the availability of permanent vaccination teams in cross bard areas where every child can get immunized while crossing the border, the program initially started with 5 sites and 30 vaccinator, working in 2–3 different shifts, mainly in Tangi Puli Charkhi, Repatriation center of IOM Kandahar, Torkham Shelter of IOM , Samarkhel and Zero point Torkham of Nangerhar, later on the sites expanded from 5 to 9, covering Islam Qala (Herat), UNHCR repatriation Center, Zero Point Returnees (Kandahar), and AADA clinic at Torkham (Nangarhar), where vaccinators are able to vaccinate thousands of children under age of 5 year, since than program is able to vaccinate about 347,798 in these center mainly with OPV, IPV and Measles.
The contribution may not count as huge towered polio eradication, however huge when it comes to head counts of children who have been immunized and protected against life time paralysis, and even death due to Measles, it can be also count as step forward for strengthening routine immunization in these areas.
Personally I feel it is an achievement that needs to be sustained and strengthened furthermore.
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References:
Shrivastava, S. R., Shrivastava, P. S., & Ramasamy, J. (2016). Recommended Strategies to Move Closer Toward the Global Eradication of Polio: International Health Regulations. International Journal of Preventive Medicine, 7(1), 17–17. Retrieved 3 28, 2019, from https://ncbi.nlm.nih.gov/pubmed/26941918
Statement of the Twentieth IHR Emergency Committee, Regarding the International Spread of Poliovirus
https://www.unicef.org/afghanistan/polio-eradication Polio eradication/Reaching every child in Afghanistan with polio vaccines
Monthly report of Returnees Coverage
