Polio Orientation and Planning Workshop District 3271– March 21st 2015 in Pearl Continental Hotel, Karachi

DGE Jehangir Moghul (3271) Aidan O'Leary Polio Team Lead UNICEF

 

The polio orientation and planning workshop held on March 21st 2015 at Pearl Continental, Karachi was aimed at encouraging President and Assistant Governor Elects (2015 – 2016) of District 3271 to play an active role in the polio eradication program. A similar one for RI District 3272 was held earlier on March 1st in Muzaraffarabad, AJK.  The master of ceremonies was the National Chair, PPPC Aziz Memon.

The session was initiated with a tilawat by Chief Zonal Coordinator Sindh PP Masood Bhalli. District Governor Elect (3271) Jehangir Moghul welcomed all Rotarians and distinguished guests and reinforced Rotary International President Elect’s stand on polio, saying it is our ‘First Goal’. The Governor thanked the National Chair for his relentless effort and commitment toward the cause of eradication of polio.

Mr. Aidan O’Leary – Polio Team Lead UNICEF Islamabad made a presentation on “Social Mobilization Strategies and Advocacy”. It aimed at 1) Strengthening Emergency Operations Centre structures and systems at all levels; 2) Shift the polio eradication paradigm from “children covered” to “continuously missed children” and place 3)Place front line workers at the centre of the polio eradication effort”. He also spoke on an enabling environment of the care givers supporting OPV and the perception of community support. He briefed the audience on the importance of contact made by every vaccinator in the field and concluded the presentation with “Regardless of Scenario, Every Vaccination Campaign Comes down To a Single, Critical Touch Point: A Short Personal Interaction With A Vaccinator: Their Success is Our Success.

Dr. Tamesgen Demeke – WHO Sindh, presented the Role of EPI in Sindh. He mentioned, in 2014, Sindh reported 30 confirmed cases, of which 23 surfaced from Karachi and seven from Interior Sindh. Todate, we have four cases from three districts in Northern Sindh but none from Karachi. The strategies in 8 Super High Risk Union Councils (SHRUCS) will be in the form of Community based vaccination in Health Camps and  BHUs; Paradigm change from “children covered” to “children missed”; Permanent Transit Point (PTP) Vaccination; Increased pre-, intra- and post-campaign monitoring by all partners and third party. He explained challenges faced by WHO were: 1)quality of SIAs implementation and management 2)Poor coverage, monitoring and supervision in Katcha areas 3)Otaq vaccination 4)Gaps in cross-border coordination with Balochistan and south Punjab, 5)Low routine EPI coverage with minimal outreach services and 6)Inconsistent and suboptimal AFP surveillance performance. He also thanked Rotary’s PNPPC for their continued support in providing PTPs, sponsoring FCV kits and social mobilizing items for their teams.

DGN2 PP Ovais Kohari spoke on Routine Immunization and said that vaccines are the greatest health achievement in the 20th century. However, because of low routine immunization, children are more vulnerable to the polio virus. He briefed the participants on the Operational Components of the Immunization System, elaborating on each one of the component: 1) Vaccine Supply 2) Logistics 3) Surveillance 4) Advocacy & Communication and 5) Service Delivery. He laid emphasis on six key components of the EPI: planning, management, coordination, supervision, training and finance and described it as the ‘Glue’ for success in every campaign. He urged Rotarians to get involved with health facilities and open more Permanent Immunization Centres (PIC) in hospitals and clinics to strengthen routine and make polio eradication their club’s signature project.

Dr. Altaf Bosan – National Technical Consultant, National Polio Emergency Operations Centre (EOC), Islamabad, thanked Rotary for their unwavering support in Pakistan. He said that the EOC is established in line with the International Monitoring Board (IMB) which stressed that all activities must have one theme, one umbrella under one person, at the Central and Provincial level. Effort in every way on part of the government is made to stop transmission by end of 2015.

Dr. Noor ul Haq Baloch, Secretary Health Government of Balochistan said if we can eradicate small pox, we can eradicate polio. In 2011 there 73 cases reported from Balochistan but in 2013 there was not a single case reported. He also said, Routine Immunization in Balochistan is 26%, and must be improved. Dr. Baloch said they will apply new strategies at the 1) UC level 2)Role of Community 3)Role of elected local Government bodies (Councilors)4)Polio Plus and 5)Strengthening of RI. He presented the new organogram for EPI and said under his charge, Balochistan will be free of polio very soon.

National Chair, PPPC Aziz Memon thanked the Balochistan Health Secretary for his participation despite his injuries in a car accident last week. The National Chair introduced Salman Ahmed as the Rotary Ambassador and encouraged Rotarians to involve Salman in their polio activities. He appreciated Dr. Jewats poem in Sindhi against polio. The National Chair highlighted Rotary’s Pakistan National Polio Plus Committees contribution in Pakistan in the form of PTPs, PICs, Resource Centers, Cell phone monitoring project involving CMW, partnership with Coca Cola in the RO Filtration plant, Speaking Book project, advocacy and awareness in workshops with Umena’s, students and civil society and holding Health camps in many deserving and needy areas. He emphasized strengthening routine and thanked all the polio partners and the Government for continued struggle to rid the country of this disease.

Mr. Ayub Shaikh, the Federal Secretary Health, Islamabad said ‘we have enough of resources, but we are lacking in dedication and commitment’. He mentioned though the EOC is in place and all effort to achieve success is being made at the Provincial and National level, as well as the Policy level to improve the dynamics of the program in Pakistan. The Federal Secretary said that for the first time after nearly four years, teams were going door to door to vaccinate children in North and South Waziristan after the military operation Zarb e Azab which took place in June 2014. He said the UAE, Islamic Development Bank and Pakistan Army collaboration have energized the Polio campaigns. He also spoke of the GAVI mission in Islamabad two weeks back, who said the program strategy is a very ‘robust one’ He ended by saying, we all need to create our own motivation and lauded Rotary Club of Khipro’s Dr. Jewat Sunder for his tenacity in creating awareness and new concepts to motivate people in improving coverage, monitoring, advocacy and awareness. He concluded by saying ‘motivated people are resourceful people’.

Haji Mohammed Hanif Tayyab – Chair, Polio Ulema Committee, PPPC said Ulemas are instrumental in convincing people of the misconceptions and myths of polio vaccine and bringing down refusals. They mobilize communities through mosques and madrassa. An Ulema Workshop is scheduled on April 5th, in the city of Multan. Rotary has held several Ulema workshops across Pakistan, and will continue to hold them, until we overcome all such families who are against the vaccine.

 

Tea followed after the Federal Secretary’s speech and a Break Out Session thereafter.

 

PP Masood Bhali was team leader of Group 1 and PP Dr. Pardeep Kumar the Team Leader for Group 2.

 

Group 1 – Recommendations – PP Masood Bhali

  1. Role of a Rotary in the challenge of Polio Eradication in Pakistan was underlined.
  2. Term missed children was defined for the benefit of the participants. Approaches in this regard were discussed with particular reference to adopting schools to locate missed houses and children with planned assistance of students and teachers of adopted schools.
  3. Rotaractors and Interactors can be usefully involved  in polio eradication.
  4. Role of Health Camps and procedure for assistance from Polio plus was brought out with clarifications in answer to points raised by participants. It was good to see clear understanding of the matter.
  5. Point 11 of the working paper was discussed as such with emphasis on efforts to ensure that established centers are working according to their charter and resolving deficiencies if required with the assistance of Polioplus. Opening of new centers to meet the community needs should be considered if feasible with a proposal to Polioplus for getting the act together.
  6. Rotary Clubs may assist in providing female volunteers in deficient areas.
  7. Group recommended that provision of articles of social mobilization to Rotary Clubs and Rotarians should be through and in consultation with the club Presidents.
  8. Areas without electricity such as desert of Tharparkar may be provided with solar refrigerators at vaccine centers.
  9. Strengthening and support of TPTS may be considered. It is time and cost effective for OPV coverage.
  10. It was emphasized that collaborations and working relationship with partners would be helpful at the district and taluka level. DHOs, TMOs and  WHO rep are important sources. Participation in Dpec  and Tpec was important.
  11. A Rotarian may be nominated. President may request to DCs and ACs to include a Rotarian in the committees if not done.

Group 2 Recommendations PP Dr. Pardeep Kumar

  1. That President elect will appoint Chairman Club Polio Plus committee and shall report the names of Chairman and members of this committee before 15th April 2015 to DGE 15-16 and Chairman Polio Plus committee
  2. This committee the will plan different Polio related activities and these will be incorporated in Club Planning guide for the year 2015-16
  3. Awareness programs regarding Misconceptions about Polio vaccines shall be organized in schools and different communities.
  4. DGE and PDG Aziz Memon will be requested if Polio Ambassadors, Dr Salman Ahmed and Shahid Afridi and other celebrities can be involved in different club activities in Karachi as well as interior of Sindh.
  5. PE will ensure to get name of Club Polio chair in DEPEC with DC and DHO .
  6.  The Club Polio Plus chair must visit PPTP once in month, irrespective of which club has sponsored it.
  7. Inclusion of chapter about Immunization and misconceptions about vaccination in slybuss of Primary schools.
  8. More cooperation with other agencies involved in Polio eradication
  9.  Recommendation must be sent to Home ministry at Both Provincial and Federal level to direct DCs to take actions against refusals by snatching their NIC, Driving license, blocking of cell phones.
  10.  Different clubs can join to form working groups to work jointly and more efficiently
  11. Some different angle must be now given to articles of social mobilizations.
  12.  More help and information from district is needed
  13. At least one permanent center for routine immunization must be included in club planning
  14. At least two health clubs may be planned in the year 15-16
  15. Involvement of Rotractors and other younger generation in these activities.

The Chair Literacy Committee PDG Faiz Kidwai presented a shield to Salman Ahmed for his support .

DGN Saleem Rao expressed his appreciation on a large turnover of Rotarians participating from Sindh and Balochistan. He thanked the delegates and PDGs, Rotarians and distinguished guests, and the National Chair for providing a forum to discuss and facilitate the involment of Rotary Clubs.

 

Report by: Alina A. Visram

Pakistan National PolioPlus Committee, RI

GAVI Global Commits $825 M for Child Immunization

Gavi Global

 

  • February 20, 2015
  • Published in Daily Times, Pakistan

 

ISLAMABAD: A high level delegation led by Global Alliance for Vaccines and Immunization, Chief Executive Officer, Dr Seth Berkeley and World Health Organization, Regional Director, Dr Ala Alwan met the National Health Services Minister Saira Afzal Tarar here on Thursday.
Ministry of National Health, Secretary, Muhammad Ayub Sheikh was also present on the occasion. The high level delegation included global and regional leaderships of Bill and Melinda Gates Foundation, UNICEF, USAID, UK Department for International Development (DFID), World Bank, and Saudi Arabia, Islamic Development Bank.
The Minister on the occasion shared that third party evaluation of the polio program has been initiated. The same monitoring mechanism will be instituted for routine EPI, she said. Lady Health Workers were being trained to deliver all EPI vaccines which will give a major boost to routine EPI coverage as there are over 100,000 lady health workers with access into homes and trust of the communities, said the Minister. She pledged that soon the international partners would see a sea change in the situation in terms of health indications.
GAVI Chief Executive Officer Dr Berkeley informed the minister that Pakistan was the world’s largest recipient of support from Global Alliance for Vaccines and Immunisation as the organization has committed 825 million US dollars support to strengthen immunization services and health systems in Pakistan. The support will be available for the next five years period till the year 2020. He emphasized that strengthening routine immunisation for children was critical to saving lives and an integral part of the strategy to eradicate polio. He pointed out that 2.7 million children in Pakistan were not being accessed by vaccine against nine preventable diseases for which efforts are required to effect a change in the situation.
WHO, Regional Director, Dr Ala Alwan pointing to the seriousness of the issue said there was need to address issues of staffing, capacity, financing and management in delivery of immunisation services. Bill Gates Foundation Global Development President, Dr Chris Elias said his foundation was pleased to support Pakistan’s polio eradication effort. He urged to do efforts for achieving MDG 4, which aimed at reducing child mortality by two thirds by 2015. He further added that increasing routine vaccination coverage would significantly contribute to decreasing infant and child deaths and achieving MDG4. He said the establishment of emergency operation centers for polio eradication at the federal and provincial levels with effective monitoring and coordination capacities impressed him.
Speaking on the occasion UNICEF’s Deputy Executive Director Dr Geeta Rao Gupta reiterated her organization support to protecting the health of children and mothers in Pakistan. “The need to improve routine immunization coverage in Pakistan cannot be over emphasized,” said Geeta. National Health Services, Secretary, Muhammad Ayub Sheikh said we are mindful of the challenges and have taken the right course to achieving our targets. The roles of the federation and provinces were being defined in the context of the post devolution scenario and strengthening sustainability of immunization services, he said. The speakers further said that they realise the challenges Pakistan faces regarding immunisation and are determined to make 2015 a turning point for the country in terms of immunising all children, especially those living in marginalized communities and hard to reach areas. The fact that nearly 400,000 children under the age of five die in Pakistan every year from diseases, which can be prevented through vaccine is simply not acceptable. These precious lives can and must be saved. They stressed the need for taking more innovative steps to improve Expanded Program on Immunisation (EPI) to routine immunisation as well as recruitment and training of qualified EPI personnel coupled with improved reporting systems.

What It Will Take to End Polio

TIME magazine online “What it Will Take To End Polio” Oct 2, 2014

http://ti.me/1xHR8l6

What it Will Take to End Polio

Jeffrey Kluger @jeffreykluger

Franklin Roosevelt never knew the Pakistani babies battling polio today, but he knew their pain. The world is fighting to end that suffering forever

 

President Franklin D. Roosevelt leaves his home at 49 East 65th Street for a short visit to his family estate at Hyde Park, north of New York City on Sept. 27, 1933.

President Franklin D. Roosevelt leaves his home at 49 East 65th Street for a short visit to his family estate at Hyde Park, north of New York City on Sept. 27, 1933.

You can still see the ramps and rails at Franklin Roosevelt’s house on East 65th Street in Manhattan—even though they’ve been gone for decades. They’re easily visible in the pictures that decorate the home. They’re visible, too, in the popular iconography of Roosevelt, who was photographed standing countless times after being paralyzed by polio in 1921, but always with a hand on a railing, an arm on an aide, a cane in his grip—and ramps and rails at the ready.

The six-story Roosevelt house, where the family lived from 1908 until their move to the White House in 1933, is now owned—and was restored—by New York’s Hunter College. These days it’s a place of learning and policy conferences. But it is also a place of historical serendipity.

“When the house was built, it was one of the first private residences in New York that had its own elevators,” Hunter president Jennifer Raab told me as we toured the building this morning. Those became indispensable once FDR became paralyzed, and it was in that house that his kitchen cabinet thus gathered in the four months between his election in 1932 and his inauguration 1933. “The New Deal was born here,” Raab says.

For FDR, there were abundant compensations for polio. As Ken Burns’ documentary The Roosevelts makes clear, the disease deepened and grounded him. It made him a champion of children with polio—an effort that led to the March of Dimes and the later Salk and Sabin vaccines—and for that matter a champion of all people who suffered hardship. It was polio that gave Roosevelt a fuller temperament—and in turn gave the nation a fuller Roosevelt.

There are no such compensations for the handful of children around the world who still contract the crippling disease. On the same morning I was making my visit to the Roosevelt house, word came out of Pakistan that the country is on target to top 200 polio cases in 2014, its biggest caseload since 2000. Pakistan is one of only three countries in the world where polio remains endemic—the other two are Afghanistan and Nigeria, with 10 and six cases respectively so far this year—and it’s the only one in which the caseloads are moving in the wrong direction.

As recently as 2005, Pakistan’s case count was down to just 28, helping to push polio to the brink of eradication. That same year, however, religious leaders in northern Nigeria declared a boycott of the vaccine, claiming that it contained HIV and was intended to sterilize Muslim girls. This led to a wildfire spread of the Nigerian strain that stretched as far southeast as Indonesia.

But Nigeria got its house in order, and the hot zone now—a more challenging one—has shifted to Pakistan, particularly in the tribal areas in the north and in the mega-city of Karachi. Some of the problem is simply the crowded, unhygienic conditions in Karachi. But the bigger piece is the fighting in the tribal regions, which have made vaccinations difficult or impossible. That’s been exacerbated by Taliban gunmen, who have shot and killed 59 polio field workers and police officers trying to protect them since 2012.

“It’s a very sad thing,” Aziz Memon, head of Rotary International’s PolioPlus team, told TIME by phone from Pakistan today. “We’re trying to get vaccinators on the ground and into the field despite the ban. And now rains and flooding that have broken 100-year-old records are creating more problems.”

Rotary, which has been the point-organization for the eradication of polio for more than 25 years, is being assisted by the Gates Foundation, Save the Children and multiple other international groups, all working to push back against the Taliban blockade. Vaccinators routinely wait at bus stops around Pakistan, climbing aboard and looking for kids who have no vaccination records and administering the drops on the spot. Refugee camps in the war torn tribal regions provide another way of standing between the virus and the babies.

“When the virus is contained like this it’s a good opportunity to step in and control it,” says Memon. “We can also take advantage of the low-transmission season, which starts soon.”

The effort to snuff out polio altogether is more than merely the moral thing, it’s also the practical thing. Bill Gates repeatedly stresses that $1 billion spent per year over the next few years can save $50 billion of the next 20 years, money that would otherwise be spent treating polio and constantly fighting the brushfire war of vaccinating against outbreaks. Eliminate the disease for good and those costs go with it. What’s more, the delivery networks that are put in place to do the job can be easily repurposed to fight other diseases.

None of this long-range thinking makes a lick of difference to the 187 Pakistani children—or the 10 Afghanis or six Nigerians—who forever lost the use of their legs this year. They are paralyzed, as they will be for life. For them, there is no offsetting wealth, no townhouse with an elevator, no path to global greatness. There is only the disease—a pain FDR recognized and fought to fix. In Pakistan, that same fight is being waged today.