05 June 2007
by James McCarten
The World Health Organization, UNICEF and the Canadian International Development Agency are among the partners in an ongoing effort to push polio out of Afghanistan, one of only four countries in the world where conflict and poverty have conspired to allow its resurgence.
Two recently confirmed cases in the southern part of the country prompted Sunday's start of a special round of vaccinations. Volunteers braved the perils of Kandahar city by going door-to-door and administering two drops of oral vaccine to every child under the age of five, said Arshad Quddus of the WHO's Kabul office.
"The objective is to interrupt the transmission of this virus, which is only now confined to the two provinces in this country," Quddus said in an interview at Kandahar city's dilapidated Mirwais Hospital.
"If we can interrupt the transmission in these remaining two provinces, there is a very bright chance for Afghanistan to become polio-free."
Over a rickety table at the hospital's main entrance, a steady stream of parents surrendered wailing children to a friendly, wizened old man, who gently squeezed open the mouths of the less co-operative youngsters, dispensing his vaccine with a toothy grin.
He then used a black felt-tip pen to crudely mark a tiny fingernail to identify a vaccinated child.
Beyond the relative safety of the hospital gate, burka-clad volunteers banged on rusty tin doors and asked family members to round up youngsters, using chalk to make Pashto markings on the wall to indicate an immunized household.
Others in the entourage cast edgy glances up and down the dusty, mud-walled alley, well aware that Kandahar remains in the grips of a security alert in the wake of last week's deadly Taliban bombings, which targeted police and government officials.
"It's very challenging work, particularly considering the security situation," Quddus said. "One of the biggest challenges is inaccessibility in some of the seriously security-compromised areas."
Polio is a highly contagious, incurable viral infection of the nervous system, which can cause crippling paralysis or even death within hours of infection.
At its peak, polio paralyzed and killed up to half a million people every year, before Jonas Salk discovered a vaccine in 1954.
Afghanistan is home to an estimated 7.3 million children aged five and under. The current campaign aims to vaccinate 1.2 million of them in the provinces of Kandahar and neighbouring Helmand, including 350,000 children in Kandahar city alone.
Many of those in the city are orphans or living on the street, which poses its own challenges, Quddus added.
"We try to make sure to catch all these children, who are probably at a high risk of being missed," he said. "We have teams at the bus station, we have teams in the markets and in the streets, to vaccinate those children, and we have special teams for the nomads."
Indeed, even a country as racked by war as Afghanistan seems at times overrun with children.
They chase barefoot after coalition convoys or tug on sleeves at the weekly bazaar, trying to lure off-duty soldiers to their trinket-laden tables. In the villages, they lurk warily behind the billowy folds of an elder's shalwar pants, emerging only to accept an offer of candy or a toy.
They're the lucky ones.
"A great many of them are just in the streets, and they scrounge, or they starve," said John Manley, a former deputy prime minister in Jean Chretien's Liberal government and now a member of CARE Canada's board of directors.
"It's just another of the countless problems this country faces . . . . It's a problem that doesn't have a lot of people working on it, as far as I can tell."
Manley spent much of last week in Kabul, grounded by sandstorms that thwarted plans to look for potential projects for CARE Canada to support in and around Kandahar, a part of the country where it has relatively little activity.
During his visit, he consulted a focus group comprised of local women about what they considered the most pressing aid priorities.
"One of the top items was classes in literacy," Manley said. While only two or three out of the group of 25 had literacy skills, all of them had children in school, "including all of the girls," Manley added.
"This is pretty good progress, considering where we were five years ago, when no girls were in school."
Orphans were also high on the group's list, he said. "That was one of the other concerns - what about the children with no parents?"
Just down the road from the rusty MiG fighter that guards the gate to Kandahar Airfield, a 30-year-old man named Hekmatullah - like many Afghans, he uses only one name - operates the Shaheed A. Ahad Karzai Orphanage, which runs largely on determination and coalition generosity.
In the last five years, the facility, which operates as an elementary school during the day and an orphanage by night, has swelled to about 360 day students and 40 dirt-poor children who are permanent residents. There are 32 staff members, including 12 teachers.
Three years ago, the U.S. provincial reconstruction team began rebuilding the facility with the help of the Afghan National Army. Last year, Canada's PRT provided chairs, tables, freezers and school supplies, and recently delivered a shipment of blankets and shoes, said Canadian Forces spokesman Lt. (Navy) Desmond James.
"In orphanage, they can make their future, they can get a good education, and they could be saved from drugs and other bad activities," said Haji Ghani, a local Kandahar resident who supports Hekmatullah's work.
"The orphanage should be supported by the Afghan government and Canadians as well. It is a very important place and it needs very much attention from Canadians."
For Manley, it's one more reason why Canada shouldn't be in a hurry to pull its troops out of Afghanistan. CIDA has already invested more than $1 billion here, including $5 million for the polio campaign, and the investment demands continued nurturing, he said.
Manley said he's been frustrated with the character of the political discourse surrounding Canada's mission in Afghanistan, and called on all sides to abandon the partisan bickering and give the issue the careful consideration it deserves.
"It's not something for passionate debate, but something to be carefully reasoned out and discussed with our allies in terms of what we should do," he said.
"We spend a lot of time trying to determine Canada's place in the world. When we find one, we shouldn't be too quick to abandon it."