Welcome and thank you
for joining us for Beyond the Data.
I'm Dr. Phoebe Thorpe.
This is a follow-on session
for our CDC Public Health Grand Rounds today
about eradicating global polio.
With me today is Dr. Elias Durry.
He's come halfway around the world from Pakistan to join us.
Thank you very much for joining us.
Elias: Thank you for having me.
Thorpe: In the session today we heard
about India has been polio free for four years.
Nigeria's working on six months, Somalia and the other countries
in the Middle East also six months, polio free.
There are many other important public health issues
that need to be addressed.
Why is eliminating polio now so important?
Elias: There is a strategy that has been working
for all countries and they made sure that,
that polio eradication can be achieved with a very strong
and well tested strategy.
So the tool is the strategy is there so yes there are a lot
of other public health issues, but the benefit
of eradicating polio is also in many forms
than just controlling it.
But, in really saving money from what it took to prevent it
or to treat, not to treat it actually,
just to rehabilitate it.
And also the few issues that poor education has brought
into the public health arena,
that by itself also is really very, very, strong.
You may have heard, you know when there was an Ebola case
or Ebola fear in Nigeria,
the system that is being used is the polio eradication system.
And of course you know you talk
about strengthening surveillance system, strengthening
in a community mobilization systems
but the polio is encumbering in and so it is a worthwhile effort
which actually is proving that the given
if it was a little bit difficult
in the past decade, that it is doable.
Thorpe: Can you tell our audience a little bit about some
of the difficulties you've had working where there isn't
as much political support as you would like to have?
Elias: The number one thing is
when we do the campaigns you have to remember.
We have to go every household, to every household.
We have to reach every child.
So it's not, it's not that we will do small work here
and then come, you know, later and do, but at the same time
within a few days we have to reach every household
so you can imagine what it needs to be able to implement that.
And that's also not straight forward public health issues,
you know you have to deal with the community, you have to deal
with the politicians, you have to deal with you know everything
that you can imagine and mostly whether it is in Pakistan
or Nigeria sometimes we have to immunize
like 35 million kids in three days.
So, imagine what it takes.
So here is where, when everybody becomes, has to become Minister
of Health, a politician, the community,
the religious leaders and so on.
So it requires really a bigger coalition to work with,
and if any of them are really not in place,
then you will find some difficulties,
not that you'll not be able to do it, but then,
the more support you get from all corners of the community
and all arms of the government the easier it is
to find these children regularly.
By the way, the next thing also is that it's not that we have
to immunize all, each house every time, we have also
to do it multiple times, so it's not a one-time deal
that we just go and immunize and go away like what smallpox used
to be, because one injection of smallpox was enough,
but here we have to go back
to the same place again and again and again.
So you have to have a solid support across the board
of the society and community.
Thorpe: One of things that we also heard today was that all
of the countries that have had polio
in the last few years have had difficulty
with security problems.
What are some of the challenges that you face when you
when you have political instability or insecurity
in the areas that you work?
Elias: It's really a very, very, very difficult situation
where you really have to think about, you know, whether or not,
you know, whether the vaccinators each day comes back
home or not.
We had about 200,000 vaccinators.
I think each drop that they gave probably is really a difficult
thing to do, people say these days
that probably the most dangerous work in Pakistan.
But it is really encouraging also to see that,
these vaccinators just keep coming out and going out
and vaccinating the children.
We're not exaggerating if we say
that this is really a Nobel prize worthy activity.
This has not been for two years and it has
and it has never slowed down,
but these vaccinators keep going out.
You know I think all of us all these,
these vaccinators make sure that this disease is eradicated
but by looking after the children who have nothing to do
with all these things, with all this problem that they see
around them and also for by looking at these vaccinators
who really truly give their life
for the children of their own country.
It's a very difficult job but someone has to do it.
And I think it's not that they are forced to do it,
but they choose to go out and do it again.
In the meantime, the government also tries
to give them a secure environment
where they could work.
But also here is where we said earlier you need working
together of one of the different government and society,
you need, you may need to provide security
but religious leaders also has to play their role,
community has to play their role, and so on.
It is really a multifaceted approach that just basically
to have a safe environment to immunize...
Thorpe (interrupts): Even to work, yes....
Elias: It is very interesting to say this way,
but that's what it is, just looking for a safe environment.
Not just by walking around with guns with them but also
to make the community accept them immunization,
protect the vaccinators.
And really save the children of that country
and also respect the vaccinators who are going out
and giving their life for the cause.
Thorpe: Can you give our audience sense
of how much security you have to provide and some of the things
that you've done to provide that security?
Elias: Security...well just as an example in the old days
when we used to go and supervise how the campaign was going on,
we used to work from health center to health center.
Now we work from police station to police station.
It's unfortunate but that's the truth.
Also the, what really makes the problem much more serious is
that where there is a security problem is
where there is also the virus circulating.
So it's a double whammy in a sense that, you know, you can't,
this is not a place that you can just leave it
because their security is not good.
But unfortunately the virus is also there.
Thorpe: I really admire all that you're doing and I wonder
where do you find the courage to go in every day?
Elias: I think it comes by just thinking about, you know,
those children who are really would be deprived
if you don't do what we do.
Of what they need.
It would be a disaster if just
because of this reason the polio resurgence can be,
you know, seen everywhere.
So we really need to protect the children,
those innocent children, to make sure
that this this this program really reaches this logical
conclusion of stopping the transmission.
But also those ones who actually go out and do this job day
after day, I mean, we just cannot turn away from them
and say, okay, you know, I've done my part.
I think our part will be finished
when we finish what they started so we must go ahead
and we must have to do it we don't have any choice.
Thorpe: Thank you for coming in and joining us.
Elias: Thank you very much
but I think before I finish I just want to say
that in our journey, you know, we are just the few ones
that I think really the unsung heroes are still even today
they're out there immunizing kids with some major threats
so we need to thank them.
Thank you.
Thorpe: Elias, thank you for the work
that you do, it's very important.
And, thank you for joining us today and thank you
for joining us today for Beyond the Data.
Please join us for the next session.