Author Jawahir Habib, March 8 2014:      "My husband hit me in the morning, he was asking for money," said a Lady Health Worker (LHW), Nadia, in Kili Shabo area of Quetta (South-west of Pakistan). "I have not received my polio immunization days payments for past four campaigns, my husband thinks I go out of house for some other purpose," she added with tears in her eyes.

In 2011 there was a massive outbreak in Balochistan province of Pakistan, 40% of the cases were reported from the province where 78% of the cases were from three districts Quetta, Pishin and Killa-Abdullah known as Quetta Block.

6,000 polio workers are engaged in the polio campaigns in Balochistan; they go door to door to vaccinate children. Less than half of these workers are women, with their peculiar issues and challenges.

The status of women in Balochistan is appalling, with the highest maternal mortality rate (MMR)  in the region which is similar to Sub-Saharan countries, female literacy rates below 30% and a female unemployment rate of 37%. For the female polio workers in Kili Shabo, things are no different.

"I come out of my home to earn some money for my disabled child," says Shaida, a polio worker waged as a volunteer, "I have 6 children, and my husband doesn’t want to provide any money for the medicines of my disabled child, I have to do it myself," she adds.  She was also not paid for the past few campaigns.

The workers also talked about the attitude of the community, as working women are not culturally accepted and the role of women in the tribal and religious society is established as limited to the house. "They say you are out of your homes to make boyfriends," said Nadia, "Some men think we are here to spoil their women, they call us bad names," she further elaborated.

The delayed payments, lack of transport facilities and harassment lead to a high turnover of female polio workers. Female participation in polio campaigns is critical to the program, as they can access the children inside households, talk with the mothers and vaccinate the children under 5, particularly the neonates.

The polio teams receive about US$2 as a daily wage for their work in polio campaigns, and the LHWs, who are a part of National Program for Primary Healthcare, earn just 70 dollars monthly for their numerous community health services. The payments and salaries are never on time; the issue has been raised in the media frequently; there are strikes, meetings and promises, but the problem lingers on.

More than 20 polio vaccinators, most of them women, have lost their lives in Pakistan due to terrorist attacks. These women workers are our unsung heroes because they fight against cultural taboos, corruption and harassment every day. All of them have simple needs: health and education of their children.

The polio cases have dramatically dropped from 73 in 2011 to 4 in 2012, and no cases in 2013. However, Balochistan still remains at risk due to persistent low quality of campaigns, extensive population movement and pockets of chronic vaccine refusals.

(The blog is dedicated to all the women who work for Polio Eradication Initiative in Balochistan)

Note: Names of the female polio workers have been kept confidential and changed into fictional names upon their request.

Disclaimer [from this blog's author, Jawahir Habib]: Views and opinions of this blog represent my own and not those of people, institutions or organizations with which I am affiliated, unless stated explicitly. My blog is not affiliated with my employer; nor does it represent the employer's views, position or attitudes.