TIME polio

The Battle to Eradicate Polio in Pakistan

A Pakistani health worker vaccinates a child in Islamabad
A Pakistani health worker vaccinates a child in Islamabad Anadolu Agency/Getty Images

Political unrest in Pakistan has been a gift to the poliovirus, with 99 cases reported there so far this year. But Rotary International, which has already vaccinated 2 billion children in 122 countries, is hitting back hard

Epidemiology can be all about geography—and that’s especially true when it comes to polio. If you live in the U.S., where polio was eradicated in 1979, the specter of the disease has faded almost entirely, though pockets of infections can occur among the unvaccinated. In Pakistan, however, things are moving in precisely the opposite direction, and have been for a while now.

One of only three countries in the world where polio remains endemic (the other two are Nigeria and Afghanistan), Pakistan had been close to joining the world’s polio-free nations, with only 58 infections in 2012. But thanks to bans on vaccinating—and deadly attacks on polio fieldworkers—by the Pakistani Taliban, the caseload rose to 93 in 2013. In 2014, the total reached 99 by July 18—a figure all the more alarming compared to this point last year, when there had been just 21 cases.

“It’s a scary number,” says Aziz Memon, Pakistani chairman of Rotary International’s polio eradication campaign. “Children in North Waziristan have been trapped for three and a half years without a drop of polio vaccine, and that’s what’s causing this.”

The folks at Rotary know what they’re talking about. Since launching their polio eradication effort in 1985, they have been responsible for the vaccination of 2 billion children in 122 countries. Along with the World Health Organization, UNICEF, The Gates Foundation and others, they have helped slash the global infection rate from 350,000 cases per year in 1988 to 416 in 2013.

That’s indisputably good news, but polio is an exceedingly sneaky virus, with 200 symptom-free carriers for every one case of the disease. That fact, combined with the anti-vaccine forces in Pakistan, not to mention the porous borders cause by war and unrest in the overall region, has caused the disease to leak out from the three endemic countries, with stray cases turning up in Equatorial Guinea, Iraq, Cameroon, Syria, Ethiopia, Somalia and Kenya. In a handful of other countries, the virus has been detected in sewage, but it has not led to any cases of the disease—yet.

It’s Pakistan though that’s considered ground zero, and Rotary has announced that it’s now deploying some very simple weapons in what has always been a village-to-village, door-to-door battle. To improve surveillance and tracking—a maddeningly difficult job in a country in which so many people live off the communications grid—Rotary has distributed hundreds of cell phones to midwives who circulate through communities, canvassing residents to find out who has received the vaccine and who has been overlooked. Information on the unvaccinated kids—the “missing children” in the fieldworkers argot—is entered into the phones and uploaded to a central spreadsheet, allowing later vaccinators to target their efforts more precisely.

“The midwives also track pregnant mothers,” says Memon. “And when their children are born they can continue to maintain complete health records, not just for polio but for other vaccines and basic health care as well.”

Rotary has also worked with The Coca-Cola Company to build what’s known as a reverse osmosis water plant—essentially a sophisticated filtration facility—in the town of Malin, within the city of Karachi. Polio is a disease spread almost entirely by human waste, and once it leeches into the water system it can spread nearly anywhere. The Malir plant, which was constructed near a school to give polio-age kids the first access to the newly filtered water, is a relatively modest one, with just 20,000 gal. (76,000 liters) of clean water on hand at any one moment, and cost only $40,000 to build. But as a pilot project it represents a very good start. “We can’t build a massive plant like the government can,” says Memon. “This is a small plant for a small community.”

One thing, paradoxically, that’s working in the vaccinators’ favor is the increased number of displaced people in Pakistan. A recent push by the Pakistani military to flush the Taliban from its safe havens has broken the vaccination blockade, and already 350,000 children have received at least one dose of the polio vaccine. But 1.5 million refugees are scattered around the country. Rotary has dispatched field workers to refugee camps and transit points to identify the children and few adults who need the polio vaccine and administer it on the spot.

“The government did not have any idea about what the numbers of displaced people would be,” says Memon. In the refugee camps, he adds, there are at least 40,000 pregnant women, whose babies will have to be vaccinated shortly after birth.

The diabolical thing about polio—and indeed any disease science hopes to eradicate—is that even one case is too many. As long as any wild poliovirus is out there, everyone needs to be protected. It is only when the last scrap of virus has been found and snuffed, that the protective push can stop. That has happened once before in medical history—with smallpox. In the case of polio, it’s tantalizingly close to happening again.

TIME Pakistan

Officials: U.S. Drone Strike in Pakistan Kills 6

(DERA ISMAIL KHAN, Pakistan) — A suspected American drone fired two missiles at a compound in a troubled Pakistani tribal region on Thursday, killing six militants, two intelligence officials said.

The strike happened in the town of in Datta Khel in North Waziristan, where Pakistan army last month launched a much-awaited operation against local and foreign militants who use the region to carry out attacks in Pakistan, the officials said.

The identity of the slain men was not immediately known and the officials said they were still trying to get details. They spoke on condition of anonymity because they were not authorized to speak to the media.

U.S. drone strikes are a serious source of tension between Washington and Islamabad. The Pakistani government regularly denounces the strikes as a violation of the country’s sovereignty.

Thursday’s strike took place in the same region where the Pakistan army on June 15 launched a major offensive against Pakistani Taliban, al-Qaida and other militants. Datta Khel is about 50 kilometers (30 miles) west of Miran Shah, the main town in North Waziristan bordering Afghanistan.

TIME Pakistan

Pakistan’s New Antiterror Law Gives Security Forces Unprecedented Power

Pakistan
Pakistan army troops arrive at Karachi airport following an attack by unknown gunmen, disguised as police, who stormed a terminal used for VIPs and cargo, Sunday night, June 8, 2014. Fareed Khan—ASSOCIATED PRESS

The law permits the arrest of terror suspects without warrants and their detention for 60 days without trial. Officials will also be able to issue shoot-on-sight orders

In an effort to curb the increasing audacity of Islamist militant groups in the country, Pakistan’s parliament passed a comprehensive counterterrorism bill on Wednesday that gives unprecedented powers to domestic security forces.

The legislation, called the Protection of Pakistan Bill 2014, has drawn the ire of human-rights groups for its rigor and breadth. Under the new law, the national government can not only arrest suspected terrorists without warrants but also detain them for 60 days without any discussion of trial.

More controversially, it permits police and other security officials to issue shoot-on-sight orders.

“This is perhaps the strongest of the laws that Pakistan has come up with to deal with militancy and terrorism,” Irfan Shahzad, a researcher at the Institute for Policy Studies in Islamabad, tells TIME. “I would not say that outright it is a violation [of human rights], but it certainly raises questions over what rights we Pakistanis have as citizens of this country.”

Thousands have died since the Pakistan Taliban began its present insurgency in 2007, and Islamabad has frequently struggled to contain the bloodshed. It is currently taking the fight to the insurgents in the mountainous region of North Waziristan, but the offensive has sparked a humanitarian crisis, displacing nearly half a million people.

Shahzad says the new legislation has been born out of increasing frustration. “If a government fails to deliver,” he says, “they resort to certain actions that they believe will increase their command over certain groups.”

Among the provisions of the new law are the granting to security forces the power to search premises without warrants, the allowing of tapped phone calls as court evidence and a steep increase in prison sentences for terrorist offenses. While the bill has vocal critics, Shahzad believes that it will be accepted by a population exhausted by years of conflict.

“We’re talking about a country where the literacy rate is just over 50%,” he says. “Even among those who are literate and who read the news, they are very much hard-pressed by the matter of their own survival. [This law] may not necessarily be a major issue to them.”

TIME

Pakistan Vows to Eliminate Terrorist Sanctuaries

ISLAMABAD— A Pakistani military operation launched in the country’s northwest will clear the area of terrorists and keep it from being used as a safe haven by militant groups, officials said Tuesday.

Pakistani officials briefed foreign media about the operation started two weeks ago against militants in the North Waziristan tribal area, which is considered the stronghold of groups such as the Pakistani Taliban, the Haqqani network and the Afghan Taliban. The long-awaited operation is being closely watched to see how aggressively Pakistan moves against the militants and whether the operation sparks a backlash of violence in the rest of the country.

“Once we are done with the operation in North Waziristan, there won’t be a single terrorist,” said military spokesman Maj. Gen. Asim Saleem Bajwa.

The U.S. has long urged Pakistan to send troops into North Waziristan because the region had become a safe haven for groups who attacked American and Afghan forces in Afghanistan. It’s also become a hub for militants intent on overthrowing the Pakistani government who have used it as a base from which they’ve launched attacks on civilian and military targets across the country.

The U.S. has been especially concerned about the Haqqani network, which has been accused of carrying out some of the most deadly attacks in Afghanistan. U.S. officials have accused Pakistan in the past of supporting the militant group and others as a way to maintain influence in Afghanistan.

Since the operation was launched in North Waziristan, one of the questions has been whether the Pakistani military would go after all militant groups equally. Officials Tuesday said they would not discriminate.

“We will not permit anybody to use the soil of Pakistan against another country — Haqqani or no Haqqani,” said the Minister of States and Frontier Regions, Abdul Qaudir Baloch.

Officials also called on neighboring Afghanistan to act against militants who attack Pakistan from Afghan soil, including the leader of the Pakistani Taliban. Both countries have accused the other of harboring militants, but in recent months cross-border tensions have flared over accusations that Pakistani Taliban militants, including the leader of the group, are in northeastern Afghanistan.

“This has been raised at every level, that the leader of the TTP, Mullah Fazlullah is sitting across the border,” said Bajwa, referring to the Pakistani Taliban’s formal name — Tehrik-e-Taliban Pakistan. “Afghanistan needs to do something about it.”

The officials declined to give a timetable for how long the operation would last, but analysts have said it could be months.

Nearly half a million refugees fled North Waziristan in a mass exodus that has sparked accusations that the government was not prepared to deal with the humanitarian crisis. The United Nations reported Monday that almost 100,000 people have also fled from North Waziristan to neighboring Afghanistan.

Officials Tuesday at the briefing disputed those figures and said the numbers were lower but declined to give any specific figures.

TIME Pakistan

Unbelievably, There Are Now Refugees Fleeing to Afghanistan

The Pakistani military’s offensive against insurgents in North Waziristan has sparked a humanitarian crisis, with thousands of Pakistanis concluding that Afghanistan is just a far safer place to be right now.

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The Pakistani military has begun operations against Islamic insurgents in the North Waziristan region, delivering the offensive that Washington has been requesting for a decade, and sparking a massive exodus of refugees — some of whom are fleeing to neighboring Afghanistan to escape the fighting.

Militants, who have long inhabited the mountainous tribal area, have found themselves the target of heavy artillery bombardment and airstrikes for the past fortnight, in what the military’s PR chief Major-General Asim Bajwa termed “the beginning of the end of terrorism in Pakistan.”

Reports began to surface on Thursday in the Pakistani press that ground troops had started moving into North Waziristan to clear out the insurgent forces.

Washington says militants have been using North Waziristan for years as a base from which to attack NATO forces in Afghanistan and to wage a terrorist insurgency against the Pakistani state.

Senior members of the Pakistani Taliban (the Tehreek-i-Taliban Pakistan), the Haqqani Network and Al Qaeda’s central command — along with a smattering of militants from as far away as western China’s Xinjiang province and Chechnya — are believed to be holed up in the area. All are on Islamabad’s kill list.

“For the military, there’ll be no discrimination among Tehreek-i-Taliban Pakistan, Haqqani network or any other militant group,” Major-General Bajwa told reporters during a press conference in Rawalpindi on Thursday.

The mountainous border dividing Pakistan and Afghanistan has been home to martial tribes for centuries. However, the presence of heavily armed insurgents and foreign jihadis is the notorious legacy of American and Saudi intelligence agencies, who used the fighters as proxy forces during the clandestine war with Soviet troops occupying Afghanistan in the 1980s.

“This is famously the powder keg, which has led to everything going wrong in the region and the beginning of heavily armed militant Islam,” William Dalrymple, the historian and author of nine books on South Asia, tells TIME. “Obviously in retrospect [it’s] one of the great mistakes of American foreign policy.”

The Pakistani secret service (ISI) is alleged to have helped insurgent elements fleeing the U.S. invasion of Afghanistan in 2001, using those militant groups to maintain pressure on the newly formed government in Kabul, which they believed harbored pro-Indian sensibilities.

“The Pakistan Army, or elements within ISI, always continued to support the Taliban as a way of getting rid of the Karzai government and a way of installing a pro-Pakistani Taliban regime in Kabul,” says Dalrymple.

That policy appears to have backfired. In 2007, the Pakistani Taliban launched a fresh insurgency against Islamabad that to date has been responsible for the deaths of tens of thousands of Pakistanis and at least 15,000 security personnel.

Prime Minister Nawaz Sharif campaigned last year on the promise of peace talks with the Taliban, but any hope of negotiations has been extinguished by a recent string of humiliating attacks, including a brazen assault on Karachi airport, deep in the country’s commercial hub.

The perennially stretched Pakistani state is now attempting to deal with the massive humanitarian fallout from the new offensive. In the less than two weeks of fighting, more than 450,000 people have been internally displaced. Officials estimate that the number will surpass 500,000 soon.

In a bizarre reversal of the norm, tens of thousands of Pakistanis have reportedly flooded into war-torn eastern Afghanistan to escape the fighting on the Pakistan side of the border.

“The [Afghan] government estimates there are over 60,000 thousand for now,” says Babar Baloch from U.N.’s High Commissioner for Refugees.

The exodus has also ignited fears that the polio epidemic rampant in North Waziristan for two years could spread to other parts of the region.

Meanwhile, analysts have already begun to criticize the new military campaign for not being part of a broader vision of Pakistan’s future.

“There isn’t yet a clear national strategy,” says Shuja Nawaz, director of the South Asia Center at the Atlantic Council. That means “operations are going to be tactical at best.” He adds: “The civilians were not brought in at the planning stage. And they’re not prepared in any way to take over from the military once the clearing has taken place.”

TIME Pakistan

Cannibal Brothers in Pakistan Sentenced to 12 years in Prison

Mohammad Arif sits in a police custody at a police station, in the town of Darya Khan
Mohammad Arif Ali, 35, right, sits in custody at a police station in the town of Darya Khan in Bhakkar district, Pakistan's Punjab province, on April 14, 2014. Reuters

They dug up a small child and cooked him in a curry

Two Pakistani brothers have been sentenced to 12 years imprisonment after the skull of a young boy they exhumed and devoured was discovered in their home.

An antiterrorism court in the state of Punjab found Mohammad Farman Ali, 30, and Mohammad Arif Ali, 35, guilty of defiling a grave, destroying property and disseminating fear. No laws specifically against cannibalism currently exist in the country. The brothers will be able to file an appeal at the Punjab high court, the BBC reports.

The pair had previously served two years in prison after being convicted of digging up and eating more than 150 bodies from a nearby cemetery in 2011. After they were released in May 2013, they quietly resumed their lives until neighbors in their small village of Khwawar Kalan complained to police about the potent smell of rotting flesh wafting from their home.

A police search on April 14 revealed the head of a 2-year-old boy who had been buried in a nearby grave. The brothers later admitted to digging up the corpse of a child and cooking him in a curry.

TIME Pakistan

After Sunday’s Siege of Karachi Airport, Pakistani Militants Strike Again

No deaths were reported and flights have now resumed

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Militants ambushed the campus of a training academy belonging to Pakistan’s Airport Security Force (ASF) on Tuesday afternoon and exchanged fire with security forces.

No one is believed to have died in the attack, although local media is reporting several wounded.

Pakistan’s Geo TV says the situation is now under control and security forces are conducting a door-to-door search of the area to apprehend the assailants.

The academy lies near Karachi’s international airport, which was under siege by Pakistani Taliban militants on Sunday night. Some 36 people died in that attack, including 10 Taliban gunmen

The Associated Press quoted Ghulam Abbas Memon, a spokesman for the ASF, saying Tuesday’s assault involved gunmen trying to enter the campus from two different entrances but who were repelled by security forces.

An AFP report had earlier quoted an ASF official spokesman as saying gunmen exchanged fire with security personnel at a checkpoint half a kilometer from the airport.

The assault is believed to be in retaliation for Pakistani military air strikes on a tribal district earlier Tuesday that killed 15 militants. Those strikes were, in turn, apparently in response to Monday’s airport attack.

All flights from Karachi’s international airport were briefly suspended but have now apparently resumed.

TIME Pakistan

Karachi Airport Witness Describes ‘Pure Chaos’ of Attacks

PAKISTAN-UNREST-KARACHI-AIRPORT
Smoke rises after militants launched an early morning assault at Jinnah International Airport in Karachi, Pakistan on June 9, 2014. Rizwan Tabassum—AFP/Getty Images

Kamal Faridi, a 29-year-old entrepreneur from Karachi, told TIME what it was like to be caught up in the Taliban assault that left at least 23 dead

Taliban gunmen besieged Karachi airport on Sunday, killing at least 23 people. Kamal Faridi, a 29-year-old Information Technology entrepreneur based in Karachi, was traveling to Germany via Dubai on Sunday night and got caught in the melee.

Faridi had checked in for his Emirates flight around 11pm on Sunday, and was waiting in the lounge for the boarding announcement. “Suddenly we heard some gun shots, which we thought were fireworks,” Faridi told TIME. “Then we saw the security forces taking position outside the lounge.”

“They asked us to lie down on the ground and hide ourselves against the furniture as the lounge was covered in glass. In another 10-15 minutes more security personnel had arrived and huddled us to another room.”

“Initially there was pure chaos as we didn’t know what was happening and everyone thought they were going to die. Within ten minutes we were told of the terrorist attack.”

The commandos told Faridi and his fellow travelers that some unidentified gunmen had taken control of the old terminal – which is more like an administrative wing and only caters to VIP and Hajj flights – which lies 2-3 kilometers away from where Faridi was waiting to board his flight. The old terminal had no passenger flights, fortunately.

Faridi said a “resigned, even fearful calm” fell upon the room where they were waiting. “Apart from the whimpers of children, it was quiet, only to be broken by a loud cheer of ‘Allahu Akbar’ when we heard on the security force wireless that a few of the terrorists had been shot down.”

“We were instructed not to receive calls or take pictures,” he said. “We lay crouching on the ground for almost 4-5 hours, by which time the security forces had announced thrice that they would evacuate us, but weren’t able to.”

“Crouching on the ground, shutting my ears and sometimes eyes tightly, I could still see the flashes of gun shots. They would stop for a second and it would all be a deathly quiet before it would start again in an interminable shower.”

Around 3.30am one of the officers came to evacuate Faridi and his co-travelers. Shaken, Faridi went straight home.

“In Pakistan it’s almost a war situation. Everyone knows anything can happen any moment and we are prepared for any eventuality,” he said. “But it’s different when you find yourself in the middle of a terror attack. The five-hour ordeal was a trauma for me. If I close my eyes I can still hear the shots ringing out and I jump in my mind.”

TIME Pakistan

The Attack on Karachi Airport Shows That Nowhere in Pakistan is Safe

Smoke billows from Jinnah International Airport in Karachi
Smoke billows from Jinnah International Airport in Karachi on June 9, 2014. Athar Hussain— Reuters

The Pakistan Taliban's strike at the heart of the country’s commercial capital is a brazen demonstration of its powerful reach

Insurgent violence exploded in Karachi again on Sunday. Armed militants rocked Pakistan’s largest city in an attack that was as gruesome as it was symbolic as terrorists proved their ability to penetrate deep into the country’s commercial nerve center, far from their tribal strongholds.

At least 28 people were killed during the fighting at Karachi’s Jinnah International Airport after militants disguised as policemen stormed one of the facility’s terminals.

“The ghastly attack on Karachi airport is symbolic, for it aimed to convey a message to the Pakistani state as it plans to fight the Pakistani Taliban,” Raza Rumi, a U.S.-based Pakistan analyst and senior fellow at Jinnah Institute, told TIME. “The choice of Karachi is also strategic as the act of terror gained global attention.”

Conflicting reports swirled early on Monday as authorities claimed to have killed at least 10 militants in the retaking of the hijacked terminal, while accounts of fresh gunfire continued to raise doubts over whether all the terrorists had been cleared from the besieged building.

Pakistani officials identified the militants as foreigners, with reports surfacing that the gunmen were ethnic Uzbeks or Chechens. No independent confirmation of the militants’ nationalities has been confirmed.

The Pakistsani Taliban, or Tehreek-e-Taliban Pakistan, took little time in taking credit for the assault.

“It is a message to the Pakistan government that we are still alive to react over the killings of innocent people in bomb attacks on their villages,” Shahidullah Shahid, a Taliban spokesman, told Reuters.

Shahid also claimed the assault was payback for the killing of the group’s former leader Hakimullah Mehsud, according to the Pakistan affiliate outlet of Newsweek. Mehsud was killed during a U.S. drone strike in Pakistan’s tribal areas last November.

“[The] Pakistani Taliban are now far more dangerous, lethal and well equipped than the Afghan Taliban,” said Hassan Abbas, a senior advisor at the Asia Society and author of The Taliban Revival.

“[The airport attack] shows their depth and networking in Karachi and even penetration in the Karachi airport. They entered from the gate which is used by top government and foreign dignitaries — supposedly the most secure.”

Prime Minister Nawaz Sharif’s government rolled out a preliminary peace process earlier this year to kickstart talks with the rebel outfit, aimed at bringing an end to seven years of insurgency that has claimed thousands of lives.

However, the process has been continually bucked by ongoing attacks from the group, along with the military’s recent targeting of insurgent strongholds in Pakistan’s federally administered Tribal Areas.

In late May, the Pakistani military ordered a series of airstrikes targeting Taliban hideouts in Northern Waziristan, killing 30 militants. On Monday, the Taliban’s spokesperson rejected Islamabad ’s peace talks as a “tool of war.”

— With reporting by Nilanjana Bhowmick / New Delhi

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