Tajikistan fends off polio outbreak risk

MACHITON, Tajikistan (AlertNet) –Doctors in Tajikistan are working with increased urgency this year to vaccinate youngsters against polio after an unexpected outbreak of the disease in 2010 killed and paralysed scores of children.

Teams of medical staff, organised by the Tajik Ministry of Health and the World Health Organisation (WHO), have travelled to remote villages across the country to vaccinate 95 percent of children under 15, compared with about 87 percent in 2008.

Stephen Chacko, a WHO doctor based in the Tajik capital Dushanbe, said polio in the country had slipped below the radar and taken people by surprise. People believed that it had been beaten.

“Some people had become complacent,” he said. “The speed of the outbreak was quite alarming.”

About 500 cases of polio were confirmed during the 2010 epidemic in the impoverished former Soviet state bordering Afghanistan.

Many of the young children who did survive last year’s epidemic now have to face life with limp, paralysed arms and legs.

At a children’s rehabilitation centre in the village of Machiton, about 20km outside Dushanbe, 7-year-old Kholikova Dilshoda lies in a hospital bed, her right arm deformed and motionless. She lives in Bokhtar, a village in the south of the country and was supposed to start school this year.

“But how will she carry her books?” her mother, Hairi, said as she looked at her daughter’s limp right arm. “Many doctors have looked at her but they have all said there is nothing they can do.”

Polio primarily affects areas with poor sanitation, spreading quickly through human contact and contaminated water.

The virus has been defeated in the Western world and in much of developing world too, and until last year’s outbreak Tajikistan had been declared free of the disease.

At one point, the outbreak in Tajikistan was considered so serious that Russia banned Tajiks under 6-years-old from entering the country. An editorial article in the Canadian Medical Association Journal in June 2010 said the outbreak in Tajikistan accounted for three-quarters of all new polio cases in the world.

The children’s rehabilitation centre outside Dushanbe is set amongst hills and trees. About 20 children recovering from polio are staying at the centre. The smell of burning candle wax hangs in the air, the gentle rhythm of playing children and chatting mothers hums in the background.

Samariddin Shoev, director of the centre, said that through exercise and massage, treatment does improve the lives of the children living with the effects of polio.

But it is still traumatic for everybody.

“The outbreak shocked the country,” he said. “Polio is a tragedy for every family. They will have to support the victim for the rest of their lives.”

UNUSUAL CASES

WHO, the Tajikistan’s Ministry of Health and other international organisations launched a vaccination drive when the severity of the outbreak became obvious and by December last year there had been no new polio cases for six months and they declared it over.

One of the most unusual features of the outbreak was that it infected people who were far older than those usually taken ill in polio epidemics. The oldest person infected was 51.

Marbori Hamidova is 19-years-old and stands out in the ward because of her age. Polio partly paralysed her legs but with training at the centre she has got some strength back.

“I could not walk for nine months and now I can,” she said. “Though, it still takes four or five people to help me go down the stairs.”

WHO said that one of the main reasons for the outbreak was unregistered Tajik children in Kazakhstan and Russia who did not receive a vaccine.

But it is a constant battle in a country that neighbours Afghanistan, where polio is still an issue. Nearby Pakistan, and India, are also battling the disease.

“People are aware of the issue and for the next few years they will be alright,” said Chacko, the WHO doctor. “But they must not relax.”

 (Editing by Rebekah Curtis)