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Enemies and epidemics

Publication Date : 25-07-2012


The US House of Representatives issued a statement on July 19 blaming the UN for an outbreak of cholera in Haiti.

In their letter to Susan Rice, the American ambassador to the UN, over a hundred Democratic members of Congress said that “cholera was brought to Haiti due to the actions of the United Nations”. The BBC reported some of the circumstantial evidence that had been gathered by its reporter, such as that the epidemic started near a Nepalese UN base, that the base dumped raw sewage (which spreads the disease) in the country’s main Arbonite River and then eventually polluted the capital Port-au-Prince, and cholera had not been present in Haiti for a century but is endemic in Nepal.

Just a day before they signed the letter to the UN, another epidemic had been on the Congressional agenda. Angered over the continued imprisonment of Dr Shakil Afridi, the doctor who operated a sham hepatitis vaccination programme through which DNA was collected to try and establish Osama bin Laden’s presence in the Abbottabad compound, Congressional representatives voted to cut aid to Pakistan by US$650 million. The measure led by Republican Congressman Ted Poe passed the house floor in a voice vote, and in his comments Poe called Pakistan “deceptive and deceitful and a danger to the United States”.

The irony — accusing an international peacekeeping agency of carelessly instigating an epidemic in one ravaged country while accusing another country of being deceitful for punishing someone involved in a sham vaccination programme run by a foreign spy agency — was predictably lost on both American media and lawmakers. In their view, the ethics of the issue were clear.

Haiti is a victim of UN negligence, Pakistan a charlatan that hid a terrorist and then punished the man who tried to help catch him. That Dr Afridi or the CIA took down, along with bin Laden, the public trust that underlies a public-health inoculation programme seemed to occur to no one.

The "war on terror" in Pakistan has morphed into a war on vaccination, with suspicion over Dr Afridi’s campaign spreading to affect anti-polio efforts as well. While allegations of Pakistan’s deceit were being lobbed back and forth in the halls of Congress, Mohammad Ishaq, a community health worker, was killed in Karachi’s Sohrab Goth area allegedly for his efforts in promoting the polio-inoculation programme. A press release issued by the World Health Organisation, with which Ishaq had been associated, detailed that inoculation efforts in that part of Karachi had already been halted days before the shooting, when two other WHO workers were shot and injured in the area. Ishaq was a hero, the release said, spending his days in diligent efforts to ensure that the underserved and poor of Karachi had access to the polio vaccine.

The interrelationships between cause and effect are of course murky where epidemics are concerned. In the story of polio in Pakistani politics, subterfuge and strategy are all amalgamated in a mess whose ultimate costs will accrue only to Pakistani children. On one hand is the US, resolute in its denial of the health consequences of using a public-health programme for intelligence gathering. On the other are the Taliban, adept at using scant grains of truth to whet the paranoia of already death-stricken populations, making the sin of a single doctor who sold himself the blameful burden of all others.

Stuck as they are in the questions of relative culpability, none of these considerations point to solutions. One can affix blame to the Tehrik-i-Taliban Pakistan whose spokesperson, several weeks ago, declared a war against all public-health workers that participate in anti-polio drives. One can lament the callousness of the members of the tribal jirga in Miramshah that reinforced the moratorium on the administration of polio drops or vaccines in an area where it is most prevalent. Or we can balk at the smug American accusations against the UN. Cholera did not exist in Haiti until the UN carried it over from Nepal. Five years ago, Pakistan did not have 198 reported cases of polio as was the case in 2011, more than any other country in the world.

Logic is no friend of war and the US is not at war with Haiti, making empathy automatic for its over 7,000 cholera victims. No such soft-heartedness can be spared for the victims in Pakistan, or the careless intermingling of public health and terrorist horror.

For both the Taliban and the US, a quarantined Pakistan cut off from the world is a worthy goal. If all Pakistanis can be contained within their borders, the Taliban can set up their medieval fiefdoms, forcing all their captives to live in a post-modern dark age where thinking heads are hacked off every Friday and vaccinations are a relic of another age. If all Pakistanis with or without questionable sympathies can be trapped within the country, the US could happily recall its pre-9/11 state of perfect safety, un-assaulted by the prospect of a Pakistani terrorist sneaking over its borders.

The possibility of a quarantined Pakistan is not simply a hypothetical. Two Pakistani Senators, both members of a standing committee on inter-provincial coordination, announced last Friday that the WHO had indicated to them that if polio inflictions in Pakistan were not curbed by 2013, in the worst-case scenario a travel ban could be issued on all travelling Pakistanis. They could be required to show proof of a polio vaccination before they were allowed into the worlds’ nations that have successfully eradicated polio.

Countries could refuse admission to Pakistanis not for their fear of terrorism but because they could literally be diseased, carrying in their bodies the deadly polio virus that paralyses and cripples.

In either case, the result would be the same: isolation both acute and damning, a collective curse on all Pakistanis.

The writer is an attorney teaching political philosophy and constitutional law.


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