Measles in Pakistan: Politics, People, and Guns

[row][span size=’5′]A lot of bad things have come together in Pakistan to produce an outbreak of measles that is incredible in its scope and size. According to news reports, there have been almost 12,000 cases reported in the Punjab region of Pakistan over the last 5 months. That’s 2,400 cases per month, or about 80 cases per day. It’s just too big to understand.[/span][span size=’3′][show-map id=’9′][/span][/row]
So what are these bad things that came together? First, there was the use of a polio campaign to take DNA samples from children in order to find Osama Bin Laden, the former leader of the Al-Qaeda terrorist organization. Next, the Taliban, a militant/terrorist organization in Pakistan and allied with Al-Qaeda, began to shoot vaccine workers and prevent vaccination drives in order to force the United States to stop unmanned drone strikes against targets in Pakistan. And now, Pakistan is having a general election full of trouble, taking time and resources away from public health programs in order to conduct them. In my opinion, it’s a mess.

Unfortunately for all those children with measles, and those who will acquire measles and other vaccine-preventable diseases, those children have no political power in that country. Further, the situation of women in Pakistan, the mothers of those children, is not very good from many perspectives. It’s not like they can walk up to the militants and the government and tell them to quit it with the fighting and to give the children what they need. (Aside from vaccines, those children need many other things as well, like clean water, food, a comfortable place to live, and an adequate education.)

I’ve been thinking about how my approach to similar problems will be once I dive deeper into public health as part of my training in the DrPH program and in whatever work I do afterward. How do you go to a foreign land and tell the authorities there that you know better? Well, you don’t tell them that. You go to a place and ask what they need, explain how you can help, and then get to work. At least that’s the impression I got after reading Dr. Alfred Somer‘s book, “Ten Lessons in Public Health.” In it, he describes his trip to Bangladesh and his actions after an enormous natural disaster.

Of course, the situation in Pakistan is not natural but man-made. There are people with big guns shooting at each other for all sorts of mundane reasons. (Mundane to me, anyway.) It takes a little bit of guts to talk to those people, and a lot of guts to talk to them face-to-face. This is something that school cannot teach anyone. You have to live it. I have, by the way. I’ve been through many checkpoints in Mexico, with soldiers aiming big guns at me, to know that you follow their directions… They’re the ones with the guns. So how do you fulfill your mission to prevent disease through action while not angering the people with guns?

The answers elude me at the moment, but I’m sure I’ll come up with something. Or someone will. Things need to change, and those children need us to act.
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I'm a fourth-year doctoral candidate in the Doctor of Public Health program at the Johns Hopkins University Bloomberg School of Public Health. All opinions posted here are my own, of course, and they do not necessarily reflect the opinions of my school, employers, friends, family, etc. Feel free to follow me on Twitter: @EpiRen