The United Nations has announced a polio emergency and has established a campaign to begin mass immunization among Syria’s 2.4 million children as well as in Lebanon, Jordan, Iraq, Turkey, Egypt and Israel, in an effort to minimize the spread of the disease as thousands of Syrian refugees continue to flee to surrounding areas.
Contaminants from Pakistan’s sewage have been found in Egypt and in Israel, putting the entire Middle East at great risk for potential polio infections.
Vaccination efforts are focused along the northern border through Turkey in a door-to-door polio campaign focused on mass immunization.
For a polio compaign to be effective, approximately 90% of the population must be immunized. After that threshold is reached, those not immunized are protected under a process called herd immunity. However, less than 70% are immunized now, leaving many vulnerable.
The fastest way to reach the outbreak is through Turkey, but the U.N. is unable to act outside of the Syrian central government and, thus, cannot provide the vaccines needed. The U.N. is only authorized to operate under the governments of sovereign states, and the restrictive Syrian regime has forbidden cross-border aid as proposed by the U.N. Security Council. The U.N. is heavily confined in its abilities to provide aid.
Some aid efforts have already been attempted, but great difficulty has been found in the efforts of Assad’s regime to restrict aid, and the general chaos and disorganization makes planning far easier than execution.
World Health Organization officials have had many difficulties in reaching citizens, as vaccines are continually witheld by Assad’s regime as an act of war. However, the numbers infected seem to be stagnating, which would indicate that World Health Organization vaccination efforts have been relatively effective.
In November, UN forces airlifted over 500,000 polio vaccinations to an office in the northeastern city of al-Hasakeh, which were then distributed overland throughout eastern Syria. These vaccinations were largely blocked by government forces from entering the most affected areas, leaving them unaided by vaccination campaigns. The Syrian government will not allow for the distribution of food or medicines in the devastated suburbs of East Ghouta in Damascus that have been under government blockade for over a year.
Aid workers not officially approved by the regime risk arrest.
The outbreak underscores the slightly less apparent effects of the conflict as the country’s healthcare system flounders in the face of civil war. Before the war, about 91% of the nation’s children were immunized against the infection; after, only about 68% are, leaving thousands highly vulnerable to infection.
Even more problematic is that only 0.1-0.5% of those infected exhibit paralytic symptoms, and about 90-95% of those infected are asymptomatic. The 22 confirmed as infected with polio are indicative of a far more massive infection amongst the general population.
This has been the first flare-up of polio in Syria in over 14 years.
Asymptomatic members can still transmit the disease to others, which makes it highly difficult to identify the hidden illness as it spreads, only displaying a visible path of transmission in a tiny portion of those infected.
Those most vulnerable are people with compromised immune systems, mainly children and the malnourished, who are making up an increasing percentage of the population as Syria’s infrastructure fails and starvation becomes a widely-used tactic of the government to weaken the civilian forces.
When accused of using tactics to starve the rebellion into remission, Assad’s regime denied all plans of starving and maiming civilians. However, even the regime sees the negative effects of the epidemic on the nation’s children and are doing less to subvert the vaccination efforts than before.
The outbreak is at risk of spreading even to Europe, which has been polio-free for over a decade.
As the virus spreads, the nation is faced with further crisis, but emergency vaccination campaigns and fierce WHO efforts have allowed some sense of triumph in stopping the spread.
Written by Claire Glass’15
