Children, Conflict, and Polio

May 14, 2014 Karie Youngdahl

National Library of Medicine, 101579926. WWI Red Cross NurseNational Library of Medicine, 101579926. WWI Red Cross Nurse
The sight of a red cross or crescent on a white background is supposed to signal medical aid, neutrality, and safety. In conflicts around the world, however, hostile actors are flouting decades of protocol and the Geneva convention itself: they are killing and kidnapping Red Cross, Red Crescent, and other emergency aid workers.

Al Qaeda-associated militants kidnapped an International Committee of the Red Cross/Crescent (ICRC) team in Mali in February this year (military forces freed them about a week later). ICRC polio vaccination workers and staff were killed in Afghanistan in April 2014. Polio vaccinators and their guards have been killed in Pakistan and Nigeria as well.

On May 8 here at The College of Physicians of Philadelphia, we hosted the annual local observance of International Red Cross/Red Crescent Day, organized by the United Nations Association of Greater Philadelphia. The theme was children and conflict, and speakers addressed a range of violent acts against children and aid workers trying to help them, such as the kidnapping of girls by Boko Haram in Nigeria, the huge numbers of refugees and internally displaced families from Syria, and, the polio situations in Syria, Nigeria, and the Horn of Africa.

Speaker Pavan Ganapathiraju, MPH, noted that when health workers cannot reach vulnerable children, disease will inevitably result. It has in Syria: Polio has emerged there after an absence of 14 years. Threats to immunization programs in Pakistan have led to a troubling resurgence of polio cases this year: Pakistan is on track to exceed 2013’s reported cases, with 59 cases already reported in 2014 (there were 93 cases in Pakistan in all of 2013).

In 2013, more than half of the cases of wild poliovirus were caused by infected travelers leaving an endemic area and infecting others in a vulnerable area. The World Health Organization on May 5 issued a declaration on the polio situation, calling recent developments an emergency and advocating restrictions for travelers leaving Syria, Cameroon, and Pakistan. WHO recommends that citizens of those countries demonstrate proof of polio vaccination before leaving the country and has recommended that certain other countries encourage travelers to vaccinate. As far as WHO statements go, this one is remarkable: in the past, pressure from affected countries has resulted in much weaker recommendations.

Devi Ramachandran Thomas of the UN Foundation’s Shot@Life program spoke at the Red Cross event as well. She explained some of the complicated facets of the polio eradication endgame and went on to describe the work Shot@Life does to raise money here in the United States for immunization efforts in developing countries.

Visit the UN Foundation’s Shot@Life’s website to donate to their efforts in honor of International Red Cross/Red Crescent Day. And you can keep track of the year-to-date polio cases reported by country at the Global Polio Eradication Initiative’s online tool.


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