Since 2015, Dr. Safdar has overseen virtually every aspect of Pakistan’s battle against polio. In his office in Islamabad, the capital, he sits among a war room’s assortment of maps and weekly reports from across the country. Local bureaucracies, the World Health Organization, the Bill & Melinda Gates Foundation, Unicef — all report to and coordinate with Dr. Safdar’s office under a federal program similar to India’s.
“People needed to have some trust in the federal government to reach a solution,” he says.
But given the rampant corruption and sometimes deadly political rivalries within that government, trust is hard to come by. And many of the impoverished families that vaccinators seek out have never met a representative of the state.
Their suspicion is compounded by rumors that the polio vaccine causes impotence, death and, ironically, paralysis. Refusals are common, and some families will hide their children from vaccinators, or even attack them.
“They’ve chased us with sticks before, even,” says Saida Baloch, a cheerful 27-year-old leading an emergency vaccination team on its rounds in Dukki.