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Story Publication logo May 28, 2015

Pakistan: The Road to Bannu


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After dozens of vaccination workers were killed in Afghanistan, polio once again began to spread...

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Multiple Authors
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Vaccinators at work in the Pakistani borderlands. Image by Syeda Amna Hassan. Pakistan, 2015.

The road to Bannu is full of roadblocks. The city borders the Waziristan Agency, the wild tribal belt of Pakistan that has remained largely lawless over the years. In the summer of 2014, when I was making my way to Bannu, the towns and villages of North Waziristan were being razed to the ground in an aggressive military operation designed to wipe from the region the Pakistani Taliban and foreign militants who called it home.

Its location made Bannu a convergence for Waziristan's internally displaced people, and the civil servants and doctors waited at the borders to provide health services. With four massive hospitals already operating in the city and large swathes of idle land around its borders, it was an ideal place to deal with the mass exodus. It also gave health officials a rare opportunity to administer vaccines to the internally displaced persons (IDPs) from Waziristan, who were previously living under a Taliban-imposed ban on polio vaccinations. The military created an artificial bottleneck around the city, ensuring that evacuees would have to pass through the vaccination checkpoints before moving on to other areas of Pakistan.

I was headed to Bannu to talk with health officials and evacuees about the vaccinations against polio, part of a series for National Geographic series documenting in Pakistan and beyond the crippling spread of the disease. Genetic sequencing had established that a strain of the virus originating in Pakistan had traveled to Syria and Egypt—a stew of anti-vaccine fatwas and rumors circled with impending ramifications internationally.

Bannu was off-limits to foreign reporters without a special permit. As the Pakistani on the team, I was now going to the IDP camps on my own, wearing my most conservative set of shalwar kameez, and fidgeting under the heavy shawl that covered my head in the sweltering heat.

In Bannu, I soon realized that, unlike most conservative areas I had been to, where conversation gradually becomes unfiltered as men get over the initial awkwardness of talking to a female reporter, Bannu was going to be difficult, not because men don't talk to women, but because of the nature of the answers they had to give to my questions. Some of the rumors about polio that the health workers were battling were obscene. People believed the polio vaccine was made with the urine of George Bush, or that it led to infertility, or enlarged genitalia. I had heard these rumors from officials in Islamabad and Peshawar, but confirming them with the locals was next to impossible when their sense of decency prevented them from mentioning urine, genitals, and fertility in my presence.

And then there were security concerns. Even though most officials and health workers were frustrated with local mullahs who encouraged folks to reject the polio vaccines and turn them away, they did not want to risk their lives by naming the clergy publicly. Three vaccinators asked for anonymity, one agreed to nod his head at the right name if I read them off a piece of paper that I held, and five feigned ignorance after first mentioning how angry they were with the local mullahs. Still, I was totally floored by their courage in continuing to vaccinate children.

When I finally visited the refugee camps, I realized how hard they were to monitor. Most of the 900,000 refugees who vacated North Waziristan on the army's orders had passed through and moved on to other areas where they had relatives, some going as far south as Karachi. Those who remained in Bannu had taken shelter with the local population in their houses.

A tented camp controlled by the military existed in Baka Khel, 14 kilometers from Bannu, but its population had dwindled to 70 or 80, as people made their way to the city.

I pulled up next to one of the schools that housed the IDPs. Six families with roughly 60 members lived in four big classrooms. In each room, the furniture was stacked against the walls, sometimes with more decorum than others. In one, a teetering pile of desks and chairs went all the way to the ceiling, and a woman slept underneath on a pile of sheets.

The veranda was littered with makeshift gas stoves, small fans hooked to batteries, and cooking utensils. A haze of heat that felt like something solid pressing in on our lungs hung in the air. Past the first two rooms, the women of the camp had hung up old bed sheets and chaddars around the verandah to hide the rest of the living quarters from view. They had to observe purdah (living in a separate room from men)—the classrooms were open to public view otherwise.

This dedication to purdah also meant that I was not allowed to photograph the women, or take my male translator inside. I ended up getting two of the camp's children, both aged thirteen, to translate their mothers' and aunts' rapid Pashto into Urdu for me.

The health officials' observations rang true. They had come from villages like Darpakhel, where Pakistani and Uzbek militants had distributed pamphlets against the vaccine, but had left the locals to live in peace otherwise. Most of their children had not been vaccinated for three years in Waziristan, while some Taliban commanders secretly vaccinated their own.

Largely, they were glad to get the chance to vaccinate their children. But the Waziris had bigger problems. They were facing the prospect of returning to their villages, after the military offensive, and finding destroyed homes, withered crops, and dead farm animals. In this state of uncertainty, talking about the polio vaccine was not high on their list of priorities.

I left with the sense that until they had a steady supply of basic necessities and stable employment, the threat posed by the polio virus to the world would seem like a tangential, even trivial, problem. This was a much bigger task than simply administering the vaccine.

Syeda Amna Hassan, an alum of UC Berkeley's Graduate School of Journalism, is now a freelance journalist and investigator based in Pakistan.






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