A child receives a polio vaccine in a recent vaccination campaign in Ethiopia. Syria has reported 10 polio cases this year, likely due to the continuing civil war. (Image Source: UNICEF Ethiopia)
Poliomyelitis, a disease that cripples and paralyzes the body also known as polio, remains active despite major efforts around the world to vaccinate children. Three countries still have native outbreaks of polio: Nigeria, Afghanistan, and Pakistan. Despite this, many other countries still suffer from polio outbreaks, either through importation, or because of effects from the vaccine. Furthermore, any country that lets up on its childhood vaccination program tend to suffer from the disease being imported into their country. Such is the case with Syria, where the ongoing civil war between Bashar al-Assad and rebels has prevented full-scale vaccination campaigns from working. The World Health Organization has now confirmed that polio that came from Pakistan has infected 10 children in Syria in 2013, and could spread elsewhere.
The WHO discovered in Deir ez-Zor, a city in eastern Syria that is currently under seige between the rebels and Assad's regime, that a strain of polio linked to Pakistan and found in sewer systems in three nearby countries matched with the 10 cases reported in the country in 2013. Previously, Syria had been polio-free since 2000. The WHO is responding by starting a vaccination campaign covering the entire Middle East but specifically targeting Syria, hoping to cover 20 million children over the course of six months. Whether or not it will actually prevent future cases in Syria remains to be seen.
While worldwide eradication efforts have brought down the rate of polio around the world to record lows, the ultimate goal of complete eradication remains elusive. The three countries that have endemic, or native cases, of polio remain so due to local distrust towards foreigners, especially Western officials and doctors, toward treating the disease. In Nigeria, rumors such as the vaccine causing female sterility have long prevented effective eradication. In Pakistan, the Pakistani Taliban have targeted and killed vaccine workers and doctors, and local elders are using polio vaccines as a political leverage tool to gain basic needs from the national government. Consequently, nearby nations have suffered with the polio virus transmitting across their borders.
In the case of Syria, vaccinations fell to the wayside as the civil war spread. The eastern provinces, mostly under the control of rebels either led by the Free Syrian Army or the al-Nusrah Front, lack the logistics and resources to maintain a local vaccination campaign, and are only interested in providing social services at the most basic level. While polio in Syria is coming only by importation, the risk of the disease becoming endemic grows as the civil war drags on with no effective conclusion.