The worth of a picture

The images of Imran Khan and other PTI men administering polio drops to children in Khyber Pakhtunkhwa have been welcomed and appreciated by many. This is especially significant given that militants in the province have rejected and obstructed polio vaccinations for some years now.
Also, just over this last year, the systematic murders and attacks on polio workers across the country have become as endemic as the disease. Some of the applause is simply an expression of relief that Khan’s party has distanced itself from the Taliban’s world-view on this issue, in more categorical terms than usual. Laudable as it is, there is, however, a problem with this picture.
When the Taliban invaded and occupied Swat between 2006 and 2009, their ‘health policy’ was to actively persecute community health workers and abolish maternal services and polio administration by issuing three fatwas. Pakistani authors of a study published in the British Medical Journal (‘How the Taliban undermined community healthcare in Swat, Pakistan,’ http://www.bmj.com/content/344/bmj.e2093), Ud Din, Mumtaz, and Ataullahjan, conducted in-depth interviews with Swat-residing, Pakhtun lady health workers.
They found that due to the Taliban’s threat and violence against the LHWs, not only did the overall infrastructure of community health suffer drastically but maternal mortality increased considerably as well. Individual LHWs were socially ostracised through a vilification campaign and many left or stopped working due to direct threats to their lives.
The fatwas were instructive and, of course, aired on FM radio. These fatwas were not directed at health services per se but against the very notion of women in public spaces, which was declared a form of public indecency. These LHWs were declared maal-e-ghaneemat and even wajibul qatl if they refused to obey the ban on their activities. Another fatwa declared it illegal for women to work for wages or occupy public spaces “acting like men”. Since LHWs carried contraceptives in their door to door visits, the Taliban fatwa declared them “house calling prostitutes”. The BMJ study cites specific examples of beheadings as well as public beatings of LHWs and firing on their houses and murders of their colleagues’ family members. All this was prior to the Osama bin Laden raid of 2011.
Therefore, the KP government must remain historically aware that while the OBL fiasco has definitely contributed to a different kind of political mistrust of the polio campaign and is unconscionable, it does not explain the historic and simultaneous oppositional strategies and violence meted out against women community workers by religious clergy and/or militants. This prejudice must also be countered rather than pretending that the resistance is just a post-OBL or misunderstood anti-polio phenomenon.
Through the outreach programme initiated by the Benazir Bhutto government in 1994, hundreds of thousands of Lady Health Workers serve far-flung communities that have little or no access to very basic healthcare. This service cannot be underestimated in its symbolic and pragmatic worth.
The work of LHWs has met with resistance from local clergymen but the state has been instrumental in extending assistance through local police support to LHWs during the polio and maternal health campaigns. Attitudes have changed drastically over the years due to this state and government support to the programme.
The resilience of LHWs also makes remarkable documentation – the most recent evidence being a mass campaign demanding minimum wage and regularisation of their jobs. Started by a single woman from Sindh, the nationwide campaign from 2010 galvanised into a series of boycotts and sit-in demonstrations by LHWs in all provinces. Ironically, the PPP government was refusing to concede this demand until the chief justice judged in favour of the award of minimum wage for the LHW programme in 2011.
Here is where the picture becomes blurry. At some of their protest demonstrations against the killings of their colleagues in the assassination spree of polio workers in 2012, the LHWs were seen burning and defacing some of the official government posters that carried images of and endorsements by, Islamic clergy and prominent ‘born-again’ cricketers and celebrities.
These (male) personalities are engaged by the government and donor agencies to popularise the polio vaccines. Such advertisements and posters are ostensibly meant to promote the subliminal message that polio vaccines are sanctioned by the clergy and are, therefore, suitable (halal or legitimate) for Muslims.
In this vein, several multinational health corporations have introduced what are advertised as ‘halal vaccines’ suggesting (falsely) that the polio drops have been prepared differently or by some ‘kosher’ method to legitimise their use in Muslim contexts. Peddling Islamic products has become a false alternative and lucrative mainly for its proprietors only.
To protest against such appeasement strategies that pander to fake rationales and abstract religious sensibilities is not simply a moral objection. More important is the fact that such diversions practically diminish the real worth of the health workers’ own worldly contributions and deflect the attention from how they are in fact, the primary, practical and neutral (for those who fear the word secular) state professionals for such services. Of course, the LHWs burn images of the religious imitators who undermine their worth.
One of the most tragic images that remain in memory are of the blood drenched Unicef folder titled, ‘Polio Eradication Campaign and Endorsement by Islamic Scholars’ found next to the bodies of those polio workers who were assassinated in Karachi in 2012. It read as a bitterly ironic comment on the futility of the attempt to synthesise religious scholarship with modern developmental progress.
By definition, a photo-op is opportunistic. Perhaps it makes for a good image to have politicians and religious leaders dropping polio drops into the mouths of babies but it would make far better policy to endorse, support, protect and promote the front-line workers as the real faces and personas in the battle against the disease and its prevention.
It would also send the critical message that the lady health workers represent a state service and that the government of KP stands behind them. That would paint a picture worthy of substance and sustainability.
The writer is a sociologist based in Karachi. Email: afiyazia@yahoo.com