The year 2013 was the worst for the anti-polio efforts in Pakistan. At least 31 vaccinators and security personnel were killed in attacks on vaccination teams during the last 15 months.

On the other hand, polio cases have increased from 58 in 2012 to 75 this year.

The world bodies as well as Pakistani authorities engaged in eradicating polio from the country have been making hectic efforts to clear misconception about the polio vaccine to reduce refusal cases -- but attacks on polio teams cannot be stopped.

There is hope that a decree recently issued by the famous Darul Uloom Haqqania in Akora Khattak town of Nowshera district in favour of polio drops will give a boost to the vaccination campaign against the crippling disease. The fatwa signed by Maulana Samiul Haq, the head of the Haqqania seminary, has made it clear that vaccination to protect children from polio, measles, hepatitis and other diseases are not harmful.

It said, "The use of drops or medicines recommended by medics is allowed under Sharia. Parents should vaccinate their children in order to protect them from polio and other diseases."

Hopes were slightly shattered after the killing of two security personnel in Swabi and Jamrud sub-division in Khyber Agency on December 13, days after the decree was issued. However, the authorities are still hopeful that the decree will have a positive impact on the anti-polio vaccination campaign in the country, especially in Khyber Pakhtunkhwa and Fata.

Polio workers too have high hopes. "Support for vaccination from such a senior religious scholar who has a huge following in Khyber Pakhtunkhwa (KP), Fata and even in Afghanistan, will hopefully help in addressing misconceptions created about vaccination," Shadab Younus, communication officer for polio at Unicef, told The News on Sunday. She added that the decree issued by the head of Darul Uloom Haqqania Maulana Samiul Haq has come at the right time.

"The ban imposed in North and South Waziristan Agencies in June 2012 has deprived more than 250,000 eligible children from receiving polio vaccines," said Younus.

In 2013, six cases were reported from Punjab, seven from Sindh, none from Balochistan, 10 from KP and 52 from Fata. In KP, four cases were reported from Peshawar, two from Mardan and one each from Malakand, Swabi, Kohat and Bannu. In Fata, the highest number came from Waziristan.

A senior official of the World Health Organisation on December 16 called the chairman of the Pakistan Tehreek-e-Insaf Imran Khan to seek his support in eliminating polio from KP and Fata. Eighty five per cent of the reported polio cases are from Fata and KP.

Imran Khan has assured to lead the anti-polio campaign from the front. Also, Asifa Bhutto Zardari has announced her support to the PTI in its drive against the crippling disease.

Noted intellectual and educationist Dr Khadim Hussain believes decrees like that of Haqqania will give an immediate relief to the polio workers and police. The decree will not only result in reducing attacks but will encourage parents to see their children get polio drops.

"Instead of finding any solution to such sensitive issues through religious decrees, there must be scientific evidence to counter any propaganda against polio vaccines," said Dr Hussain.

The Unicef had published a booklet earlier this year with 24 fatwas of various religious scholars from Al Aqsa Mosque, Darul Uloom Deoband and others from Pakistan and Egypt to clear the misconception about polio drops. The booklet also includes decrees from the religious leaders of North and South Waziristan, asking their followers to vaccinate their children.

Yet, the attacks on polio teams have not ceased.

On December 13, two policemen were killed in Swabi when they were on their way to provide security to polio teams while another official was killed in Jamrud sub-division of Khyber Agency when he returned home after the vaccination campaign.

As per the independent statistics at least 31 volunteers and security personnel were killed in attacks on polio teams during the last 15 months. The attacks accelerated with the killing of five polio vaccinators in Karachi and another in Peshawar on December 17 last year. The polio vaccination campaign had to be halted all over Pakistan following the attacks. The KP government, however, refused to halt the campaign, saying the killing of polio worker Farzana was due to a personal issue. They, however, had to halt the drive after another two workers, Zakia Begum and her driver were killed in Charsadda and teams were attacked all over Charsadda, Peshawar and Nowshera the very next day.

Police had to be engaged all over KP for the security of the polio teams after attacks on them. The attacks, however, did not stop, even security personnel have come under continuous attacks since then.

Two polio workers were killed in Peshawar and another two in Charsadda in 2012. Again, in 2013, two polio workers were killed in Peshawar and another two in Swabi while one worker was injured in attack in Mardan. Besides, three security personnel were killed and 15 wounded in Peshawar, another three were killed in Swabi and one in Mardan while protecting polio teams in 2013, as per statistics provided by the concerned organisations.

However, this source cannot be relied on, as at least five security personnel were killed in a single bombing in Sulemankhel village in the limits of the Badaber police station in September. The independent source said eight security personnel and polio vaccinators have been killed in Peshawar during the current year.

Most of the volunteers risking their lives to protect children from the crippling disease are getting only Rs 500 per day allowance during campaigns that continue for three to five days a month.

"Instead of spending millions on advertisement campaigns and countering anti-vaccination propaganda, the world bodies and the local authorities must provide respectable allowance to the real workers who are risking their lives. There is no compensation for the families of those killed while performing duty," said a female worker, who refused to disclose her name.

A former lawmaker of the Awami National Party (ANP), Bushra Gohar said the huge challenge of polio outbreak cannot be addressed by issuing decrees and counter decrees. "The outpouring of decrees from groups and individuals on issues bring to question the credibility, accountability and effectiveness of the whole exercise".

Bushra Gohar added, "Government needs to recognise and assume greater responsibility to counter the alarming spread of polio virus by improving its outreach, quality of polio virus vaccine, training and security of anti-polio campaign teams. Radio, TV, newspapers and community level forums must be used to create awareness among public."

She further added the district administration should prepare outreach and awareness plans in consultation with district civil society organisations. "Action must be taken according to law against groups that use religion to spread confusion against anti-polio campaigns, issue decrees and threats. The anti-polio campaign must be decentralised," said Bushra Gohar.