by Brian McAfee

While great strides have been taken in ridding the world of polio there are four countries where the disease continues to endanger the lives of children. The countries where the World Health Organization (WHO) and UNICEF have confirmed the existence of and are now immunizing children from polio are Pakistan, Afghanistan, Nigeria and Syria.

Pakistan has had the most reported cases. In 2013 there were 93 reported cases of polio, so far in 2014 there have been 24 new cases. Health workers that have been vaccinating Pakistani children have been targeted by the Taliban and other Islamic fundamentalists. Over 40 health workers and police monitoring their safety have been killed since December of 2012. In spite of the risks health workers from UNICEF and the WHO and other aid organizations continue to work under potentially dangerous conditions. Last month Islamic scholars from the Islamic Advisory Group gave an official declaration that "Shariah allows polio vaccinations". Despite this proclamation polio workers continue to be attacked.

Afghanistan reported their first polio patient late last year, a three year old girl. For 2013 Afghanistan had two reported cases of polio, so far this year there have been three new cases. The WHO believes Afghanistan's polio cases may have originated in cross border contact with Pakistan.

Nigeria in 2012 had 200 cases of polio, for 2013 there were 53 reported. There are none so far for 2014. The WHO and UNICEF have been quite active in Nigeria and that is probably why Nigeria has been polio free so far this year. Polio workers have been attacked in Nigeria as well. In February of 2013 nine were killed in attacks on two clinics in northern Nigeria.

Until last year the last time any Syrian children had polio was 1999. In November of 2013 the WHO said it had found 17 cases. In Syria at least 6.5 million people are internally displaced and another 2.3 million have fled to Jordan, Lebanon, Turkey, Iraq or Egypt. Given the increasingly precarious situation in the region in the region the number of children with polio is probably no longer 17.

Another country, not generally included among the top few for polio but I believe should be, is South Sudan. 70 thousand of South Sudan's children have been vaccinated against polio. There is an ongoing civil war now under way in South Sudan. UNICEF and the WHO are active in the region, and continued monitoring of South Sudan as well as the others mentioned is worth encouraging,

This month the WHO and UNICEF will give polio vaccinations to 10 million children across the Middle East. I encourage people to donate to UNICEF or other charities of their choice. UNICEF's website is .unicefusa.org or call them at 1-800-367-5437

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I welcome any comments or suggestions. -Brian McAfee brimac6@hotmail.com