In Syria, immunizations are withheld as an act of war and polio is on the rise

Syria was once one of the countries where polio was no longer a problem. The government began mandatory, free immunizations in 1964 and declared victory in 1995. But now, polio is back, writes Annie Sparrow in the The New York Review of Books, and she builds a case that Bashar al-Assad is to blame. Imagine if, instead of causing a traffic jam, Chris Christie's aides had prevented towns that didn't support him from getting access to basic childhood immunizations. According to Sparrow's research, that's exactly what the Assad regime did. And now, children are paying the price.

This man-made outbreak is a consequence of the way that Syrian President Bashar al-Assad has chosen to fight the war—a war crime of truly epidemic proportions. Even before the uprising, in areas considered politically unsympathetic like Deir Ezzor, the government stopped maintaining sanitation and safe-water services, and began withholding routine immunizations for preventable childhood diseases. Once the war began, the government started ruthless attacks on civilians in opposition-held areas, forcing millions to seek refuge in filthy, crowded, and cold conditions. Compounding the problem are Assad’s ongoing attacks on doctors and the health care system, his besieging of cities, his obstruction of humanitarian aid, and his channeling of vaccines and other relief to pro-regime territory.

Sofie (not her real name), the first Syrian child known to have come down with polio, came from Spighan, a small town on the Euphrates River in the Mayadin district of Deir Ezzor. An unimmunized three-year-old, her initially unremarkable symptoms of fever and a cold were followed by acute flaccid paralysis, the sudden loss of muscle function, as the polio virus destroyed Sofie’s nerve cells. Untreated, polio has left her crippled, stigmatized, and shunned. Since then dozens more children in Deir Ezzor have succumbed. In August, cases started cropping up in other parts of the country: first in Aleppo, then in an opposition-held suburb of Damascus, Idlib, al-Hasakeh, and finally Raqqa in December.

... This politicizing of public health meant that many children born in 2010 or later could not commence or complete the routine course of polio vaccination required for effective protection. Of the roughly 1.8 million children born since the conflict began, more than half may be completely unvaccinated. WHO estimates that the vaccination rate has dropped from 83 percent of two-year-olds before the war to 52 percent in 2012.3 The Syrian Ministry of Health states that the vaccination rate has dropped from 99 percent pre-war to 68 percent in 2012. More than three million children across Syria may now be vulnerable.