
Dusty roads, choked lungs: Poor AQI spikes rush at OPDs
According to Gandhi Medical College (GMC) pulmonologist and associate professor, Dr Parag Sharma, "We're seeing a 10% to 15% increase in acute exacerbations among patients with asthma and baseline chronic obstructive pulmonary disease (COPD). The dust acts as a direct irritant, triggering inflammation and breathing difficulty, especially in vulnerable individuals."
The latest Air Quality Index (AQI) measurements indicate that PM10 levels in the city reached approximately 80 µg/m³ during Sunday's daylight hours.
This level surpasses the World Health Organisation's suggested limit of 45 µg/m³ by about 40%. PM10 particles, which measure 10 micrometres or less in diameter, are approximately one-fifth to one-seventh as wide as a human hair, enabling them to travel deep within the respiratory system and cause inflammatory responses.
Rising respiratory ailments are being observed in Bhopal's hospitals due to the absence of rain and deteriorating road conditions, which have led to increased dust levels.
The combination of damaged roads and post-monsoon dust has caused air pollution to exceed permissible thresholds.
Doctors across the city are seeing a noticeable uptick in patient with existing COPD, asthma and bronchitis.
"We've seen a sharp rise in patients complaining of breathlessness, coughing, and chest tightness. The dust from broken roads is a major contributor. It's not just an inconvenience, it's a public health hazard," said another health expert, seeking anonymity.
The spike in pollution comes just weeks after the monsoon rains, which had temporarily settled airborne dust. But as the rains receded, vehicular movement on damaged roads began stirring up fine particulate matter again, leading to a double increase in the city's AQI — from 40s to upper 70s.
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Time of India
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First Post
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After billions spent, why is polio still spreading in Pakistan and Afghanistan?
Despite a decades-long global push and over $20 billion spent, polio remains entrenched in Pakistan and Afghanistan. Health workers report falsified data, mismanaged campaigns and persistent vaccine mistrust. As eradication deadlines continue to slip, insiders question whether the strategy — particularly the use of the oral vaccine — is part of the problem, not the solution read more For the last ten years, Sughra Ayaz has walked from house to house in southeastern Pakistan, urging parents to permit their children to receive polio vaccinations as part of a worldwide drive to eliminate the crippling illness. She often hears their concerns and objections. Some are rooted in daily struggles — families often prioritise essentials like food and clean water over immunisation, The Associated Press (AP) reported in a feature. Others are based on baseless rumours — like claims that the oral vaccine is designed to cause infertility in children. STORY CONTINUES BELOW THIS AD Amid widespread misinformation and growing pressure to deliver results, Ayaz revealed that some supervisors have told vaccinators to falsely record children as immunised. She also noted that the vaccines, which need to be kept refrigerated, are not always stored at the required temperatures. 'In many places, our work is not done with honesty,' Ayaz told AP. The global effort to eradicate polio was launched by the World Health Organisation (WHO) and its partners in 1988, aiming to eliminate the disease — a milestone previously reached only with smallpox in 1980. Afghan children wait in line to get a polio vaccine in Jalalabad, Afghanistan, May 26, 2025. File Image/AP Progress was notable, especially in 2021, when just five wild polio cases were identified in Afghanistan and Pakistan. But numbers rose again, reaching 99 last year, and multiple self-imposed deadlines for eradication have been missed. Pakistan and Afghanistan are the only nations where polio transmission — a highly contagious disease mainly affecting children under five and capable of causing lifelong paralysis within hours — continues uninterrupted. As a result, these countries have been the primary focus of the polio campaign's attention and resources for the last ten years. However, according to campaign workers, public health experts, and internal documents reviewed by AP, the Global Polio Eradication Initiative (GPEI) has struggled due to poor management, an outdated strategy, and persistent reliance on the oral vaccine. STORY CONTINUES BELOW THIS AD These issues have hindered progress in what is one of the most ambitious and costly public health programmes in history — costing more than $20 billion and involving nearly every country on Earth. Internal materials and accounts from staff indicate that some officials have fabricated vaccination data, appointed unqualified individuals to distribute vaccine drops, neglected to deploy vaccination teams during critical drives, and dismissed alarms about the oral vaccine's role in triggering outbreaks. In Pakistan and Afghanistan — neighbouring countries with widespread vaccine scepticism and fragile health systems — field workers like Ayaz have raised concerns to top-level managers for years. Yet, insiders claim these warnings, along with similar alerts from global health experts, have often been ignored. A health worker administers a polio vaccine to a child in Karachi, Pakistan, April 21, 2025. File Image/AP Campaign officials highlight key achievements — vaccinating over 3 billion children and preventing paralysis in an estimated 20 million individuals. Yet they also concede that obstacles remain in Afghanistan and Pakistan, from difficult terrain and remote communities to cultural and religious objections to vaccines. STORY CONTINUES BELOW THIS AD Since the campaign's inception, hundreds of health workers and security personnel have been killed, targeted due to their perceived ties to the Western-led initiative. Dr. Jamal Ahmed, WHO's polio director, defended the campaign's strategies in Pakistan and Afghanistan, pointing to localised interventions tailored for resistant regions. 'There's so many children being protected today because of the work that was done over the past 40 years,' he said. 'Let's not overdramatise the challenges, because that leads to children getting paralysed.' Ahmed expressed optimism that the virus could be eliminated in the next 12 to 18 months. The eradication campaign has now set a goal of 2029. To meet that target, officials say approximately 45 million children in Pakistan and 11 million in Afghanistan must be vaccinated this year. Each child generally requires four doses to be considered fully immunised. Dr. Zulfiqar Bhutta, a member of several advisory boards for WHO and the Gates Foundation, urged campaign leaders to heed constructive criticism. STORY CONTINUES BELOW THIS AD 'Continuing blindly with the same strategies that we have relied on since eradication began is unlikely to lead to a different result,' he said. Internal reports reveal persistent flaws in vaccination campaigns Internal WHO evaluations of polio immunisation efforts in Afghanistan and Pakistan — shared with AP by past and current employees — expose how, as early as 2017, local staff were warning about serious issues to their superiors. These documents detail repeated instances of forged immunisation records, replacement of trained vaccinators with untrained family members, and improper administration of vaccines. WHO's own assessments frequently found that 'vaccinators did not know about vaccine management,' citing failure to maintain cold-chain requirements. A health worker, left, marks a house after administering polio vaccines in Karachi, Pakistan, April 21, 2025. File Image/AP Reports also noted discrepancies in vaccine usage logs, stating there were 'more used vaccine vials than were actually supplied.' An August 2017 report from Kandahar, Afghanistan, described how interference by local authorities and others led to the appointment of 'underage and illiterate volunteers' as vaccinators. Many campaign teams worked hastily, lacking supervision or proper monitoring. For example, a team in Nawzad, Afghanistan, in 2017 missed half of their designated area, skipping 250 households entirely. According to local elders, no team had visited the area in at least two years. Health workers and officials in both countries corroborated the contents of the internal documents. They pointed out the extreme difficulty of conducting door-to-door immunisations amid cultural sensitivities, distrust in vaccines, and chronic poverty. STORY CONTINUES BELOW THIS AD 'Most of the time when we go to vaccinate and knock on the door, the head of the house or the man is not at home,' one worker told AP under the condition of anonymity. 'Many people find it offensive that a stranger knocks on the door and talks to a woman.' Some households are abandoned or relocated, and on occasion, workers face verbal abuse or threats. 'We have shared these problems with our senior officials,' the worker said. 'They know about it.' Responding to AP's inquiries, Dr. Ahmed acknowledged 'operational challenges' in the region and claimed that the campaign has 'robust monitoring and evaluation processes.' Ayaz spoke of practices like 'fake finger marking' — the ink on a child's pinky, meant to signify vaccination, is sometimes applied without administering the drops. 'There is so much pressure,' Ayaz said. Oral polio vaccine remains a point of contention Before the first polio vaccine became available in 1955, the virus — spread through contaminated water and fecal matter — paralysed hundreds of thousands of children annually. During outbreaks, public gatherings were avoided, and hospitals filled with children relying on iron lungs to breathe. In places with inadequate sanitation, polio spreads when children encounter infected waste. According to WHO, a single infected child can jeopardise the health of children everywhere. STORY CONTINUES BELOW THIS AD Eradicating polio requires near-perfect immunisation coverage, with over 95 per cent of children vaccinated and zero wild virus cases. Yet experts and former WHO staff criticise the campaign for being far from flawless, especially concerning the oral vaccine. While this vaccine has safely immunised more than 3 billion children, it carries very rare risks. Scientists estimate that one in every 2.7 million first doses may lead to vaccine-induced paralysis. In rarer situations, the live virus in the vaccine can mutate and trigger outbreaks in regions with low immunisation coverage. Since 2021, hundreds of such vaccine-derived cases have been reported annually, with at least 98 already identified this year. Most health professionals agree the oral vaccine should be phased out as soon as feasible. However, the injectable alternative — which carries no live virus and avoids these risks — is in short supply, costlier, and harder to administer. More than 25 current and former senior polio figures told AP that agencies leading the campaign have resisted reviewing or altering their approach, despite ongoing issues. STORY CONTINUES BELOW THIS AD Dr. Tom Frieden, a former CDC director and current member of the polio eradication oversight board, stated that eradication is unattainable without the oral vaccine. However, he has advocated for adapting strategies, including faster detection of cases. Since 2011, he and his peers have regularly issued reports on systemic failures in the campaign. 'There's no management,' Frieden said, citing a lack of oversight and accountability. In 2023, former WHO scientist Dr. T Jacob John emailed WHO Director-General Tedros Adhanom Ghebreyesus twice, calling for a fundamental overhaul of the campaign. John, who provided those emails to AP, said he received no response. 'WHO is persisting with polio control and creating polio with one hand and attempting to control it by the other,' John wrote. Ahmed, in his reply to AP, maintained that the oral vaccine remains a 'core pillar' of eradication, highlighting that 'almost every country that is polio-free today used (it) to achieve that milestone.' 'We need to step back and really care for the people,' he added. 'The only way we can do that in large parts of the world is with oral polio vaccine.' He also pointed to India's success in eliminating polio — once deemed improbable. In the final four years before eradication there, nearly 1 billion doses of the oral vaccine were administered to over 170 million children. Currently, nearly all polio cases worldwide — primarily in West Asia and Africa — stem from mutated versions of the oral vaccine, except those in Pakistan and Afghanistan. Scott Barrett, a professor at Columbia University, called for a thorough investigation into campaign failures, especially after a misstep in 2016 where a strain was removed from the oral vaccine. That move triggered outbreaks in over 40 countries and left more than 3,000 children paralysed, according to an expert WHO-commissioned report. Last year, a baby in Gaza was paralysed by a mutated virus linked to that error. 'Unless you have a public inquiry where all the evidence comes out and WHO makes serious changes, it will be very hard to trust them,' Barrett said. Scepticism toward eradication efforts continues With a yearly budget near $1 billion, the polio initiative is among the costliest in public health. After the US withdrew from WHO and US President Donald Trump reduced foreign aid, WHO officials admitted privately that maintaining funding will be challenging without demonstrable progress. Some argue that these funds could better address other health priorities. 'We have spent more than $1 billion (in external polio funding) in the last five years in Pakistan alone, and it didn't buy us any progress,' said Roland Sutter, a former WHO polio research leader. 'If this was a private company, we would demand results.' Many villagers have protested the focus on polio, staging hundreds of boycotts since 2023. They demand medication, food, or electricity instead of repeated immunisation drives. A police officer stands guard while a health worker, centre, administers a polio vaccine to a child in Karachi, Pakistan, April 21, 2025. File Image/AP In Karachi, residents told AP they couldn't understand the government's obsession with polio, especially given pressing issues like contaminated water and rampant heroin abuse. Health workers often operate under armed protection — Pakistani officials report that since the 1990s, more than 200 health workers and security personnel have been killed, largely by militants. Adding to the challenge is a flood of false information — including rumors that the vaccine contains pig urine or causes premature puberty. Some say growing anti-vaccine sentiments in countries funding the initiative, particularly the US, are fuelling distrust in Afghanistan and Pakistan. In southwest Pakistan, Saleem Khan, 58, claimed his grandchildren under five were vaccinated against his family's wishes. 'It results in disability,' Khan said, without providing evidence. 'They are vaccinated because officials reported our refusal to authorities and the police.' Johns Hopkins University professor Svea Closser said resistance was much lower decades ago. Now, resentment over the focus on polio — while other illnesses like measles and tuberculosis go unaddressed — fuels conspiracy theories. 'Polio eradication has created a monster,' Closser said. She noted that public confidence in vaccination drives took a hit in 2011 when the CIA used a fake hepatitis campaign to try to locate Osama bin Laden through DNA collection. Field workers say they face that mistrust every day. In a remote mountainous area of southeastern Afghanistan, a mother of five said she wanted her children to be vaccinated but was overruled by her husband and other male relatives who believe false claims that the vaccine harms fertility. 'If I allow it,' she told AP, withholding her name for fear of reprisal, 'I will be beaten and thrown out.' With inputs from AP