Leaving Kabul, Afghanistan, for the border with Pakistan was like traveling back in time from 21St. to the 5ththe century. I was there in the spring 15 years ago. Dirt roads from one small town to another were pockmarked with deep craters, and huge boulders the size of Volkswagens blocked one lane and sometimes the entire road, necessitating long detours. None of the towns had electricity. Men and boys walked along the sides of the roads leading rows of donkeys loaded with firewood, grain and cans of kerosene. At night, the slopes of the mountains on either side of the road closed like great curtains. The darkness at the bottom of the gorge formed by the Kunar River was absolute. You couldn’t see your hand in front of your face.
I thought I had time-traveled as far as I could until I arrived in Asadabad, an illegal-smuggling town just a mile or two from the Pakistani border in the Pashtun area largely controlled by the Taliban. Asadabad is located at the intersection of two rivers, the Pech and the Kunar. Both rivers were running fast and icy with glacial snow melt from the foothills of the Himalayan mountains when I arrived in a four-wheel drive truck I had taken from Jalalabad, a market town to the south. The 35 miles of road between the two towns was so bad that it took more than eight hours to make the trip. The truck’s shock absorbers failed along the way, and about two miles out of town, they were bleeding fluid from all the brake rotors, and the brakes failed as well.
The man who rolled under our lifted truck to replace the shock absorbers had no legs. “Polio,” explained Esos, my translator. “There are no vaccines here. It’s an epidemic.” Walking through town a few minutes later, we were accosted by dozens of children limping on makeshift crutches or pushing themselves on low wheeled platforms they had cobbled together from plywood and shopping cart wheels. Other children had open sores. Staph infections or marked with red spots and dots from measles. Adult polio victims, too, limped past on crutches made from tree branches wrapped in rags. I thought polio had been eradicated decades ago. I was wrong. You didn’t have to be an anti-vaccine to be exposed to polio and measles diseases in Asadabad, Afghanistan in 2004. All you had to be was live and be poor.
The World Health Organization has launched a campaign to eradicate polio in the Afghanistan-Pakistan border region, vaccinating children everywhere they can reach. A polio outbreak in 2014 claimed 202 victims in Pakistan alone, according to The Guardian. Health workers blame the Taliban for hampering their efforts. The fact that the CIA used a bogus vaccination program to gather information on Osama bin Laden’s whereabouts in 2011 didn’t help. However, militant opposition to vaccination programs waned over time, with only 12 cases reported in Pakistan last year. The number of polio infections in Afghanistan has similarly decreased, but regions under Taliban control remain difficult for aid workers and vaccinators working with the WHO to reach. Parents of Afghan and Pakistani children often travel many miles on foot to reach vaccination sites in less dangerous areas. Cross-border vaccination teams are targeting families involved in illicit smuggling and nomadic peoples grazing herds of sheep and goats along the unmarked border between the two countries.
Compare what’s happening on the other side of the world to this country, where this week the Center for Disease Control announced that the measles outbreak had exceeded 700 cases for the first time. “More than 500 of the 704 cases recorded as of last Friday were in people who had not been vaccinated, the CDC reported,” according to the Times. “Sixty-six people have been hospitalized, a third of them with pneumonia.” New York City reported that there have been 423 measles cases since the outbreak began last October, the majority among the city’s Hasidic community. Upstate counties reported 236 more cases, also mostly among Hasidim. Nationwide, about 100,000 children under the age of two have not been vaccinated, according to the CDC. Some infants and young children are allergic to the ingredients used to make the vaccine or have health complications, but most do not get vaccinated because their parents avoid the procedure. These people are known as “anti-vaccines”.
There were no anti-vaccines in Leavenworth, Kansas, when I was in second grade. Within a couple of months in 1954, an outbreak of polio infected more than 70 schoolchildren at Fort Leavenworth, where my father was stationed for the Army. If you wanted a petri dish for poliovirus, nothing better than eastern Kansas. Summers were terrifyingly hot, with temperatures regularly in the 90s and humidity hanging in the air like an invisible mist. Everybody at Fort Leavenworth had to be there because husbands and fathers were under army orders, so you couldn’t just pack up and go. And parents back then didn’t take their children out of school, not even for an epidemic of disease. I remember being told to wash my hands after going to the bathroom and to be careful not to touch other children. But the virus spread almost widely among schoolchildren that year. There were children who had contracted polio and suffered from paralysis or weak legs and other ailments in every classroom at Fort Leavenworth Elementary School.
There was no polio vaccine yet, so we were led to receive injections of gamma globulin purified from the blood of polio survivors. It was thought to be effective in preventing polio, or at least reducing the severity of the disease if infected. I remember when I got out of the car at the post office clinic, I could hear the screams of the children inside as they took their injections. The gamma globulin was the consistency of motor oil, so they had to use huge needles to stick it up their asses, and it took them more than a minute to administer the injection. It was incredibly painful. I yelled. Also my brother and sister. All the children did it, the injection hurt a lot.
We were among the first children in the country to receive the Salk vaccine in the early summer of 1955, when it was launched. One quick shot with a comparatively small needle and it’s over. No one was happier to see the development of a polio vaccine than the school children of Leavenworth, Kansas, and no one was a greater hero to those children and their parents than Jonas Salk.
That’s why I don’t understand these anti-vaccine parents. A disease like measles can be deadly, though advances in medical treatment over the last half century make that less likely (there have been no deaths among the more than 700 measles cases counted by the CDC. So far). Polio can be deadly and carries the danger of paralysis and weakened legs in children. In adults, paralysis occurs in one in 75 cases, and quadriplegia is possible. Polio and measles are terrible diseases. What father would want his child to be infected by one of them? . . or for both?
I think there are two things at stake with anti-vaccines. The first is the desire of modern parents to be involved in everything related to their children. Helicopter parenting reaches its apex with the anti-vaccines. You’re not going to touch my son with that needle unless he says you can! The second is a decline among the general population to tolerate inputs to the greater good. This is how a vaccine works. It works for everyone if everyone gets vaccinated, but its effectiveness is reduced by unwillingness to unite in common cause. Right-wing survivors are the fringe of this phenomenon, but so are the organic-eating arch-liberals, who are convinced that if their kids eat right, exercise properly, and live a healthy life, all will be well. Vaccines for diseases like polio and measles have worked so well that entire generations have been born and reached adulthood without ever seeing people with either disease.
It’s a shame that anti-vaccines of either stripe don’t visit places like Asadabad and see the results of not being vaccinated. I saw a polio epidemic in elementary school, and 50 years later I saw another on the other side of the world. He scared me to death both times. Anti-vaccines should also be afraid.