Amina Sarwar, Communication Officer, UNICEF
August 23, 2024: In the center of Dera Ismail Khan (D.I.Khan), a district in southern Khyber Pakhtunkhwa (KP), Pakistan, where infrastructure is lacking and the poliovirus poses an ongoing threat, Aliya Ejaz has committed herself to improving the community's health. Since joining the Integrated Service Delivery (ISD) initiative as District Coordinator in August 2023, Aliya has been tirelessly linking polio vaccination with essential healthcare and nutrition services, tackling the region's persistent challenges.
Aliya recalls one of her earliest encounters in Union Council (UC) Muryali, where she met Asma Khan, a mother of nine who was hesitant about vaccinations.
"We can't afford to treat our children when they get a fever after receiving any kind of vaccination," Asma had said, echoing a common concern among the area's residents.
Recognizing the family's needs, Aliya utilized the opportunities provided by ISD to offer free medications, mosquito nets, and essential prenatal and postnatal care, including an ultrasound for Asma during her pregnancy. Over time, Asma’s family, who had previously refused vaccinations, became strong advocates, ensuring all their children under five received both polio drops and routine immunizations. Significantly, the provision of free fever medication, such as paracetamol, addressed concerns about post-vaccination fevers, leading to higher vaccination rates.
“Because of the difficult terrain and scattered population, we usually end our work very late, sometimes reaching home in the evening during the campaign week. Initially, I was confused and faced many challenges due to the distance and hard-to-reach areas. But now, I am familiar with the region and its people. I worry that if someone new takes over, they might miss houses for vaccination,” Farooq shared.
During each campaign, the brothers load their bicycles onto a boat to cross the river and reach their assigned area. Despite the harsh weather conditions, they remain undeterred, driven by their dedication to the cause. The local community holds them in high regard for their relentless efforts.
Asma Khan, once hesitant, is now committed to fully vaccinating her children under five after benefiting from health services provided by the Integrated Service Delivery in D.I. Khan. PC @NEOC/2024
Aliya Ejaz, a dedicated team member of the Integrated Service Delivery in D.I. Khan, KP province, engaging Afghan refugee women in Village Kohat on the importance of early childhood development. PC @NEOC/2024
Aliya's journey as the District Coordinator has been marked by significant milestones. Under her guidance, 12 Basic Health Units (BHUs) in the target district have been incorporated into the Integrated Service Delivery, led by UNICEF in collaboration with National and Provincial Emergency Operation Centers. This initiative has brought together health care, nutrition, water, sanitation, hygiene, and birth registration services in 22 union councils, including D.I.Khan and North Waziristan, targeting communities that have historically resisted vaccinations.
The impact in UC Muryali, one of the twelve union councils under Aliya’s responsibility, has been remarkable. In this area, home to over 55,000 people, the uptake of immunizations and polio vaccinations has surged significantly.
When Aliya first started, outpatient visits to the BHUs were only 300-400 per month; now, that number has risen to 1,600-1,700 monthly.
Additionally, the number of home births has decreased as more women are choosing skilled delivery care at the BHUs. The introduction of essential WASH infrastructure, including latrines, handwashing stations, and solar-powered water systems, has also strengthened community trust in the health facilities.
Before the launch of the ISD, D.I.Khan was known for its high number of polio vaccine refusals—about 300 families in UC Muryali alone in 2023. These refusals have dropped to just 10 during the Sub-National Immunization Days (SNIDs) held in June. And even these remaining refusals were due to temporary health issues affecting the children.
Aliya's success is not just in numbers but in the deep trust she has built within the community.
"I joined this project as a religious obligation," Asma says. "Seeing malnourished children and struggling mothers drives me to do more for them."
Her commitment has not gone unnoticed. Local influencers, including religious scholars now openly express their gratitude for the health services provided under her leadership, recognizing the positive change she has brought to their community.
“We are grateful for Aliya’s contributions to our community. We now have access to essential medicines and healthcare, which has greatly improved how we handle health issues. Our women feel secure seeking her help, and we trust the facilities provided for all vaccinations, including polio,” says Muhammad Riaz, a religious influencer in UC Muryali, district D.I. Khan, KP.
Aliya Ejaz overseeing the setup of essential health equipment, including cold storage for polio vaccines, during a vaccination campaign in D.I.Khan. PC @NEOC/2024
The ISD initiative now includes comprehensive services such as pediatrics, nutrition, family planning, antenatal care, and birth registration. These services, coupled with off-site health camps linked to polio campaigns, have made a lasting impact on the community's health and well-being.
As Aliya reflects on her decade-long journey, she is filled with a sense of accomplishment. "It is overwhelming to see the positive changes in people's behavior and attitudes," she says. "We have not only increased immunization rates but have also built a healthier, more resilient community."
Aliya’s efforts have earned recognition from both her supervisor and colleagues. “The area, which primarily consists of refugee families, had over 2,800 polio vaccine refusals in 2018, including many chronic cases that were once seemed unmanageable even by the district administration. However, with the help of the ISD and the distribution of free medicines, the number of refusals has significantly decreased," said Ali Raza, the Union Council Polio Support Person in D.I.Khan.
Aliya's work stands as a testament to the power of integrated health services in overcoming challenges and building trust in communities long resistant to change. Her story is a beacon of hope, illustrating how dedicated efforts can lead to lasting, meaningful improvements in public health.
Aliya Ejaz leading an influencer engagement session for the Integrated Service Delivery in D.I. Khan, KP. PC @NEOC/2024
For more information, please contact: Amina Sarwar | UNICEF Pakistan Country Office This email address is being protected from spambots. You need JavaScript enabled to view it. | +92-3125190383