Two months ago, doctors working in the rebel-held area of Deir al-Zour in northeast Syria reported the initial cases. Polio had been nearly wiped out globally, and this was the first outbreak in Syria since 1999.
Clearly an emergency vaccination campaign was needed. With sanitary conditions deteriorating under regime bombs, the outbreak could explode if spread throughout the region by Syrian refugees.
But here's the kicker. The fastest way to reach many endangered areas would be to transport vaccine across the Turkish border; opposition medical personnel and activists in Turkey and Syria organized a task force for distribution within Deir al-Zour and other northern districts.
However, the U.N. agencies that provide such vaccines - the World Health Organization and the United Nations' Children's Fund (UNICEF) - will only work through governments, meaning the Assad regime.
WHO and UNICEF won't deliver aid across the Turkish border to Syrian children because the Assad regime won't OK it. "United Nations agencies do not provide such cross-border aid fearful that their operations in Damascus will suffer reprisals," complains Dr. Joanne Liu, president of Medecins sans Frontieres International, a private aid agency that sends medical aid across the border.
The U.N. stance means the Syrian government is in charge of the vaccination effort. True, U.N. personnel and Syrian health workers do take big risks crossing endless checkpoints to deliver vaccine to many parts of the country. But tens or even hundreds of thousands of children in opposition-controlled areas are not getting the vaccine. (Children in areas of Damascus and Homs besieged by government soldiers are getting no medicine at all.)
Last week, I met Dr. Bashir Tajaldin, an epidemiologist with the opposition's transitional government in Gaziantep; he insisted that WHO's two vaccination campaigns since the October outbreak have failed.
Tajaldin said Assad's health ministry sent the vaccine to its office in Deir al-Zour, which sits in a small government-controlled area in the middle of rebel territory. In order to collect the vaccine, subdistrict health officials have to cross a bridge from rebel-held to regime-held territory. "Every day five, 10 people are killed on this bridge," Tajaldin said. "Some subdistrict employees fear to go."
Their fears are enhanced by the regime's brutal campaign against opposition doctors and medical personnel. "The government tries to bomb field hospitals," Tajaldin told me. "I was 100 meters away from a hospital when it was bombed in Latakia. Many of my doctor friends have been imprisoned or killed." Only last week, a British doctor arrested by the regime a year ago, and finally set for release after international pressure, was found hanged in his cell, an alleged "suicide."
In contrast to the government, Tajaldin says that the opposition's medical network can go door to door with vaccines, the optimum procedure for anti-polio campaigns.
He also claims he got a "verbal promise from senior WHO and UNICEF officials" that they would deliver polio vaccine to Gaziantep in early December. Aid groups could then ferry the vaccine in without requiring U.N. agencies to violate their rules on sovereignty. However, the allegedly promised vaccine has not arrived.
Asked about Tajaldin's claim, Cairo-based WHO spokesperson Rana Sidani replied: "We cannot confirm that such a pledge has been made."
If it hasn't been made, it should be. After almost eradicating polio, it is criminal for the United Nations to risk a resurgence for reasons of politics.
Although WHO says there are 17 confirmed polio cases, Tajaldin says there are 66, with two more recently discovered in Tal Abyad, right on the Turkish border. For each known case, he says, there are 200 asymptomatic carriers who could be spreading the disease. Whoever is correct, the disease has not been contained.
When the world feared a genocide in the Darfur region of Sudan, the United Nations sent in food from Chad without asking the Sudanese government's permission. True, that operation obtained a U.N. Security Council mandate, which it might not get on Syria because of the Russian veto. But would Moscow really nix an anti-polio campaign to help Bashar al-Assad? If so, the world community should mount a global campaign aimed at shaming Moscow - or stand complicit in the coming epidemic.
As for WHO and UNICEF, the global protectors of children's health, they must find a way to speed vaccine across the Turkish border to Syria, and soon.