Rafia Zakaria

Karachi is hot in April, searing and unbearably scorching. It is so hot that the plastic consoles inside cars melt; the backs of shirts are always wet. On the streets, blaring horns and flaring tempers rise with the boiling temperatures, snarling and shouting in a raucous din. The sun baked asphalt can blister a bare foot; the still, vapid torpor of tiny rooms crammed with people can suffocate. It was in this tepid mix of poverty and pollution and exhaustion that the lady health workers of Pakistan were working. In and out they go from tiny hovels in one of the most crowded neighborhoods of the country. In the alleys, there are usually only children. Their mothers, older sisters and grandmothers all inside the homes. Few doors open for men; hence the task is left for the women.  

Outside each door they wait, clad in their white coats and holding their government issued box of vaccines and basic health supplies. Inside, they ask the mothers, many of them only teenagers, to bring the babies, to unfurl the crying bundles on a bed or a table, so they can administer the drops of polio vaccine into their gaping mouths. The older children scurry around their feet, curious about their bag, their coats, and everything else. The mothers barrage them with questions. For millions, these young lady health workers are the only connection with a healthcare system. “Give me an injection,” one woman may beg, believing like so many that a shot can cure anything. Before the female health workers arrived, the women bared arms with rashes and revealed festering infections. They don’t listen when the health workers say there are not doctors. Most have never seen an actual doctor, and never will.

It was in just such a Karachi neighborhood on April 16 that a team of health workers was working with their vaccines and their boxes and their pamphlets on basic health information. The gunshots began suddenly coming from the other end of the alley. The workers, all unarmed, scattered and screamed and tried to take cover. The bullets bounced from the walls and shattered the windows of the small houses on either side. They were lucky that day; they lived. The polio drive in the city, however, which has reported several new cases of polio in the past year, was temporarily suspended.

Just four months earlier, in December 2012, five female polio workers had been gunned down in the city. They had been working in one of the city’s Pashtun neighborhoods, inside homes with women who leave their houses only when they wed or when they die. Their intrusions would no longer be tolerated, the militants who killed them announced over their bullet-ridden bodies. Their bereft families cried before television cameras, but the killings did not stop in December. They did not stop after the attack in April, either. In May, Pakistan held a national election and a new government was sworn in, and the attacks on polio workers continued. The last one happened in Peshawar, the capital city of Khyber Pakhtunkhwa province. In Karachi, the polio program that had been suspended last year remained so, and no more health workers went door to door in the most densely populated areas of the city. The lady health workers protested the suspension, the lack of security, the cessation of the task of inoculating Pakistan’s next generation. They tried to remind the government and the world that without them the poorest women and children of a poor country would not receive any healthcare at all. No one listened.

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The film Zero Dark Thirty iconized what has been touted as the Obama Administration’s biggest victory in the War on Terror.  With most Americans unapologetically news-averse and war wearied, it presented a sophisticated call to patriotism in a glib, even feminist package. The heroes were not the expected golden warriors of the secret Seal Team Six, who scurried into Pakistan in the dead of night and cornered the worst man on the planet. Instead, it was Maya, the stalwart, dogged FBI agent, who kept her eye on the target and was undeterred by the foot-dragging and eye-rolling of easily distracted male colleagues. Here, the movie argued mightily, was a good model for the new American woman, a catcher of sinister terrorists, sniveled away in the bowels of suspicious nations like Pakistan.

Expectedly, there are no Pakistani women in the movie. As all movie makers know, in stories of great courage, there is room for only one heroine, the incidental assistance of others a mere distraction from the paean to greatness so tunefully being sung. This quite likely is the reason that there is only fleeting emphasis, a smattering of scenes, on how spies seeped into the private spaces of the heavily female Bin Laden household, which secreted the notorious terrorist. The male doctor who headed the program is shown, but the female health worker who went inside is nameless and faceless. Reflecting reality is not important in film; anointing central characters to the altar of heroism is. Most American viewers left the movie theaters applauding Maya. Almost none registered the fact that the crucial bit of proof that led to Bin Laden was garnered through the auspices of a fake polio vaccination program. The DNA that determined Bin Laden’s identity procured through the collusion of a real doctor and fake lady health workers.

The story ends well for the United States. Osama Bin Laden is killed, a victory whose dramatic satellite-streamed final moments were watched all the way at the White House. The troop pull-outs from newly unpopular wars could not have proceeded without this appropriately theatrical sense of closure, this widely publicized death of Osama Bin Laden.  With his killing, something had been achieved. The bad man had been killed, and the next chapter, authored by a shifting pendulum of greater American self-absorption and a disinterest in the affairs of other nations, could now begin. It was especially nice to place an American woman at the center of the cinematic homage to victory; it underscored, after all, the incredible difference between those backward places where terrorists hide and the progressive, feminist, American ones that give birth to the women who catch them.

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In American movies or in American media, the story of the lady health workers has remained untold. The question is one of cost appraisal. In the American calculation, the death of Osama Bin Laden is a good that outdoes all harm.  Harm in the equation would be limited to only to the mayhem visible to American eyes, the direct maiming and massacre that could have resulted if the United States, Seal teams, and lady FBI agents had all chosen to undertake a ground invasion of Pakistan, or even engage in a bombing campaign of the compound. In the selling of the Bin Laden operation, with its female architects who searched so doggedly for the enemies of America and the golden warriors that undertook it so valiantly, the watching world is kept rapt in the goodness of it all, it’s precision, and, yes, its humanity.

The lady health workers of Pakistan have no tools at their disposal. The fact that they operate in a country so ravaged by war and its chaos as to all but have obliterated truth does not help their situation. Medical mishaps happen so often in Pakistan that conspiracies are often the best way to explain them, and for those who cannot expect a solution, such explanations are crucial. In this midst, when proof is paraded of a ruse posturing as a cure, of a lady health worker working under the auspices of a CIA agent, of a deceptive vaccination program that could be so easily doctored up by spies searching for a killer, no shreds of faith remain on which to erect a case for their innocence. If one polio vaccination program could be co-opted by the Americans to achieve their purposes, what guarantee is there, after all, that not all of them could be somehow altered. It is hard to convince Pakistani parents that Americans care about their babies. In the aftermath of the Bin Laden raid, the Tehreek-e-Taliban Pakistan announced that the polio vaccine is meant to sterilize all the babies to whom it is administered. After all, they said, the Americans had obliterated Native Americans with the help of just such methods.

In the immediate aftermath of the first attacks, the Lady Health Workers of Pakistan, who number about 100,000, tried to make a statement. They were angry about the politicization of their program, of being caught between an America that saw victories only in the deaths of terrorists and the Taliban who were happy to kill health workers, who saw them as doing America’s spying. After the December attacks, the Organization of Lady Health Workers disassociated from the “Short Interval Dose” program that was to begin on December 27, 2012. Several of their leaders tried to organize a strike, attempted to get attention in the media for the fact that millions of Pakistani women and children would be denied healthcare. Osama Bin Laden’s death had taken from them the access they had enjoyed to the private spaces where women reside, the spaces where ulterior motives are not permitted to enter. Before the raid they were tolerated. Afterwards, they became targets.

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The question of feminist solidarity, of what women in one part of the world owe to those in others, has been one at the fore of many discussions in recent years. As America enters the years of its withdrawal from Afghanistan, a country it invaded under the specific pretext of “liberating” its women, the question is likely to receive some play again. The maimed faces of abused Afghan women, the stories of bombed schools and burned shelters, will once again emerge, packaged in this or that political agenda. Those in favor of intervention will argue again that something is owed to the women who were asked to accept schools made from American aid on one day and bombs from American drones on another.

Nowhere in this debate will be the inherent misogyny of a War on Terror that decides which forms of liberation must be anointed as worthy of saving and which can be discarded for more crucial strategic ends. In the two years since the death of Osama Bin Laden, Pakistan, where polio was nearly eradicated, has registered fifty-six new cases of polio in twenty-eight different districts in the country. With the polio program all but stalled, and the newly elected government interested mostly in making peace with the Tehreek-e-Taliban Pakistan, this number is likely to increase. On May 28, 2013, with the death of another female polio worker in Khyber province, the cumulative death of health workers since December went up to twelve. The death was the first since the inauguration of a new polio drive in Khyber province that is using 682 teams of health workers to try and inoculate over 200,000 Pakistani children. On June 16, 2012 two more male polio workers were killed in Khyber Pakhtunkhwa which is reporting the highest number of polio cases in the country.

Developed in 1994, the Lady Health Worker Program of Pakistan took educated Pakistani women from rural and urban areas of the country and trained them in basic health provision.  In a country that is struggling to give its women a voice, where women have been deeply enmeshed in a fight against draconian laws and archaic cultural mores for the near seven decades of its existence, the program was a bold step forward that actually worked. Many of its kind have been destroyed by the incursions of patriarchal power, or rendered ineffective by the machinations of economic agendas that never see the health of women as a priority. Nearly all of these have been local evils, in which the enemies are filial and quite familiar. As the Lady Health Worker Program in Pakistan gasps for breath, with its workers killed and targeted, its work thwarted and delegitimized, the culprit is not one of these usual local suspects. Instead, it is an enemy that came from afar, under the cover of night, for whom the death of Osama Bin Laden, with its symbolic statement of strength, was more important than allowing the Lady Health Worker Program of Pakistan to live.

Rafia Zakaria is a columnist for DAWN, Pakistan’s largest English newspaper. She is a writer and PhD candidate in political philosophy. Her work and views have been featured in the New York Times, Dissent, The Progressive, Guernica, and on Al Jazeera English, the BBC, The Hindu, and National Public Radio. She is the author of The Upstairs Wife: An intimate history of Pakistan, forthcoming from Beacon Press.