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DE RUEHNE #8419/01 3531148
ZNR UUUUU ZZH
O 191148Z DEC 06
FM AMEMBASSY NEW DELHI
TO RUEHC/SECSTATE WASHDC IMMEDIATE 1570
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UNCLAS SECTION 01 OF 05 NEW DELHI 008419 
 
SIPDIS 
 
SIPDIS 
 
HHS OGHA (STEIGER/BHAT) 
 
E.O. 12958: N/A 
TAGS: PGOV PHUM SCUL SOCI KISL IN
SUBJECT: HINDI BELT MUSLIMS EAGER TO COMBAT POLIO BUT 
PROGRESS WILL BE SLOW 
 
REF: NEW DELHI 8243 
 
NEW DELHI 00008419  001.2 OF 005 
 
 
¶1.  (SBU) Summary:  The persistence of polio in Western Uttar 
Pradesh (UP) has been the subject of considerable media 
speculation and analysis, with much of the focus on the 
Muslim community.  Poloff and POL FSN traveled to the area 
December 11-13 to gauge Muslim views on the subject.  The 
near-universal consensus was that Islam has almost nothing to 
do with the problem, as the community and its leaders 
(including mualvis) support fully government efforts to 
eradicate the disease.  The problem is poverty, compounded by 
weak governance.  Poverty is endemic in much of West UP and 
the Muslims, for a variety of reasons, are towards the bottom 
in social indicators.  The poor suffer from lack of 
education, and a near total absence of basic infrastructure. 
In addition, UP does not possess adequate infrastructure to 
administer a comprehensive polio eradication program.  Births 
are not registered, there is little or no record keeping, few 
health professionals, and inadequate infrastructure to 
transport and store vaccines.  Until significant numbers of 
people (including Muslims) are lifted out of poverty, it will 
remain extremely difficult to eradicate polio or carry out 
any effective program aimed at improving the dismal social 
indicators in the state.  End Summary. 
 
Embassy Participation 
--------------------- 
 
¶2.  (U) Health and Human Services (HHS) and USAID are 
supporting India's polio eradication program.  HHS's Centers 
for Disease Control and Prevention (CDC) has detailed four 
professionals to India for this task. 
 
¶3.  (U) Director CDC Dr. Julie Gerberling is in Delhi 
December 19 to meet GOI officials and multilateral partners. 
She will urge the GOI to stay focused and redouble its 
efforts to reach all children to ensure that the polio virus 
is eradicated from India.  She will also state that India's 
success will be a global success, as India is the world's 
largest reservoir of polio. 
 
¶4.  (U) The GOI's Ministry of Health has organized a round 
table meeting on December 19 on polio eradication, which will 
be co-chaired by Health Minister Dr. Anbumani Ramdoss and the 
CDC Director. 
 
Bellwether Project:  Uttar Pradesh 
----------------------------------- 
 
¶5.  (SBU) New Delhi's POL and ECON sections will take the 
economic and political temperature of key states over the 
next year.  Such snapshots will give us a better sense of how 
local trends affect national politics, and ultimately, US 
foreign policy goals.  Uttar Pradesh (UP) (one of the 
"bellwether" states) is facing a state election in early 
¶2007. Poloff and POL FSN traveled to Muslim majority areas in 
the West of the state to the cities of Moradabad, Bareilly, 
and Rampur December 11-13.  This region of UP is one of the 
few remaining areas of the world where polio eradication 
 
NEW DELHI 00008419  002.2 OF 005 
 
 
efforts have failed, and much of the onus has centered on 
alleged Muslim reluctance to fully embrace the program and 
its goals.  During the visit, Poloff and POL FSN met with a 
cross-section of Muslims, from influential opinion leaders to 
ordinary villagers to gauge their thoughts on this issue.  We 
hope these reports will give Washington readers better 
insight into the vast India outside Delhi's Ring Road and the 
economic, security and social trends that will determine 
where India is headed over the long run. 
 
Polio and Muslim Behavior 
------------------------- 
 
¶6.  (SBU) Much has appeared in the Indian media regarding 
UP's failure to eradicate polio.  The centerpiece of the 
anti-polio program is a series of oral vaccines administered 
to infants and young children.  Despite protracted efforts to 
ensure 100 percent coverage in UP, there are populations 
which remain out of the program and whose children continue 
to contract the disease.  Polio has persisted in Western UP, 
which is home to a sizable Muslim minority, with some 
districts having a Muslim majority.  Much of the blame for 
this failure has centered on alleged Muslim antipathy or 
indifference to polio eradication efforts, with some 
commentators depicting this as an indicator of Muslim 
"backwardness" and inability to function in the modern world. 
 
 
¶7.  (SBU) For example, prominent Indian journalists Harish 
Khare and Sanjay Kapoor wondered to Poloff why Muslims inside 
India appear reluctant to accept polio vaccine when in India, 
but quietly accept it when going on the Haj to Saudi Arabia. 
They pointed out that Saudi Arabia will not accept Indian 
Muslim pilgrims unless they produce a "polio certificate" 
that documents that their children have been administered the 
vaccine.  At the behest of the Saudis, pilgrims are even 
administered polio drops at the Haj terminal at New Delhi 
International Airport.  In their view, the persistence of 
polio among Muslims in UP reflects an "active disinformation" 
campaign carried out by the most conservative elements of 
Muslim society.  The essential elements, they alleged, are a 
whispering campaign aimed at illiterate rural Muslims. 
Rumors circulate that the anti-polio campaign is actually a 
family planning program sponsored by the GOI to curtail the 
Muslim population.  The rumor purportedly asserts that the 
two drops of oral vaccine administered to Muslim children 
will only allow that child to have two offspring. 
 
Moradabad - Poverty is the Problem 
~---------------------------------- 
 
¶8.  (SBU) In Moradabad, Mohammad Akram Shamsi, a prominent 
businessman, and community leader, maintained that this 
problem had nothing to do with Islam or Muslim cultural 
attitudes and everything to do with lack of education, 
stating that "only uneducated people are resisting."  To back 
up his assertion, he pointed out that the Mayor of Moradabad, 
himself a Muslim, has joined hands with the entire Muslim 
leadership of the city to support the vaccine administration 
 
NEW DELHI 00008419  003.2 OF 005 
 
 
drive.  He also asserted that the city's maulvis are fully 
supportive and that the city leadership has documented 100 
percent compliance.  The problem, however, is in more remote 
villages, where resistance is sometimes encountered. 
 
¶9.  (SBU) Shamsi also asserted that, since polio in West UP 
has proven more resistant to vaccine, the government should 
establish a "first class lab" in Moradabad to develop vaccine 
better suited to the population.  Shamsi said that the 
lifestyle of West UP's poor, regardless of religion, also 
contributed to the prevalence of the disease, as they live 
with an almost total lack of sanitation, and often consume 
tainted food.  Muslims are principally affected as they are 
predominantly meat-eaters and eat meat that has not been 
fully cooked.  One problem, he noted, involved media coverage 
of polio programs.  Illiterate people are often ignorant of 
cause and effect, and all it takes is one instance of a child 
dying or coming down with a serious illness after consuming 
the vaccine, for villagers to conclude that it is dangerous. 
Shamsi urged governments to establish a comprehensive 
education program aimed at inculcating sanitation and proper 
hygiene practices to the poor.  Another problem, he noted, is 
the lack of infrastructure in this poorly developed region. 
Without proper refrigeration, it is very difficult to 
transport live vaccines.  He predicted that with overall 
economic development would come a rise in literacy and an 
increase in sanitation that would eventually conquer polio. 
 
Bareilly - Muslims Mobilize 
--------------------------- 
 
¶10.  (SBU) In Bareilly, Lt. Javed Khalid heads the National 
Cadet Corps (NCC) program at Islamia Inter College, the 
largest Muslim educational institution in the region.  He 
described the NCC's effort to contribute to an all-out Muslim 
program to eradicate polio in Bareilly and the surrounding 
area.  According to Khalid, the NCC has targeted specific 
Muslim villages and neighborhoods.  Provided with vaccine, 
the cadets distribute flyers several weeks in advance 
notifying residents of the program.  On the appointed day, 
always a Sunday when workers have a day off and families are 
more likely to be home, the cadets go house to house 
administering the polio drops and providing sweets to the 
children.  Khalid maintained that no family in urban Bareilly 
has resisted or refused the drops.  However, in surrounding 
villages, there was some initial resistance, with some 
families expressing fear that the drops were dangerous. 
Khalid was adamant that with the help of local Maulvis and a 
vigorous advertising campaign featuring the much-admired 
Hindi film star Amitabh Bachan, villagers have been convinced 
to accept the vaccine. 
 
Bareilly - Government Efforts Inadequate 
---------------------------------------- 
 
¶11.  (SBU) Dr. SP Goyal was, until recently, the Chief 
Medical Officer in Bareilly and administered the anti-polio 
effort there.  Dr. Goyal asserted to Poloff that the 
government of UP was simply not up to the task of running a 
 
NEW DELHI 00008419  004.2 OF 005 
 
 
successful program.  He pointed out that there were 17 
documented cases of polio in Bareilly, but that 15 had run 
their course with no ill-effects on the children.  This was, 
he noted, because the children had been administered polio 
vaccine as infants, which was enough to "abort the symptoms" 
before they became crippling.  Dr. Goyal pointed out that for 
a child to be fully immunized against Polio, he must take 
five separate doses of the vaccine starting at the age of six 
weeks.  He asserted that only 15 to 20 percent of the area's 
children had been administered all five required doses, and 
blamed this on the lack of government follow-up. 
 
¶12.  (SBU) Dr. Goyal pointed out that the government of UP 
had so far failed to put in place a mandatory birth 
registration process, and that without it, it is almost 
impossible to have an effective childhood immunization 
program.  This is compounded by an almost total lack of 
adequate medical infrastructure, including a serious shortage 
of health professionals capable of administering an effective 
anti-polio campaign.  Dr. Goyal pointed out that there are 
four million persons residing in the Bareilly area and only 
400 government health professionals.  He maintained that UP 
is facing a shortage of 3,000-4,000 qualified medical 
personnel.  Dr. Goyal also noted that there is not effective 
record keeping and not even one vehicle to allow government 
doctors to visit remote villages to monitor programs.  Dr. 
Goyal pointed out that this is compounded by the fact that 
Western UP is an "endemic zone" for polio, and that persons 
in the region have more resistance to common vaccines. 
 
UP's Weak-Failing Health Care 
----------------------------- 
 
¶13.  (SBU) HHS/CDC staff who have visited the polio affected 
areas of UP have been told by community leaders that there is 
a complete absence of health care in poor, Muslim dominated 
localities.  This absence of government supported programs 
for other diseases is the leading cause of the persistence 
and spread of infectious disease in these regions.  Because 
of the lack of health care programs, poor, uneducated 
citizens of UP are doubtful of the significance of the 
much-touted polio eradication campaign. 
 
Comment - Need to Get Beyond Stereotypes 
---------------------------------------- 
 
¶14.  (SBU) Indian media has been quick to assert that Islam 
and Muslims are behind the lack of progress in eradicating 
polio in West UP.  This is indicative of the often shallow 
and stereotypical reporting one sees regarding Muslims in 
India.  One does not have to travel far from Delhi and into 
the countryside to see poverty on a massive scale and it is 
this poverty that is making it so difficult to eradicate 
polio.  Muslims, for a variety of reasons, are predominantly 
poor in UP, and the problems associated with poverty are 
found in abundance among them as clearly documented in the 
recently-released Sachar report (Reftel).  Poor 
infrastructure, lack of sanitation, lack of hygiene, lack of 
education, lack of medical care, all but guarantee the 
 
NEW DELHI 00008419  005.2 OF 005 
 
 
persistence of the disease.  This is compounded by the 
deep-rooted governance problems that plague the state.  A 
poorly performing government bureaucracy is incapable of 
delivering basic health services to the overwhelmingly poor 
population of the region.  Poverty is pervasive in rural UP 
and without significant progress in lifting the population 
out of its depths, any social programs, whether they involve 
health, education, female empowerment, or provision of basic 
infrastructure will make little progress.  These economic and 
political factors will all but ensure that it will take a 
long time to totally eradicate polio.  Although most 
interlocutors were convinced that polio would eventually 
disappear, they advised lots and lots of patience. 
 
¶15.  (U) Visit New Delhi's Classified Website: 
(http://www.state.sgov.gov/p/sa/newdelhi/) 
PYATT