Pakistan is one of only two countries in the world where poliovirus remains endemic – the other being neighbouring Afghanistan.
Pakistan launched an eradication campaign to combat the spread of the disease in 1994. The country once reported 20,000 cases a year, according to government health officials. Although the number has dropped significantly — just five so far this year — the disease remains widespread.
According to the Pakistan Polio Eradication Program, Pakistan administers more than 300 million doses of the oral vaccine every year with the help of at least 350,000 vaccinators.
Healthcare workers and accompanying security officials have often been subjected to harassment, ridicule, abuse, threats and physical attacks, and government officials say at least 102 have been killed in the field, including during operations carried out this year.
In addition to these attacks and refusal to take the vaccine, health workers face other challenges including low wages, delayed salary payments and difficult working conditions. One health worker who spoke to Al Jazeera said he was being paid just 1,360 rupees (around $5) for an eight-hour day.
Some polio survivors working in eradication efforts say they have no access to transportation or medical care despite their disease, and that they have to walk through difficult terrain and harsh weather conditions while working.