好英语网击毙拉登可能影响抗击小儿麻痹症
Did the killing of Osama bin Laden have an unintended victim: the global drive to eradicate polio?
击毙奥萨玛·本·拉登(Osama bin Laden)是不是给在全球根除小儿麻痹症的努力带来了意外的副作用？
In Pakistan, where polio has never been eliminated, the C.I.A.’s decision to send a vaccination team into the Bin Laden compound to gather information and DNA samples clearly hurt the national polio drive. The question is: How badly?
小儿麻痹症在巴基斯坦从未根除，而很明显，美国中央情报局(C.I.A.)利用疫苗小组在本·拉登住宅收集信息和DNA样本的做法损害了巴基斯坦全国抗击小儿麻痹症的工作。问题是：损害有多严重？
最后的百分之一 5月，巴基斯坦的白沙瓦，一名儿童正在接受小儿麻痹症疫苗接种。
After the ruse by Dr. Shakil Afridi was revealed by a British newspaper a year ago, angry villagers, especially in the lawless tribal areas on the Afghan border, chased off legitimate vaccinators, accusing them of being spies.
一年前，一家英国报纸披露了这个由沙基勒·阿夫里迪(Shakil Afridi)医生带队的秘密行动，愤怒的村民，特别是阿富汗边境混乱部落地区的村民，开始驱赶正规的疫苗接种人员，说他们是间谍。
And then, late last month, Taliban commanders in two districts banned polio vaccination teams, saying they could not operate until the United States ended its drone strikes. One cited Dr. Afridi, who is serving a 33-year sentence imposed by a tribal court, as an example of how the C.I.A. could use the campaign to cover espionage.
接着，上个月底塔利班两个区的指挥官下令禁止小儿麻痹症接种小组的工作，称除非美国停止无人机轰炸，否则他们不能开展工作。一个指挥官还说，阿夫里迪就是中央情报局利用疫苗接种来掩盖其间谍行为的例子。阿夫里迪目前已被一个部落法院判刑33年。
“It was a setback, no doubt,” conceded Dr. Elias Durry, the World Health Organization’s polio coordinator for Pakistan. “But unless it spreads or is a very longtime affair, the program is not going to be seriously affected.”
“毫无疑问，这是一次挫折，”世界卫生组织巴基斯坦根除小儿麻痹症协调官员埃利亚斯·迪里(Elias Durry)承认。“但只要事态不扩大，或者不具有长期性，项目就不会受到严重影响。”
He and other leaders of the global war on polio say they have recovered from worse setbacks. The two districts, North and South Waziristan, are in sparsely populated mountains where transmission is less intense than in urban slums. Only about 278,000 children under age 5 — the vaccine target population — live there. By contrast, in northern Nigeria, where polio is being beaten after years of public resistance to the vaccine campaign, children number in the millions.
他和其他一些领导全球小儿麻痹症防治工作的人士称，他们经历过更严重的困境，现在也走出来了。南北瓦济里斯坦(Waziristan)两个区处于山区，人口密度小，和城区贫民窟相比，疾病传染强度相对较弱。这里，5岁以下的目标接种儿童只有27.8万人。相比之下，尼日利亚北部有数百万儿童，前几年，当地人抵制接种疫苗，这里的小儿麻痹症已经得到控制。
Also, Dr. Durry said, vaccinators reached 225,000 Waziristan youngsters in early June, before the ban. All will need several doses to be fully protected, but each dose buys time.
迪里还称，6月初在禁令发出之前，疫苗接种者在瓦济里斯坦已经给22.5万青少年接种。他们都需要几次接种才能得到全面保护，但每一次接种都争取了时间。
And, said Dr. Bruce Aylward, the W.H.O.’s chief of polio eradication, vaccination teams are posted at highway checkpoints, train stations and bus stations. They give drops to all the children they find.
此外，世界卫生组织根除小儿麻痹症项目负责人布鲁斯·艾尔沃德(Bruce Aylward)称，接种小组驻扎在高速公路检查站、火车站和公交车站。只要发现孩子就给他们接种。
The truth probably won’t emerge until the summer spike of polio cases tapers off in the fall. The virus likes hot weather, and the summer monsoons flood the sewage-choked gutters where it lurks.
可能要等到秋天，夏季高发期过去，我们才能看到真实的情况。小儿麻痹症病毒喜欢高温天气，而夏季丰沛的雨水又会把它们从隐藏的污水沟里冲出来。
Paralyzed children may also be found in neighboring countries with better surveillance, as they have been before just over the China and Tajikistan borders. Genetic testing will show whether the strains are Pakistan-based.
在其他疫情监控较好的邻国也能发现瘫痪儿童，比如在中国和塔吉克斯坦边境就发现过。基因检测将测出这些病毒株是否来自巴基斯坦。
By contrast, if the eradicators are winning, local paralysis cases will slowly shrink to zero, as they have in India, a former epicenter which has not had a case in almost a year and a half. And the virus will no longer be found in sewage samples from Pakistani cities, as it is now.
相反，如果根除小儿麻痹症的努力能够成功，当地的瘫痪病例就会像在印度一样，慢慢减少至零。印度曾经是小儿麻痹症发病的中心，现在已经有一年半没有发现病例了。如果医疗工作者取得成功，巴基斯坦的城市污水样本中也将不会再发现病毒。
Local anger was at its height last July, when The Guardian exposed the C.I.A. connection. It was confirmed by Defense Secretary Leon E. Panetta in January. Public outrage flared again in May after Dr. Afridi was sentenced. A coalition of aid groups protested to David Petraeus, the director of Central Intelligence.
去年7月，《卫报》曝光了中央情报局的活动后，当地的愤怒曾达到最高潮。今年1月份国防部长利昂·E.·帕内塔(Leon E. Panetta)证实了这一消息。5月份，阿弗迪里被判刑后，群众的愤怒再一次爆发。一个援助组织联盟向中央情报局局长大卫·彼得雷乌斯(David Petraeus)提出了抗议。
“There could hardly have been a more stupid venture, and there was bound to be a backlash, especially for polio,” said Dr. Zulfiqar A. Bhutta, a vaccine specialist at Aga Khan University in Pakistan.
“几乎没有比这更愚蠢的冒险了，而且肯定会引起强烈反应，尤其是在小儿麻痹症疫情上，”巴基斯坦阿迦汗大学(Aga Khan University)疫苗专家佐勒菲卡尔·A.·布塔(Zulfiqar A. Bhutta)称。
The setback was just one more in the endless war on polio, which was supposed to have been over by 2000. The fight is against the last 1 percent of cases. Paralysis cases worldwide have shrunk from 350,000 in the 1980s to about 600 now.
这只是与小儿麻痹症漫长斗争史上的又一次挫折而已。根除小儿麻痹症的努力曾被预期要在2000年结束。目前的努力是为了消除最后百分之一的感染。全世界瘫痪病例的数字已从20世纪80年代的35万减少到目前的600例。
Victory gets tantalizingly close, and then recedes, forcing health authorities to appeal for another $1 billion, as they did recently in Geneva.
胜利就在眼前了，但又出现了反复。卫生机构最近不得不在日内瓦另外申请10亿美元的救援资金。
Nigeria had only 62 cases last year; Pakistan had 198. For every known case, there are about 200 carriers with no symptoms, experts believe. Thus far in Pakistan this year, only 22 confirmed cases have been found. But the virus is still in sewage samples, meaning people are still shedding it.
去年尼日利亚只有62个病例；巴基斯坦有198个。专家称，每发现一个病例，就意味着有大约200个没有任何症状的病毒携带者。今年在巴基斯坦只确认了22个病例。但污水样本中仍然有病毒发现，说明还有人携带病毒。
Paradoxically, Dr. Afridi was not offering polio vaccine, but hepatitis B vaccine.
而令人不解的是，阿夫里迪提供的不是小儿麻痹症疫苗，而是乙肝疫苗。
Exactly why has not been elucidated, but there is a possible explanation: Hepatitis vaccine is injected, while polio vaccine is oral drops. If the objective was to gather DNA — which Dr. Afridi’s team apparently failed to do — it would be easy to aspirate a little blood into each needle.
没有人解释这究竟是为什么，但是一种可能的解释是：肝病毒疫苗是通过注射接种的，而小儿麻痹症疫苗是口服的。如果目的是为了收集DNA，那么，在每个针管里抽取少量血液是很容易做到的，但阿夫里迪似乎并没有成功收集到DNA。
Also, “hepatitis B could be kept under the radar,” Dr. Bhutta said. “For polio, there are too many players and agencies,” he said.
此外，“防治乙肝可以比较隐蔽地进行，”布塔说，“小儿麻痹症的工作，有太多人和机构参与。”
But polio is the vaccine with a long history of controversy among Muslims in many countries, so Pakistanis who were not familiar with the difference turned on polio vaccinators.
但小儿麻痹症的疫苗在很多国家的穆斯林中长期以来都有争议，所以分不清楚其中区别的巴基斯坦人就会把矛头指向小儿麻痹症疫苗接种者。
Rumors about polio vaccine abound: that it is a Western plot to sterilize girls, that it is unclean under Islamic law, that it contains the AIDS virus. The W.H.O. and the United Nations Fund for Children, which oversee the campaign, have asked Islamic scholars, including top Saudi clerics, to issue fatwas saying the vaccine is safe and should be given.
关于小儿麻痹症疫苗的谣言有很多：有人说是西方用来给女孩绝育的手段，有人说伊斯兰法律认为这不洁净，还有人说里面含有艾滋病毒。负责监督小儿麻痹症工作的世界卫生组织和联合国儿童基金已请求包括沙特神职领导人在内的伊斯兰学者给出裁断，声明疫苗是安全的，应该接种。
Five years ago in Afghanistan, when Taliban sympathizers beat vaccinators, Unicef and the W.H.O. successfully appealed to the Taliban leader Mullah Muhammad Omar for letters of protection their teams could carry.
五年前在阿富汗，发生了塔利班支持者殴打疫苗接种人员的事，世卫组织和联合国儿童基金会向塔利班领导人奥马尔提出申诉，成功得到了庇护令，供医疗小组随身携带。
Now they are trying to open talks with the local commanders in Pakistan.
目前，他们正尝试与巴基斯坦当地的指挥官开展对话。
“They know we don’t have any control over drone strikes,” Dr. Aylward said.
“他们知道我们对轰炸机没有任何控制权，”艾尔沃德说。
Vaccination would be more welcome if other services were added, like care to prevent deaths in childbirth, Dr. Bhutta said.
如果增加其他服务，比如有助于降低产妇分娩时死亡率的医疗护理，这样的话接种疫苗的工作会更容易被接受，布塔说。
Pakistan’s polio failures started long before a Navy SEAL team killed Bin Laden. A “mafia” of local leaders was pocketing gasoline money, putting children on the payroll, fielding ghost teams and faking statistics, Dr. Durry said. More than 300,000 children lived in areas considered too dangerous to enter.
早在在海豹突击队击毙本·拉登以前，巴基斯坦根除小儿麻痹症的努力就已经失败了。迪里说，当地一些“黑帮”首领赚汽油钱，他们雇佣儿童上战场，捏造数据。约有30万以上的儿童生活在被认为由于太危险而不能进入的地区。
Then, in early 2011, stung by India’s success and with the W.H.O. threatening to issue travel warnings, the prime minister rolled out a new plan.
2011年初，印度根除小儿麻痹症成功，世界卫生组织警告要向巴基斯坦发布旅行警告，面对这样的压力，巴基斯坦总理才推出了一项新计划。
Officials were ordered to recruit mothers as vaccinators, and stipends for them went up. . Fundamentalist imams were lobbied to endorse the vaccine. “Knock on wood, the program is functioning well,” Dr. Durry said.
新计划要求官员招募母亲做疫苗接种的工作，给她们的津贴也增加了。原教旨主义的伊玛目们也被游说，要求他们支持疫苗接种。迪里说，“所幸这个项目现在开展的比较顺利。”
While the C.I.A. ruse hurt, Dr. Bhutta said, he still believes that Pakistan will eliminate polio.
布塔说，虽然中央情报局的行动带来了反作用，但是他相信巴基斯坦能够根除小儿麻痹症。
“Tragic as it is, I’m confident resistance will die down,” he said. “The rational religious establishment is engaged now, and the lunatic fringe is just the lunatic fringe.”
“虽然这有点悲哀，但我相信抵制会渐渐消失，”他说，“现在，理智的宗教组织已经介入，那些少数疯狂的极端分子只不过是少数疯狂的极端分子而已。”