In the wake of the May 2, 2011 takedown of public enemy number one, Osama Bin Laden, a doctor was taken into custody in Pakistan. Dr. Shakeel Afridi had been working on behalf of the CIA in Abbottabad when he set up a fake vaccination center with the explicit intent of taking blood samples from children believed to be relatives of Bin Laden. The Pakistani born and trained physician now faces a sentence of 33 years in prison and a hefty fine for his work attempting to triangulate the location of the world's most wanted man and, possibly, for militant links himself. As the Afridi case unfolds we are observing the delicate international relation bonds that allow medical work to continue as they are strained by political and religious pressure.
Within hours of the sentence outrage rocked the already fragile relationship between Washington and Islamabad with some members of Congress calling on Pakistan to release the doctor or face economic sanctions. In the eyes of many Americans, Afridi is a hero - one Congressman even authored legislation that would see the doctor become a naturalized citizen.
But there is another aspect of the CIA's use of a doctor in their quest for international justice that deserves attention. Indeed, while the goal of delivering up the leader of Al Qaida is noble, the means, in this case, have consequences the world round. Turning members of the medical community into possible CIA agents threatens to derail crucial humanitarian work especially, and most devastatingly, in the Muslim world.
In the West we are familiar with anti-vaccine movements that typically originate in the fringes of legitimate scientific communities (the debunked vaccine-autism connection). In the Muslim world, however, there is a far more sinister conspiracy theory that now, with the revelation that Afridi was working for the CIA, has gained a certain amount of credence. The conspiracy theory alleges that the USA is using vaccine programs as a way to sterilize and kill off Muslims. In Muslim regions like Pakistan, Afghanistan, and Nigeria, where Islam dominates the political and religious landscape, any move that lends legitimacy to the rumors are destructive - especially as diseases like polio are making shocking comebacks.
Just months after India was proclaimed "polio free" thanks to a well executed vaccination program, its neighbor to the Northwest, Pakistan, is slipping. With the highest rate of polio cases in the world, 200 children paralyzed by the disease in 2011 alone, Pakistan is taking center stage as ground zero in a resurgent outbreak. Even as Islamabad is taking action, targeting 33 million children for vaccination, there are some Islamic clerics who insist these programs are nothing more than American attempts to destroy the children of Islam - literally. And now, thanks to Afridi, they have "proof."
At the heart of the issue is the question of how the medical community should be utilized in times of war. The use of Afridi in the assassination of Bin Laden has now jeopardized the lives of millions of children worldwide – setting a precedent that doctors cannot be trusted. Living in an age of globalization requires us to consider the consequences our actions will have on a large scale. In the short term Afridi appeared a good tool. In the long term, however, the use of doctors as agents of death puts the entire medical community in the position of having to prove itself innocent of political intrigue prior to effecting health care.
Yet the cultural impact of the American use of Afridi in its quest for Bin Laden is only one aspect of the resurgence of polio in the Muslim world. While the move was assuredly reckless and irresponsible, the system that has allowed the outbreak was already in place: rampant religious fervor responding to the radical inclinations of a few, poorly educated clerics. The dominos were lined up in advance of the American bumble.
Osama Bin Laden was assassinated following a global campaign that targeted him for his role, not in the organization or execution of the September 11, 2001 attack on the United States, but as the proverbial “godfather” of the terrorist network that perpetrated the acts. While his death was accompanied by a sense of closure for many in the West, what we assuredly do not want is a polio outbreak resulting from the manner in which that man’s life was taken. We do not want to be responsible for igniting the fears of the credulous simply due to a poorly planned operation in Abbottabad. The current outbreak could have been avoided had more foresight been applied – and while we surely have the benefit of hindsight at the moment, this case has again underscored the need for us to better appreciate the cultural landscape wherein our military operates.