While these most recent attacks occurred outside the tribal areas (where they usually occur) and in major cities, health care continues to be delivered in normally dangerous areas. In Pakistan this means the tribal territories, which have never been completely under government control (as in local government, police, and such). In many of the tribal areas along the Afghan border the government uses troops and paramilitary forces to guard medical care teams, which are very popular with the civilians, not so much with the Islamic radicals. The medical teams are very active in trying to control communicable diseases. Most notably, these teams took part in the effort to eradicate smallpox in the 1970s and are now trying to eliminate polio. Unlike smallpox, the growth of Islamic radicalism and paranoia since the 1970s has made it much more difficult to wipe out polio.
The Pakistani government has been unable to completely eradicate polio in its tribal territories because of myths (that the immunization is actually a Western plot to kill Moslem children) and Taliban opposition to the presence of government health workers (and government employees in general). Since Osama Bin Laden was killed last year, the terrorists now justify attacks on vaccination programs because one of the ploys used to confirm the location of bin Laden was to have a CIA sponsored diphtheria vaccination team go to the bin Laden compound. Because of that, the Islamic terrorists consider all vaccination programs suspect, and many local and Western journalists agree with that assessment.
Still, the Pakistani government has made a considerable effort. As a result, there have been no certified cases of polio in Pakistan since 2008. But there have been reports of cases of children becoming paralyzed (what polio usually does, if it doesn't kill the victim) in tribal areas where the government had no control. Pakistani disease experts are pretty certain polio is still alive in remote areas and have urged the government to do whatever it takes to eliminate this terrible (that mostly hits children) disease. The recent attacks are dangerous because they occurred in large cities where there is a constant stream of new arrivals from the tribal territories. One kid infected with polio could cause dozens, or more, new polio victims, especially among children the vaccination teams were not able to reach.
Three years ago the government convinced the Pakistani Taliban to let health teams vaccinate children against polio. The Taliban leadership and government did this by agreeing that the presence of health workers was not an admission that the government controlled any area where the vaccination teams were operating. The government has also put more pressure on tribal leaders and now plans to punish parents (with fines and withdrawal of benefits) who do not get their kids vaccinated. That does not work if its Taliban death squads who are preventing the vaccination.
It's been a long fight. Five years ago the Afghan Taliban backed off on their opposition to polio vaccinations for children. As a result, there have been only 17 cases in 2007, 31 in 2008, and 34 so far this year. Radical Islamic clerics in Pakistan took the lead in pushing the idea that vaccinations for diseases are a Western plot to poison Moslem children. This particular fantasy has been rattling around for nearly a decade and has prevented a major vaccination effort from wiping out polio.
Like small pox, once there are no people with polio the disease is gone for good. That's because it can only survive in a human host or, like small pox, as a few samples, frozen in a heavily guarded government lab. The Islamic clerics urging parents not to vaccinate their children against polio has the effect of providing the disease with hosts and keeps it going. In 2006, 24,000 children were not vaccinated in northern Pakistan because of this paranoid fantasy. In Afghanistan it was even worse, with 125,000 children denied vaccination by Taliban terrorists (who attack the vaccination teams) that year. It took a major information and diplomatic effort by more clear thinking Islamic clerics and politicians to turn the situation around. But the paranoid opposition to vaccinations always seems to return.
The victims (usually children) either die or are crippled for life. When confronted by angry parents the Taliban says that it's "God's will" that the kid is dead or crippled. Many Moslem parents accept that because Islam means, literally, "submission" (in this case, to a bearded guy with a gun). But popular anger at this Taliban policy forced many radical clerics to drop their opposition to polio vaccinations (administered via a drop of vaccine on a child's tongue).
Islamic radicals in northern Nigeria (which is largely Moslem) have been waging a similar campaign against medical personnel trying to wipe out polio. Islamic paranoia about Western medicine has, for nearly a decade, been the major obstacle to wiping out polio.