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The largest development initiative of its kind in the Middle East.

Our approach

A unique financing model

Looking out the window, Ayesha wakes up every day with a new dream, new hope.

#### Dive into the world of Ayesha Reza, a courageous polio survivor, who is committed to eradicating the virus from the lives of under-5 children in Pakistan.

Lahore – the legendary city of conquering emperors and one of the last vestiges of Mughal culture and grandeur, echoing through a 30-feet high gigantic wall and thirteen gates that surround the old city.

One of these gates lead out into a suburb town of Ghaziabad where the protagonist of our story – Ayesha Reza – lives with her husband and daughter. 

To meet this brave polio survivor and follow her journey as a dedicated polio health worker, we squeezed through a honeycomb of narrow and cacophonous streets of Ghaziabad. Greeted by the quintessential sight of careless bikers, carefree children, loafing dogs, and hungry cats, we reached a solitary two-storey house in a dead-end street.

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Despite her physical limitations, Ayesha makes sure that she does not miss a single day at work.  

“Walking down these busy bustling streets is a way of life for me. I get ready for work every day by 7:30 am, slightly earlier if it’s the immunization day,” Ayesha told smilingly in her open-air veranda.

It was the summer of 1988 when Ayesha, only two years old, woke up with high grade fever and terrible weakness in her left leg. Considering it a common occurrence among children of her age, Ayesha’s parents treated her with regular over-the-counter medicines and herbal teas.


But when the stubborn fever refused to subside, leaving Ayesha’s left limb weaker than before, her father rushed her to a nearby hospital, without suspecting the chance of a life-threatening disease hitting his daughter. After medical tests, Ayesha was diagnosed with polio.

"My parents had not heard of polio before. In 1988 the awareness about polio was almost non-existent. There was no vaccine either. But when the doctor explained it to my parents, they were obviously very worried. I’m sure they couldn't bear the thought of their daughter unable to walk normally for the rest of his life," Ayesha said.

Ayesha was completely paralyzed in the beginning but with available treatment she gained some stability and strength at the age of 5. She started her schooling at the age of 6, but her mother's failing health forced her to discontinue her education beyond matric.

![Childhood Photos.png](https://llf-content-cdn.azureedge.net/llfcms/assets/Childhood_Photos_bfaa851b13.png)
Ayesha flashbacks at her childhood that was different from the rest of her siblings and children in the family and neighborhood.  

Ayesha, now 38, grew up facing discrimination and jeering remarks because of her unusual walking style, but she stood her ground and pushed ahead. Ayesha recalls, “Growing up with polio is not easy for any child. Besides being physically dependent on others, this disease breaks you emotionally and spiritually too. But now I’ve learnt to use it as my strength.”

A part-time seamstress, Ayesha found her true calling after marriage in 2013 when her father-in-law showed her openings in the Punjab Health Department. She immediately applied and was inducted into the Dengue Surveillance Team and later made it as a polio vaccinator.

Pakistan is one of the two South Asian countries where children below five are at risk of contracting the debilitating, highly infectious polio virus that can lead to paralysis and death. The massive polio eradication program, constituting country wide campaigns spearheaded by nearly 300,000 health workers and vaccinators, is one of the largest public health programs in the world that is tackling the global emergency of polio virus head-on.

The Islamic Development Bank and its donor partners such as Bill & Melinda Gates Foundation, Abu Dhabi Fund for Development, Islamic Solidarity Fund, King Salman Humanitarian Aid and Relief Centre and Qatar Fund for Development, are playing a pivotal role in the Polio Eradication Initiative by the Government of Pakistan.

With critical polio financing, worth US$ 160 million, through the Lives and Livelihoods Fund, these global partners have brought over 500 million oral poliovirus vaccines (OPVs) for 43 million under-five children to their doorstep. The assistance has also set vital immunization and awareness raising activities in motion throughout the country.

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One family at a time: Ayesha’s work motto as she waits outside a house during door-to-door polio vaccination campaign.

“I go from house-to-house raising awareness about polio and vaccinating children under the age of five,” tells Ayesha. “The bulk of my work is debunking old wives’ tales about polio vaccines. Parents are always hesitant, but sometimes they get aggressive, and for our safety and security we call in senior officials and police.”

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Children receiving free polio vaccine from their favorite Aunty Ayesha in the street. 

“A lot of time I use my condition to demonstrate to parents what their children might suffer if they don’t get them vaccinated on time. I tell them how my body has weakened over the time despite treatment. I cannot walk or stand for lengthy hours as I fall; this has affected my right knee. It is not easy to present yourself as an example, but I do not mind doing it if it makes a difference in the lives of our children,” Ayesha continues. 

![Ayesha with her daughter on bed.jpg](https://llf-content-cdn.azureedge.net/llfcms/assets/Ayesha_with_her_daughter_on_bed_e61b9f528a.jpg)

As Ayesha forayed into motherhood after a 11-year long wait, her struggle and commitment got a new meaning. The three-month old Umme Aiman has taught her to be more patient and empathetic towards parents, especially mothers, who are reluctant to get their kids vaccinated.

“As a mother, I’m thankful to Islamic Development Bank and LLF for providing us with vaccines and saving our future generations from lifelong disability and dysfunction,” concludes Ayesha with a smile in her eyes.

![Register 2.png](https://llf-content-cdn.azureedge.net/llfcms/assets/Register_2_7fa0568905.png)

At work, ‘Tikoo’ – vaccination mascot - is Ayesha’s best friend that keeps her daughter and other children protected from fatal diseases. 

Ayesha Reza is one of the 300,000 stories of inspiration, courage, and grit. Our frontline health workers and vaccinators are heroically driving the polio eradication program forward. A marked increase in vaccination rates, community awareness levels, and general trust in the local healthcare system are direct results of their efforts. 


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We are funding programs that combat infectious diseases, such as malaria and polio, ensure routine immunization, and strengthen primary health-care systems. 

Healthcare

THE CHASE

World Health Day

Four-day old Zain receiving his first dose of oral polio vaccine in Rawalpindi, Pakistan.
**PHOTO: Pakistan Polio Eradication Program**


#### ISLAMIC DEVELOPMENT BANK AND PARTNERS LEAVE NO CHILD BEHIND IN THEIR FIGHT AGAINST POLIO IN PAKISTAN

Wedding festivities are in full swing in one of the nomadic settlements in Rawalpindi - the fourth most populous city in Pakistan. The four-day old Zain is the youngest guest at the wedding, who has travelled all the way from Multan with his 50 year-old grandmother Sakina Bibi. 

It’s a big day for Zain as he is about to receive his first dose of free oral polio vaccine in Union Council Cant. 10, which is one of the 192 polio hotspots in Rawalpindi, and is on the radar of local authorities for regular tracking and targeted immunization drive. 

Known as ‘khana badoshs’ locally, the nomads in Pakistan, like elsewhere, are particularly more vulnerable to polio because they are perennially on the move and likely to give a miss to door-to-door vaccination campaigns. Although sometimes polio workers don’t have a door to knock on. Only a makeshift tent.

“Mobile and migrant populations are under-vaccinated compared to settled groups. As a result, they act as a vehicle carrying the virus to and from the reservoir and diluting population immunity.” says the District Health Officer of Rawalpindi, Dr Abdul Jabbar.

However, the financing partnership of US$ 160 million between the Islamic Development Bank (IsDB) through the Lives and Livelihoods Fund (LLF) and global development partners such as the Bill and Melinda Gates Foundation, the Abu Dhabi Fund for Development, the Islamic Solidarity Fund for Development, KSrelief and the Qatar Fund for Development, is reversing the situation for the better. 

The IsDB and LLF assistance to the Government of Pakistan’s Polio Eradication Initiative (PEI) has been critical in operationalizing immunization activities and securing 501.14 million oral poliovirus vaccines (OPVs) for 43 million children across the length and breadth of the country.

![Girls access to polio vaccines.jpg](https://llf-content-cdn.azureedge.net/llfcms/assets/Girls_access_to_polio_vaccines_bff41e3c03.jpg)
The LLF-supported National Immunization Days have shattered stereotypes about the polio vaccine as well as paved the way for more girls to have access to them. **PHOTO: Pakistan Polio Eradication Program**

“How to reach children where they leave from and where they land, even if that “landing” is only for a few days stay at a relative’s house, is by no means easy. It requires a different approach to the process of microplanning and immunization activities,” tells Sidrah Nouman, who has just administered the drops to Zain.

“My seven grandchildren get vaccinated each time the vaccinators come at our doorstep; we do not have to go anywhere,” exclaims Amana Bibi, one of the residents of UC Cant. 10.

The operational support from LLF has helped launch 12 National Immunization Days (NIDs), which catalyze community mobilization in urban and rural cities. The close collaboration between different partners and cooperation from communities have also ensured that the national immunization campaigns run on the wheels in wake of natural and health emergencies. The dedicated efforts of all stakeholders were particularly noticeable when NIDs resumed after COVI-19 hiatus in 2020. More than 260,000 trained frontline workers took part in anti-polio campaign and administered vaccine among children without touching them.
The skilled frontline health workers trained by LLF are the linchpin of a monumental feat of eradicating polio. They travel many kilometers, often into uncharted territories, rife with disasters and insecurity. Sometimes they run out of fuel, sometimes they’re welcomed with aggression, but the vaccinators take it in their stride. 

![Polio health worker waiting outside.jpg](https://llf-content-cdn.azureedge.net/llfcms/assets/Polio_health_worker_waiting_outside_d4352a5afe.jpg)
Health workers often must wait outside in scorching heat before being permitted into the house to vaccinate children in rural regions of Pakistan. **PHOTO: World Health Organization/Pakistan**

One such vaccinator is Zareen Khanum, who is part of the 260,000 strong frontline workforce that regularly defies all odds to reach vulnerable children with the polio vaccine during NIDs. She is now joined by her 20-year old son, Mujeeb. Together this mother-son duo covers more than 120 houses from dawn to dusk.

“I do not support my mother for money or ambition, rather, I feel proud to be part of this national cause for my country and my country’s children,” says Mujeeb. 

“People listen to me as I am committed to this cause. They know and recognize my mother and me from years of knocking on their doors during campaign rounds. I have always made it a point to inform them of scientific evidence in order to overcome any misinformation or conspiracy theories they may have about the polio vaccine,” he added.

In addition to achieving operational efficiency, the Lives and Livelihoods Fund’s contributions to the Pakistan Polio Eradication Initiative have strengthened other areas of work like strategizing and finding solutions to immunize hard-to-reach children, surveillance, vaccine procurement, awareness raising, and communications – all of which have made the program more adaptable and responsive to the dynamic and rapidly changing polio eradication environment. The success of the initiative has also inspired confidence in the healthcare system and provided a strong foundation for countering other public health threats, while also improving healthcare seeking behavior among parents. 


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 STEMMING THE TIDE OF POLIO

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Lives and Livelihoods Fund is a joint vision of the Islamic Development Bank (IsDB) and other development cooperation partners aimed at raising the poorest out of poverty in IsDB member countries.

About us

The Lives and Livelihoods Fund enables member countries to invest in themselves by providing concessional financing for projects with high human development impact.

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The portfolio of projects approved by the LLF from 2016 to 2020 is already transforming thousands of lives and livelihoods.

Latest updates

World Health Day

THE CHASE

08, April 2024

Latest updates

World Health Day

THE CHASE

08, April 2024

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The largest development initiative of its kind in the Middle East.

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