LENS The New York Times

Photographing the Front Lines of the Global Battle Against Polio

By JAMES ESTRIN September 30, 2015

Diego Ibarra Sánchez did not hesitate one moment to have his infant son vaccinated against polio this year.

Unlike most other parents, Mr. Ibarra, a Spanish photographer, has seen up close the devastating cost of avoiding polio vaccinations, because of his experience photographing the fight against the disease in Pakistan, Afghanistan, Iraq and Nigeria.

By focusing less on the crippling condition and more on the factors preventing polio eradication, Mr. Ibarra has documented how violent conflict, fear and suspicion have made vaccinating children difficult in recent years.

“Children are paying the consequences of the violence, the bad practices of governments, and insurgent groups in war,” he said.

His work on this subject began in 2011, and in 2013 he continued to pursue the project in Karachi, Pakistan, while on assignment with the New York Times correspondent Donald G. McNeil Jr.

World health organizations are tantalizingly close to the total eradication of polio, but persistent pockets in war-torn areas have proved resistant to billions of dollars worth of eradication efforts. Last year, only 359 children worldwide were paralyzed by polio; 41 cases, all in either Pakistan or Afghanistan, have been found this year.

Resistance to vaccination campaigns increased in Pakistan after the death of Osama bin Laden, when it was revealed that the Central Intelligence Agency ran a phony vaccination program as a ruse to obtain DNA evidence from members of his family.

Rumors abound that vaccinations are dangerous, unclean under Islamic law and contain the virus that causes AIDS. Local residents have been warned that vaccinations were a Western plot against Muslims to sterilize girls. And as in some parts of the Western world, many hold firm to a disproved belief that vaccinations are more harmful than helpful to children.

In Pakistan, many health care workers have been killed while conducting vaccination campaigns.

Mr. Ibarra also photographed anti-polio campaigns in Nigeria and Afghanistan last year, and along the Syrian border and in the Kurdish areas of Iraq this year. In all of these countries, violent conflicts have contributed to the difficulty of vaccinating the population.

In Nigeria, he photographed a health care worker who was in hiding, fearing for his life after he survived an attack by Boko Haram, the Islamic militant group, which killed 11 co-workers. Despite Boko Haram’s opposition to vaccinations, Nigeria has been free of polio cases for the last year.

Mr. Ibarra also documented success stories, including a skateboard-riding soccer team in Nigeria for young men whose legs were paralyzed by polio.

Along the border between Syria and Kurdish areas of Iraq, he photographed programs to inoculate children fleeing war. Syria had a high vaccination rate before the uprising in 2011, but because of the conflict it has been difficult for health care workers to reach many children.

“I am not only showing health care workers giving vaccines, but trying to go deeper and show all the problems in daily life — the violence, the paranoia, the fear of terrorist attacks and the lack of sanitation that contributes to the persistence of polio,” he said.

Born and raised in Zaragoza in northwestern Spain, Mr. Ibarra is a founding member of MeMo, a cooperative of photojournalists who produce MeMo Magazine, an app for smartphones and tablets. He often works for The Times and last year embedded with United States Special Forces in Afghanistan.

Mr. Ibarra moved from Islamabad to Beirut in 2014, and now focuses on polio eradication in Syria and Lebanon.

Though he has covered war extensively, he prefers to show the consequences of war rather than men holding guns. His focus on the effects of violent conflict led him to follow the polio story, he said.

In Pakistan, Mr. Ibarra met several men who refused to vaccinate their children. They later became paralyzed by the disease.

“If you don’t vaccinate your children, you may see your children suffer for the rest of their lives,” he said. “They’re not likely to die, but they will suffer the consequences of your mistakes.”