What Type of Social Entity Are You?

The Regular Jo(e)

Category III – The Regular Jo(e)
You are the quintessential standard conjured by the word ‘Friend’.

What Type of Social Entity are You?
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Via Randy McDonald


Via The Acorn comes this Nawaz Sharif interview about Kargil.

Insisting that he was kept in the dark over Pakistan Army’s Kargil aggression, former Pakistan prime minister Nawaz Sharief has said the then Pakistan Army chief General Pervez Musharraf and two other top military commanders toppled his government in October, 1999 as they feared their court martial for planning and executing it.

[…] “Initially, when the scuffle had started, Musharraf said it was the Mujahideen that was fighting in Kashmir, I thought since Mujahideen keep fighting, therefore, it is not a new phenomenon,” Sharief said in an interview to India Today magazine in its latest edition.

He revealed, “Later, I got a call from Vajpayee saab, saying ‘Nawaz saab, ye kya ho raha hai (Mr Nawaz, what is happening)? Your army is attacking our army. They are fighting our army’. I said there was no Pakistan Army fighting against his army… I suppose I should have known about all this. But frankly, I hadn’t been briefed.”

[…]Sharief said he had wanted to settle the matter directly with Vajpayee but it was Musharraf who was keen that he approach US President Bill Clinton to intervene.

The two-time former prime minister said he had later contemplated removing Musharraf ‘straightaway’ but had avoided ‘this kind of action’.

“I felt the proper thing was to first appoint a commission and have a thorough investigation into the whole matter… While I was in that process, Musharraf acted on that and that is why he took the action against me,” Sharief said.

“Musharraf and those two people, (Lt Gen) Mehmood Ahmed (Commander of 10 Corp) and (Lt Gen Mohammad) Aziz (Chief of General Staff). These three general were the main culprits who toppled my government. They all feared a court martial if an inquiry was conducted,” he said.

Prime Minister Chaudhry Shujaat refused to consider a commission of inquiry on the Kargil issue and also refuted Nawaz Sharif’s allegations.

Prime Minister Chaudhry Shujaat Hussain on Sunday categorically rejected a PML-N demand for the formation of a judicial commission to investigate the Kargil episode, saying that such a step would amount to opening a Pandora’s Box.

[…]the prime minister said whatever had happened in the Kargil sector was the ‘collective responsibility’ of the Nawaz Sharif government.

He said that as army chief Gen Pervez Musharraf had kept the then prime minister fully informed about what was happening in Kargil, and any assertion to the contrary would be baseless.

He recalled that at a meeting Gen Musharraf had told Mr Sharif the dates, the days and even the time when he had informed the latter about the situation in Kargil. But when the meeting ended, Mr Sharif remarked that he had not been given details.

I think I have mentioned it before that Musharraf (and other planners of the Kargil war) should have been court-martialled. However, Nawaz Sharif can’t escape responsibility as Ayaz Amir points out.

The ill-fated Kargil operation – carried out for no rhyme or reason appealing to the rational mind – is Banquo’s ghost at General Musharraf’s table, a bitter reminder of a misadventure that resulted in hundreds of deaths and cost the nation dearly.

[…]Was Nawaz Sharif kept in the dark about the genesis of Kargil? Of all the questions thrown up by the Kargil crisis this is about the most useless. He was the prime minister and should have known. But if, as he maintains, the wool was pulled over his eyes, what did he do when he came into the picture? He should have asked some searching questions. He seems to have done nothing of the kind, not even at the June 13 meeting in Lahore. Kargil put national security to its greatest risk since the 1971 war with India. Truman sacked Gen McArthur for much less.

All the evidence suggests that Nawaz Sharif was briefed or cursorily informed about Kargil sometime in April, probably at the Ojhri Camp, halfway between ‘Pindi and Islamabad. He may not have been given all the details but then it was for him to find out. If he did not, he was at fault. If he did not understand, he was at fault again.

The real question about Kargil is not whether Nawaz Sharif knew or not. It is something else. What accounts for the army’s institutional capacity to dream up ventures lacking any geostrategic or political context? The 1965 war (which ended up by derailing Pakistan and paving the way for the eventual separation of East Pakistan) was one such venture. The army crackdown on the Awami League in East Pakistan in 1971 was another. Kargil makes up the third of this holy trinity.

Read the whole article. It makes a number of important points.

The Acorn has a number of posts on this topic which have provided me some easy links for this post.

One thing is certain: Nawaz Sharif’s mention of Kargil has brought about a discussion about Kargil in the Pakistani media. Here are some highlights:

  • An editorial in the Daily Times accepts part of Nawaz’s story.
  • Dawn has an editorial arguing for a judicial commission of inquiry into the Kargil affair.
  • An article in Dawn talks about Hassan Abbas’s book Pakistan’s drift into extremism: Allah, the army, and America’s war on terror and concludes that Nawaz Sharif was informed of the Kargil operation in March 1999, which was after the Lahore visit of Indian Prime Minister Vajpayee in February.
  • Khalid Hasan has some more information from Hassan Abbas’s book.
  • Dr Hasan-Askari Rizvi claims that Nawaz Sharif was first briefed on the Kargil plans in Dec 1998-Feb 1999. He also says that the Kargil operation was a major diplomatic setback to Pakistan.
  • Nasim Zehra, currently a fellow at Harvard, was a journalist in Pakistan and I think was involved in Imran Khan’s political party Tehrik-e-Insaf. She deconstructs Nawaz Sharif’s statements on Kargil but is, in my opinion, too lenient on the army leadership.

If you need a refresher on the Kargil fiasco, here’s the BBC timeline. However, it tries too hard to be neutral. Global Security.org has a short description of the conflict as well.

Most interesting are the materials related to the Kargil conference at the Center for Contemporary Conflict at the Naval Postgraduate School.

UPDATE: Here is an interview with Chaudhry Shujaat Hussain.

Selecting a Pediatrician

When you have a baby, you need a pediatrician. That much I knew. But then it was suggested that we needed to find a pediatrician before the baby was born. Why? Because a pediatrician examines the baby in the hospital when she is born and that might as well be her regular pediatrician instead of whoever’s on duty. Plus, babies need to be taken to the doctor every month and the first visit is at 2 weeks of age. So might as well select a pediatrician now than scramble to find one immediately after her birth.

How to choose one? Looking at the list of pediatricians in the area, it seemed like there are too many. I counted more than 50 within 5 miles of our zip code. An interesting thing was that may be about 40% of them are Indians. We do live in an area which has a large South Asian population and the central Jersey center of desi (South Asian) activity, Iselin, is close by. However, South Asians seem more concentrated in pediatrics than the other fields we usually need (primary care physician, ophthalmologist, gynecologist, etc.)

We asked friends as well as our doctors for a recommendation. They recommended a few doctors, but one doctor’s name was common in most lists. So we went to see her. I had no idea what to ask the doctor, but our baby book recommends these questions:

  • What are the office hours?
  • What is the best time to call with routine questions?
  • How soon after birth will the pediatrician see your baby?
  • When will the baby’s next exams take place?
  • When is the doctor available by phone? E-mail?
  • What hospital does the doctor prefer to use?
  • What happens if there is an emergency?
  • Who “covers” the practice when your pediatrician is unavailable?
  • How often will the pediatrician see your baby for checkups and immunizations?
  • What are the costs of care?

The Great Game

Conrad Barwa has an insightful post at the Head Heeb on the structural and strategic elements in Pakistan’s policy towards the tribal areas and Afghanistan. Here is his conclusion:

What does seem clear is that the production of any ‘HVTs’ [high-value targets, i.e. terrorist leader] will not be an easy task and will only be accomplished, if at all, with painstaking care and effort as well as, where ever possible co-operation and neutralization of any distrustful actors on the ground. Given the absence of usual governance structures and the relative autonomy enjoyed from any centralized state authority that has historically predominated this belt on both the Afghan and Pakistani borders, any other approach, unless reinforced by a substantial investment of manpower, resources and time will not bear fruit. Moreover, it runs the risk of weakening the faultlines within the polity with the possibility of a serious breakdown of order and expanded domestic conflict. The debilitating linkages between foreign and domestic policy, noted by Jalal and cited earlier, that have put in place a structural conflict between external security goals and internal stability need to be severed and re-articulated. Such drastic de-linking between the external and internal spheres involving foundational changes in definition of ‘national interest’ have occurred before, most notably with the re-orientation of Egyptian foreign policy in relation to the Arab-Israeli conflict. Such wholesale changes in how foreign policy is conducted and the ‘national interest’ defined, in order to be successful need to obtain the acquiescence of the state policymaking elites and crucial sections of the political leadership, in order to overcome the opposition to change. Usually, such redirections are carried out by authoritarian nationalist leaders, who can ride roughshod over any domestic resistance; but in this case for a real peace dividend to be achieved for the region and the domestic population as a whole, only a democratic government has a realistic long-term chance of successfully enacting such a change and carrying it through to its conclusion.

I think the strategic factors in the Pakistan-Afghanistan relationship do not get commented on frequently enough here in the US as opposed to the religious and ideological ones. Conrad’s post is useful since it focuses on the the “Great Game” which continues unabated.

Sepoy of Chapati Mystery posted recently at The Acorn about the history of the tribal areas of Pakistan which has been pretty constant since the late 19th century policy put in place by the British.

Quite some time ago, I touched upon the acrimonious history of Pakistan-Afghanistan relations before the Soviet invasion.

And finally an Amnesty International report on human rights abuses by Pakistani army in its South Waziristan operation:

Amnesty International is concerned that during the two-week long operation in March 2004 intended to remove people believed to be associated with the Taleban and al-Qa’ida from South Waziristan in the tribal region of Pakistan, a range of human rights violations were committed. They included arbitrary arrest and detention, possible unlawful killings and extrajudicial executions and the deliberate destruction of houses to punish whole families when some of their members were alleged to have harboured people associated with the Taleban or al-Qa’ida. Tribal fighters who may be associated with the Taleban or al-Qa’ida appear to have taken —- and in some cases killed —- hostages.

Do They Look Like Me?

You might have heard about the terror induced by 14 Syrian musicians on a Northwestern flight.

There is no doubt that something out of the ordinary happened on Northwest Airlines Flight 327 from Detroit to Los Angeles on June 29. The plane was met at the airport by squads of federal agents and police responding to radio messages from the pilots about concerns that 14 Middle Eastern male passengers had spent the four-hour flight acting suspiciously.

But was the episode a dry run for a terrorist attack, as is now being widely suggested on the Internet and on talk radio, or an aborted terrorist attack? Or was it an innocent sequence of events that some passengers, overcome by anxiety and perhaps ethnic stereotyping, misinterpreted as a plot to blow up their plane?

It started with a 3,300-word story by Annie Jacobsen who was on the flight. Her narrative reads like one right out of a creative writing class. I agree with Donald Sensing that “Annie’s story is simply a scarily well-written shaggy-dog story.” Lots of bloggers have commented on the article, some skeptical while others feel scared or worse.

Aziz Poonawalla writes about the suspicious things he has done on an airplane. I fly quite frequently, but haven’t noticed anyone staring at me. However, I usually read a book at the gate and in the plane. I have been asked a couple of times where I am from after someone sitting next to me heard me speaking in Urdu to Amber on the cellphone. Depending on my mood and sunspots, I give different answers to that question.

This incident reminded me of the three medical students who were supposedly heard making terrorist plans in a restaurant in Georgia about two years ago.

The scare began when Eunice Stone said she overheard the three Muslim men at a Shoney’s restaurant Thursday morning making suspicious comments. At one point, Stone said the bearded man said if Americans “were sad on 9/11, wait until 9/13.”

Stone said she heard one of the men ask “Do you think we have enough to bring it down?” Another one of the men replied, “If we don’t have enough to bring it down, I have contacts and we can get enough to bring it down.”

“To me, that meant they were planning to blow up something,” she said.

She called authorities, who in turn issued the bulletin for authorities to be on the lookout for the vehicles. The men were pulled over at 1 a.m. Friday on Alligator Alley, after one of the cars allegedly went through a toll booth without paying.

In the end, it turned out the guys were innocent. It never was clear who was speaking the truth, the three Muslims or Ms. Stone, but PhotoDude had his preferences:

In the end, I, a 44 year old who’s lived in Georgia for 24 years, am left to believe people I don’t know: either a 44 year old woman from Georgia and her son, or these three men. Now, I don’t know Eunice Stone, but after 24 years in this state, I know Eunice Stone’s type.

[…]I’m very thankful the day ended with no one injured, and no one even in jail. But if I have to believe one version or another of the story, I think you know which one I choose.

I guess I can play that game as well. I also don’t know any of the people involved. But having lived in Georgia for almost 7 years and visited north Georgia quite a lot, I have heard stories about the small-town people there being nice and polite and sometimes suspicious of strangers, especially those who look different. This was definitely the case before September 2001 and I doubt it has changed now. On the other hand, I don’t know the Muslim medical students but two of them seem to be Pakistani-Americans and I know the type.

In the end, no one was injured, as PhotoDude noted, and no one was jailed, but the students lost their medical internship in Florida because the hospital received numerous threats (by anti-Muslim bigots, I assume).

Where am I going with this? Obviously, I am not blogging to criticize a 2-year-old post by PhotoDude. I was reminded of this somewhat “tribal” behavior that we are all guilty of at times because of an excellent blog post by Katherine. She starts out with the September 11 terrorist attacks.

I won’t describe where I was that day, or what I felt; you obviously remember where you were and what you felt. You saw the same images I saw. I would guess that even now, when there has been more time since an attack than you thought we would ever have again, you can imagine the worst case scenario. Perhaps in New York, perhaps in your own city. The fires and the frantic cell phone calls. The bewildered crowds fleeing the clouds of ash on foot. The full or eerily empty emergency rooms. You probably cannot come much closer than I can to understanding what it would really feel like to be trapped there, or to find out that your family member had vanished. But voluntarily or involuntarily, consciously or subconsciously, you have made the attempt. It is a plausible scenario.

The opposite extreme is not plausible. You cannot imagine the stray air strike that hits the apartment building. Not the relative or friend disappeared, not into the air but into some unknown prison. Not the deportation to a country you can barely remember. Not the questions you know you can never answer to their satisfaction, because you are innocent. Not the complete powerlessness of solitary confinement for—you have no idea when it will end, or if it will end. Certainly not the abuse or torture..

Her whole post is worth reading. Her point is that most of us cannot empathize with the victims of torture at Abu Ghraib or the immigrants who were abused in detention immediately after September 11 or the 14 Syrians who were most likely innocent musicians or the three medical students or Pakistani-American Ansar Mahmood.

If Mahmood had not decided to pose for a souvenir snapshot taken by a co-worker on a sparkling fall day in October 2001, he might still be in Hudson, dutifully spending money to his family in Pakistan. But the scenic setting that Mahmood chose for this photo was a water-treatment plant with the Catskill Mountains in the background. Amid the post-9/11 hysteria, employees of the plant alerted police that a possible terrorist was photographing this vulnerable target.

[…]Because he held a green card and the initial suspicions that he wanted to poison the water supply were so exaggerated, Mahmood won release within a week. But a search of his apartment led to the discovery that Mahmood had co-signed a lease for a Pakistani couple who were in the country illegally. In an interview with The New York Times, Mahmood later explained that he had not inquired about the couple’s immigration status. “They never ask me if I have a green card, and I cannot ask them either.”

Reflecting the get-tough attitudes of the months after 9/11, federal officials charged Mahmood with the felony offense of “harboring aliens.” On the advice of his court-appointed lawyer, Mahmood pleaded guilty in federal court in January 2002, accepting a lenient sentence of probation and time served.

Our story might have ended there with a sadder-but-wiser Mahmood learning that he should not be so eager to do favors for his fellow Pakistanis. But the revised 1996 immigration law eliminated discretion in a situation like Mahmood’s. As soon as he uttered the word “guilty,” Mahmood was subject to deportation. He was moved to the Batavia detention facility, as his appeals process worked its way through the courts.

After more than two years in prison, Mahmood lost his last legal gambit Tuesday [June 29, 2004].

A lot of photogrophers and other civil libertarians have talked about the restrictions put on photography in recent times, but most Americans won’t have the misfortune of being an immigrant from Pakistan and hence have all their life scrutinized because they took a photograph. In that scrutiny, law enforcement might find a crime, a technical violation of immigration law or even some blunders by immigration authorities which affected the immigrant’s status.

Or consider the case of Ian Spiers whose tale of harassment because of photography is detailed here.

There are lots of other examples, like Maher Arar, a Syrian Canadian who was sent to Syria by US authorities to be tortured and interrogated.

I am a political liberal and a secular Muslim. I detest the terrorists and thugs who kill in the name of my religion. I am dismayed at the lack of democracy and civil liberties in Pakistan. However, when I read about incidents like the ones described in this post, I remember that like Ansar, I am a Pakistani immigrant to the US; like the Syrians on the Northwestern flight, my native language is written in the Arabic scrript; and so on. For me, unfortunately, these things are not beyond imagination. I can easily think of myself in their shoes and the feeling I get is scary. At a rational level, I understand that the US is a better place in terms of liberty than most other countries and that the chances of anything bad happening to me or my family are quite minute. I just hope that we get over these “tribal” attitudes and get to the task at hand: getting rid of terorrism and spreading democracy and human rights around the world.

UPDATE: Unmedia has an update of the Jacobsen and Syrians in flight story.

UPDATE II: Time has an interview with a Federal Air Marshall on the plane.

Hamilton or Hijabman?

If you were a woman looking for marriage, based on their list of requirements for a spouse, which guy would you choose: Alexander Hamilton or HijabMan?

Childbirth Class

Saint Peters University Hospital offers childbirth classes in two formats. Either you can take the class one day a week for a month or spend a whole day one weekend learning about childbirth and specifically Lamaze. We decided that spending 7 hours (9am—4pm) was the better option. So, off we went with 2 pillows (for the breathing practice on the floor).

The class was interesting and we did find out a number of things we didn’t know about labor and delivery. But as they say, knowledge can be a dangerous thing. My idea of taking this class was to find out about childbirth and get Amber to be more comfortable about it since she has been a little scared of the whole process. That, however, backfired since Amber seemed to grow more frightened as she found out about all the pain and the length of labor. Ignorance, in this case, might have turned out to be bliss.

The breathing techniques did not impress me much. I am not sure how effective they are. However, present labor and delivery practice is much better than it was for our parents’ generation when science and medicine was quite misused and misguided. Our instructor, who had been a nurse longer than I have been in this world, did tell us about all the narcotics and other strange practices from 30 years ago when childbirth was considered a surgical procedure. In my opinion, some people are going too far in the other direction nowadays with natural births in bath tubs etc., but at least it is considered a natural process now.

One reason we took this class at our hospital was that we wanted to get a look at the maternity facilities we’ll be using. A tour was included in our schedule. The LDR (labor, delivery, recovery) room looked nice and comfortable (I am sure it won’t be when we get there during labor), but the postpartum room could be better. Only half of their postpartum rooms are private, the others are “semi-private”. I guess that means 2 patients per room. The rooms also seemed too small with a not-so-good chair for me. The hospital is otherwise pretty good in terms of their medical expertise and facilities.

Urdu Font / اردو فونٹ

آصف نے یہ بہت اچھا کام کیا ہے کہ اردو کے فونٹ اکٹھے کر دیئے ہیں۔ اب قارئین کو لمبی ہدایات نہیں دینی پڑیں گی کہ فونٹ کیسے انسٹال کرنا ہے۔

آصف نے یہ بہت اچھا کام کیا ہے کہ اردو کے فونٹ اکٹھے کر دیئے ہیں۔ اب قارئین کو لمبی ہدایات نہیں دینی پڑیں گی کہ فونٹ کیسے انسٹال کرنا ہے۔

میں نے سارے نفیس فونٹس (نستعلیق، نسخ، پاکستانی نسخ، ویب نسخ) اور ٹاہوما کو جمع کر کے خود بخود انسٹال ہونے والے ایک چھوٹے سے پروگرام کی شکل میں ترتیب دے دیا ہے جسے یہاں سے ڈاؤن لوڈ کیا جا سکتا ہے ۔ جیسے ہی آپ اسے انسٹال کریں گے تو کمپوٹر کو دوبارہ چلائے بغیر آپ کو مائیکروسافٹ آفس، اور ونڈوز کے دوسرے پروگراموں میں یہ فونٹ دستیاب ہو جائینگے۔ اس کے علاوہ آپ ویب صفحات پر بھی اردو زبان کو ویب نسخ میں پڑھ سکیں گے جو ٹاہوما سے بہت زیادہ خوبصورت ہے۔

آصف کے کہنے پر میں نے بھی ٹاہوما کو ترک کر کے نفیس ویب نسخ استعمال کرنا شروع کر دیا ہے۔ نفیس نسخ ٹاہوما کے مقابلے میں کافی بہتر لگتا ہے۔

اس کے علاوہ میں نے ونڈوز ایکس پی کے لئے ایک فونٹک کیبورڈ بھی ڈاؤنلوڈ کیا ہے۔ اس کی وجہ سے میری ٹائپنگ کی رفتار کافی بہتر ہو گئی ہے۔

اعجاز نے اردو ویب سائٹ کے لئے ایک اچھی تکنیک بتائی ہے جو میرے خیال سے ویب پیج کی سرخیوں کے لئے کافی فائدہ مند ہے۔

Asif has created an installable package of Urdu fonts which takes the hassle of long instructions to Windows users about installing Urdu fonts. He also suggests that everyone use Nafees Web Naskh which looks much better than Tahoma. I have followed his advice. However, if you haven’t got Nafees Web Naskh on your computer, then Tahoma will be used as the backup font.

I also downloaded a phonetic Urdu keyboard layout for Windows XP. This has made a tremendous difference in my Urdu typing speed.

Ejaz has posted an interesting method to use background images instead of text in an Urdu (or any other language) website. The idea is intriguing and useful for headings which you want to pretty up.

Travel Tales

I like traveling quite a lot and hence am quite fond of blogs describing or photographing travel around the world.

Amanda Butler of Crescat Sententia is blogging about her experiences as a Peace Corps volunteer in Kazakhstan. Her descriptions make me want to plan my Central Asian trip soon.

Brian Ulrich talks about the standard greeting in Kazakhstan being the same as in Morocco. That fact is not surprising because the greeting is “Assalam o Alaikum” (السلام علیکم), the standard Islamic greeting. What was more interesting to me was the Kazakh words which are familiar to me because of their use in Urdu. For example, “dastarhan” (دسترخوان) and “dukan” (دکان).

Brian spent the last couple of months in Morocco. He wrote quite good descriptions of his travels there. Unfortunately, he doesn’t have category archives, but his weekly archives starting in late May should cover his posts about Morocco.

You should definitely read both Amanda’s and Brian’s posts. One thing missing in their travel blogging though is photography. They should post some pictures of Kazakhstan and Morocco.

And the Head Heeb is back from vacation in Australia and is posting about the country.

Immunization of Infants

Since we are having a baby next month, we are thinking of immunizations along with other baby-related topics. So I was surprised to find out that some people like us don’t vaccinate their children.

Struggling, inner-city parents are more likely to neglect to completely vaccinate their children, while parents who refuse to vaccinate at all tend to be white and well-off, U.S. researchers reported Tuesday.

[…]In 2001, only an estimated 62.8 percent of all children aged 19 to 35 months were fully vaccinated, Philip Smith and colleagues at the Centers for Disease Control and Prevention’s National Immunization Program found.

More than 2 million children or 36.9 percent of toddlers were not fully vaccinated in 2001, and 17,000 children or 0.3 percent were not vaccinated at all, Smith’s team wrote in Tuesday’s issue of the journal Pediatrics.

[…]Several studies have shown two barriers to full vaccination — a lack of adequate medical care and affluent, educated people who question the need to vaccinate their children.

“Among parents of unvaccinated children, 47.5 percent expressed concerns regarding safety, compared with 5.1 percent of parents with undervaccinated children,” the researchers wrote.

And those who refuse vaccines often do not trust doctors.

“Among parents of unvaccinated children, 70.9 percent said that a doctor was not influential in shaping their vaccination decisions for their children, compared with 22.9 percent among undervaccinated children,” the researchers said.

Of the children not vaccinated, 57 percent were boys.

“In response to concerns about the perceived risk of autism resulting from vaccinations, parents might have avoided having their sons vaccinated at a higher rate than their daughters, as a result of knowing that they have risk factors for autism and knowing that the rate of autism is 4 times greater for boys than for girls,” the researchers wrote.

Last month, the Institute of Medicine reported that a panel of experts could find no evidence that vaccines cause autism, but groups that question vaccine safety vowed to continue to fight to prove a link.

Here are the conclusions from the abstract of the paper.

Undervaccinated children tended to be black, to have a younger mother who was not married and did not have a college degree, to live in a household near the poverty level, and to live in a central city. Unvaccinated children tended to be white, to have a mother who was married and had a college degree, to live in a household with an annual income exceeding $75,000, and to have parents who expressed concerns regarding the safety of vaccines and indicated that medical doctors have little influence over vaccination decisions for their children. Unvaccinated children were more likely to be male than female. Annually, ~17,000 children were unvaccinated. The largest numbers of unvaccinated children lived in counties in California, Illinois, New York, Washington, Pennsylvania, Texas, Oklahoma, Colorado, Utah, and Michigan. States that allowed philosophical exemptions to laws mandating vaccinations for children as they entered school had significantly higher estimated rates of unvaccinated children.

There is lot of interesting data in the paper itself.

Among all children 19 to 35 months of age, an estimated 36.9% were undervaccinated. In the undervaccinated group, children were most frequently NUTD on varicella vaccine (23.5%), diphtheria, tetanus, and acellular pertussis vaccine (18.2%), hepatitis B vaccine (11.2%), and polio vaccine (11.0%).

[…]Compared with fully vaccinated children, unvaccinated children were […] more likely to live in a household with ≥4 children than in a household in which he/she was the only child.

[…]Estimated rates [of unvaccinated children] ranged from a low of 60 per 100,000 (Rhode Island) to 1125 per 100,000 (Utah). Among the 10 states with the highest estimated rates per 100,000 children 19 to 35 months of age, 7 were western states (Utah, Montana, Oregon, Colorado, Washington, Alaska, and Idaho).

Other states in the top 10 were Oklahoma, Maine, and Vermont.

The counties with the largest numbers of unvaccinated children were Los Angeles, CA, and Detroit, MI (including Wayne, Oakland, and Macomb Counties). The remaining counties among the 20 with the greatest numbers of unvaccinated children included the cities of Chicago, IL, Pittsburgh, PA, Dallas, TX, Houston, TX, Oklahoma City, OK, and Grand Rapids, MI. Also included among those counties were Westchester County, NY, and Lancaster County, PA. New York City was not among the 50 areas with the greatest estimated numbers of children with no vaccine doses.

[…]In 2000—2001, all states allowed exemptions for medical reasons, 48 for religious reasons, and 17 for philosophical reasons.

I understand medical reasons. I don’t agree with religious reasons for skipping vaccines but that is still understandable. But what really is a philosophical reason to expose your child to these killer diseases?

Razib probably won’t be surprised with this next bit of data.

12.3% of all children attending public schools and 18.8% of children attending day care in Ashland, Oregon, in 2002 claimed exemptions from mandatory vaccination laws, compared with 2.4% for the entire state that year.

Fear of autism does seem to affect vaccination decisions.

Siblings in families in which there was an autistic child were 3 times more likely to be unvaccinated, compared with siblings in families in which there was a child with attention-deficit/hyperactivity disorder.

MedPundit had a reminder we all need.

Before immunizations were routine, pediatric wards were full of children in iron lungs who couldn’t breathe on their own thanks to polio. When I was in training, older physicians used to tell horror stories of children gasping for their last breaths as pertussis (whooping cough) closed up their airways, and there was nothing they could do to stop it. Measles used to be a significant cause of blindness and deafness. Congenital rubella caused all sorts of birth defects. The success of the immunization programs against these highly communicable diseases have wiped them from our collective memory. Now, the vaccines seem worse to many than the diseases. (Same as smallpox, no?)

The people who don’t vaccinate their children are relying on the benefit of the majority who do immunize. However, any regional concentration of unvaccinated people can be quite dangerous as disease can spread quite easily there. MedPundit and Foreign Dispatches have pointed out about a Nigerian state’s recent campaign against polio vaccination.

Coming from the developing world, I am quite familiar (much more so than an average American I think) with the threat of diseases like polio, measles and whooping cough, etc. I remember campaigns in Pakistan to vaccinate children and eradicate these diseases as I was growing up. Even smallpox was not eradicated in Pakistan until I was 4 years old. I still have the smallpox vaccine scar on my arm.