'Americans bomb our children every day, so why would they care about polio?'

Just over a fortnight ago, a 14-month-old girl in the Afghan province of Kunduz was diagnosed with polio. Within days, the Taliban granted health workers access to parts of northern Afghanistan for the first time in 15 months, enabling them to resume a polio vaccination programme.

Until it was blocked, leaving about 170,000 children in Kunduz province without inoculations, the scheme had almost eradicated the disabling viral disease in Afghanistan. But polio can spread quickly, with even a single case potentially enough to widen the disease’s footprint. When the girl in Kunduz’s Dasht-e-Archi district became the third child this year diagnosed with polio, Taliban commanders relented.

Local commanders have long been the main obstacle to polio vaccinators in Kunduz. Qari Bashir, the Taliban health chief in the province, had demanded construction of a clinic in Char Dara district to treat civilians and wounded fighters, on a par with clinics in government-held areas. But the WHO does not build trauma clinics.

Speaking to the Guardian, Bashir confirmed his demand for a clinic but said there were other concerns. Chief among them was a suspicion among villagers that polio teams could be infiltrated by spies.

Polio was a top issue in village council meetings, Bashir said. But while some locals argued he was obliged to allow vaccinations, others warned him not to trust foreign-run health teams, a scepticism Bashir shared.

“Every day, the Americans are bombing Afghan children. I don’t think this was so important to them,” he said.

Regional distrust of the international community increased in 2011, when the CIA used a Pakistani polio doctor, Shakil Afridi, to track Osama bin Laden to Abbottabad, where he was later killed. Afridi is serving a 33-year sentence imposed by a tribal court.

Nonetheless, the WHO insists it is rare for access to be denied as it was in Kunduz. “Our community engagement in Afghanistan and Pakistan is as good as it’s ever been,” said Christopher Maher, the organisation’s polio eradication manager.

Polio thrives where there is mass displacement and access for health workers is restricted. Once a global disease, it is now endemic in only three countries: Nigeria, Pakistan and Afghanistan.

Last year, two children in Nigeria were paralysed by polio after more than two years without a case in the country. The affected children were in Borno state, a stronghold of the Islamist Boko Haram group, where more than half a million children are beyond the reach of health workers.

In Afghanistan and Pakistan, the spread of polio has been driven by mass movement between the two countries, which the WHO has described as a “common reservoir”. Last year, 13 cases were documented in Afghanistan and 20 in Pakistan.

To maintain public acceptance in Afghanistan, the WHO tries to work with local Islamic scholars and recruits as much as possible, according to the WHO’s country director, Rik Peeperkorn. “We appreciate that all parties to the conflict acknowledge the need to immunise all Afghan children,” said Peeperkorn.

The WHO was granted access after Taliban commanders in Peshawar, Pakistan, intervened, said Bashir. “Our elders called us and said, ‘We should allow [the polio campaign] here.’ I changed my decision as I found out there would be no negative consequences for us or for the people who are vaccinated. Our shura [council] said, ‘We will solve your problem, don’t request from the UN to build a clinic.’

“People are very poor here, they don’t have enough money to go to the bazaar or the city,” added Bashir. “We are happy for international agencies to come here and help. We just need to find out if it’s important for the people or not.”

Additional reporting by Aziz Tasal