Vernice D. Ferguson, Leader and Advocate of Nurses, Dies at 84

Vernice D. Ferguson, who fought for greater opportunities, higher wages and more respect for nurses as a longtime chief nursing officer for the Veterans Administration, died on Dec. 8 at her home in Washington. She was 84.

NYU Photobureau

Vernice D. Ferguson served at the Veterans Administration.

Her niece Hope Ferguson confirmed her death.

America faced a nursing shortage when Ms. Ferguson began overseeing the agency’s more than 60,000 nurses nationwide in 1980. Historically, the nursing ranks were overwhelmingly female, but as job opportunities began to expand for young women in the late 1970s, nursing, with its prospect of strenuous work, irregular hours and relatively low pay, was losing its appeal.

Doctors, most of whom were men, were paid far more and rarely discussed medical treatments with nurses, despite nurses’ hands-on knowledge of patients.

“What is good enough for the doctor is good enough for me and the nursing staff,” Ms. Ferguson was quoted as saying in the book “Pivotal Moments in Nursing: Leaders Who Changed the Path of a Profession,” by Beth Houser and Kathy Player. “Whatever the boys have, I am going to get the same thing for the girls.”

In 1981, Ms. Ferguson told National Journal, “Hospitals are going to have to rethink and restructure their policies to let nurses perform nursing services and let others attend to ‘hotel’ services,” like making beds and handling phone calls.

Ms. Ferguson helped establish an agency scholarship program to recruit and retain nurses and made educational programs that had been restricted to doctors open to nurses as well.

By 1992, when she left the agency — then the Department of Veterans Affairs — the number of registered nurses there with bachelor’s degrees or higher had more than doubled. Nurses’ salaries also increased throughout the field. In 1980, their average annual pay was $26,826 in 2008 dollars; in 2008, it was $66,973, according to the most recent survey of registered nurses.

Vernice Doris Ferguson was born on June 13, 1928, in Fayetteville, N.C. Her father was a minister in Baltimore, where she grew up, and her mother was a teacher. At a time when few black women attended college, Ms. Ferguson graduated from New York University with a nursing degree in 1950 and was awarded the Lavinia L. Dock prize for high scholastic standing. At the awards ceremony, the director of nursing refused to shake her hand, Ms. Houser and Ms. Player wrote.

Ms. Ferguson’s first job out of college was in a research unit financed by the National Institutes of Health at Montefiore Medical Center in the Bronx. She went on to be a co-author of papers in The American Journal of Nursing, The Journal of Clinical Nutrition and The Journal of Clinical Investigation.

She worked in several hospitals around the country, and from 1972 to 1980 was the chief of the nursing department of the Clinical Center at the National Institutes of Health. A brief marriage ended in divorce. Her survivors include a sister, Velma O. Ferguson, and several nieces and nephews.

After retiring in 1992, Ms. Ferguson was appointed senior fellow at the University of Pennsylvania School of Nursing.

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World Briefing | The Americas: Canada: Court Seeks a Balance on Veils

The Supreme Court of Canada ruled Thursday that witnesses could cover their faces for religious reasons while testifying in court under some circumstances. A Muslim woman, who cannot be named under a court order, asked to wear a niqab, a full-face veil, for religious reasons when testifying in an Ontario court against two men whom she has accused of sexual assault. The Supreme Court did not specifically rule on her request. But it provided trial judges with a four-part process for analyzing such requests to maintain a balance between religious freedoms and the right to a fair trial. The defendants’ lawyers argued that the faces of witnesses provided clues about the truthfulness of their testimony. Canada’s immigration minister recently barred women from wearing a niqab when taking the citizenship oath.

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Bits Blog: Instagram Does an About-Face

11:14 p.m. | Updated
SAN FRANCISCO — In the aftermath of the uproar over changes to Instagram’s privacy policy and terms of service earlier this week, the company did an about-face late Thursday.

In a blog post on the company’s site, Kevin Systrom, Instagram’s co-founder, said that where advertising was concerned, the company would revert to its previous terms of service, which have been in effect since October 2010.

“Rather than obtain permission from you to introduce possible advertising products we have not yet developed,” he wrote, “we are going to take the time to complete our plans, and then come back to our users and explain how we would like for our advertising business to work.” Users had been particularly concerned by a clause in Instagram’s policy introduced on Monday that suggested Instagram would share users’ data — like their favorite places, bands, restaurants and hobbies — with Facebook and its advertisers to better target ads.

They also took issue with an update to the company’s terms of service that suggested users’ photos could be used in advertisements, without compensation and even without their knowledge.

The terms of that user agreement said, “You agree that a business or other entity may pay us to display your user name, likeness, photos (along with any associated metadata) and/or actions you take, in connection with paid or sponsored content or promotions, without any compensation to you.”

Following a reaction that included customers defecting to other services, Mr. Systrom told Instagram users on Tuesday that the new policy had been misinterpreted. “It is our mistake that this language is confusing,” he wrote, and he promised an updated agreement.

That statement apparently was not enough. With more people leaving the service, the company, which Facebook bought for $735 million this year, reacted again by returning to the old rules.

Acknowledging those concerns late Thursday, Mr. Systrom wrote: “I want to be really clear: Instagram has no intention of selling your photos, and we never did. We don’t own your photos — you do.”

Mr. Systrom said the company would still be tweaking its privacy policy to quell users’ fears that their photos might pop-up on third-party sites without their consent.

But Mr. Systrom did not clarify how Instagram planned to monetize its service in the future. Facebook is under pressure to make Instagram earn income.

“It’s a free service — they have to monetize somewhere,” said John Casasanta, a principal at Tap Tap Tap, the maker of Camera+, a photo-filter app that has shunned advertising and instead charges users for premium features. “The days of the simple banner ads are gone. Their user data is too valuable.”

It was unclear whether reverting its terms of service would be enough to satisfy high-profile users like National Geographic, which stopped using its Instagram account in light of the moves, or other users who have aired their grievances on Twitter and Facebook.

The controversy has driven traffic and new users to several other photo-sharing applications.

Pheed, an Instagram-like app that gives users the option to monetize their own content by charging followers to see their posts, gained more users than any other app in the United States on Thursday. By Thursday morning, Pheed had jumped to the ninth most downloaded social-networking app in Apple’s iTunes store, just ahead of LinkedIn.

O. D. Kobo, Pheed’s chief executive, said Thursday morning that subscriptions to the service had quadrupled this week and that in the last 24 hours users had uploaded 300,000 new files to the service — more uploads than any other 24-hour-period since Pheed made its debut six weeks ago.

Another runaway success was Flickr, Yahoo’s photo-sharing service, which redesigned its app last week to make it easier to share photos on Twitter. In a stroke of good fortune, it released the app to positive reviews just as Instagram announced it would no longer sync with Twitter, a Facebook rival.

The day before Instagram announced changes to its terms of service, Flickr’s mobile app was ranked at around 175 in Apple’s overall iTunes app charts. Since that day, the application skyrocketed to the high 20s.

Of course, most of these services are still tiny compared to Instagram, which claims to have more than 100 million members who have uploaded upward of 5 billion photos using its service. And it was unclear if the services’ newfound members had also deleted their Instagram accounts or were merely dabbling in other offerings. But the migration, whether temporary or permanent, was a reminder of the volatility of success and that the fall to bottom can sometimes be as swift as the rise to the top.

Facebook and Instagram declined to say whether they had seen any significant number of account deletions or if they were concerned about losing ground in the photo-sharing market to rivals. Some photo apps took direct aim at Instagram. Camera+ even went so far as to include a snide, holiday-themed reference to Instagram’s stumbles in an app update on Wednesday.

“We’ll never do shady things with your shared pics, because it just isn’t right,” the update noted. “On that note, happy Christmas to all, and to all a good night!”

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Op-Ed Contributor: Labs, Washed Away

BEDPAN ALLEY is the affectionate name given to a stretch of First Avenue in Manhattan that is packed with more hospitals than many cities possess. This stretch also happened to be right in the flood zone during Hurricane Sandy. Water damage and power failures closed down all three of the New York University teaching hospitals — Bellevue Hospital, Tisch Hospital and the Manhattan V.A. Two months later, they are still not admitting patients, though two are on schedule to begin doing so shortly.

The harrowing evacuation of hundreds of patients made headlines nationwide. The disruption of regular medical care for tens of thousands of outpatients was a clinical nightmare that is finally easing. And the education of hundreds of medical students and residents is being patched back together.

All academic medical centers, however, rest on a tripod — patient care, education and research. The effect of the hurricane on the third leg of that tripod — research — has gotten the least attention, partly because rescuing cell cultures just isn’t as dramatic as carrying an I.C.U. patient on a ventilator down flights of stairs in the dark.

But, of course, there is an incontrovertible link between those cell cultures and that patient. For every medication that a patient takes, someone researched the basic chemistry of the drug, someone designed the clinical trial to test its efficacy, and of course a volunteer stepped forward to be the first to take the pill. Scientific research has engineered the impressive advancements of medical treatment, and every patient is a beneficiary.

When the hospitals were hit by Hurricane Sandy, hundreds of experiments were obliterated by the loss of power. Precious biological samples carefully frozen over years were destroyed. Temperature-sensitive reagents and equipment were ruined. Medications and records for patients in clinical trials were rendered inaccessible. And sadly, many laboratory mice and rats perished (though 600 cages of animals were rescued during the night by staff members who used crowbars on inaccessible doors and carried the cages out through holes cut in the ceiling).

On a slushy, rainy day earlier this month, I sat in on a meeting of N.Y.U.’s research community. Hundreds of scientists packed the chilly lecture hall to discuss what the future might hold. It was clear that the damage to laboratories and samples would not be amenable to easy repair. Some 400 researchers were being relocated to a patchwork of temporary sites so that they could restart their work.

But scientists can’t just walk in to a new space with a lab coat and a notebook; they need centrifuges, deep-freezes, lab animals, electron microscopes, incubators, autoclaves, gamma counters, PET scanners. They come with graduate students, lab techs, post-docs and collaborating investigators. For clinical researchers, there are also the patients enrolled in their clinical trials, with their medications and voluminous records.

Even beyond their eagerness to get back to work, researchers felt a sense of loss, not just in time, money, momentum, samples and grants, but of a part of their lives. Some senior scientists lost decades of archived samples. Others lost irreplaceable mice with genetic mutations for studying how coronary plaques resolve, the role of inflammation in lymphoma and the development of neural networks. At the other end of the spectrum were post-docs whose nascent careers were suddenly up in the air. Some were in tears.

Walking down First Avenue after the meeting, I passed a young researcher pushing a cart laden with cages, transporting lab rats to their new home. There was a blanket over the cages to protect them from the rain, but it kept slipping. She slogged up the wet avenue, one hand pushing the cart, the other struggling to keep the cover over her charges.

The logistical efforts to relocate and reignite such a vast research enterprise are staggeringly complicated. But the administration has cataloged each person’s research needs to match them with available space elsewhere, and hundreds of researchers have successfully rekindled their investigations despite the prodigious challenges.

Bellevue and Tisch are returning to their clinical operations and will be able to admit patients shortly. But even after the hospital wards and clinics are bustling at full capacity, the ribbon won’t feel ready to snip until the researchers are restored to their homes as well. For many patients, the thrum of research within a medical center is invisible. But it is an integral — and very human — part of a hospital. When a hurricane disrupts research, it is a loss that resonates well beyond the laboratories.

Danielle Ofri, an associate professor at New York University School of Medicine, is the editor of the Bellevue Literary Review and the author, most recently, of “Medicine in Translation: Journeys With My Patients.”

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Op-Ed Contributor: Labs, Washed Away

BEDPAN ALLEY is the affectionate name given to a stretch of First Avenue in Manhattan that is packed with more hospitals than many cities possess. This stretch also happened to be right in the flood zone during Hurricane Sandy. Water damage and power failures closed down all three of the New York University teaching hospitals — Bellevue Hospital, Tisch Hospital and the Manhattan V.A. Two months later, they are still not admitting patients, though two are on schedule to begin doing so shortly.

The harrowing evacuation of hundreds of patients made headlines nationwide. The disruption of regular medical care for tens of thousands of outpatients was a clinical nightmare that is finally easing. And the education of hundreds of medical students and residents is being patched back together.

All academic medical centers, however, rest on a tripod — patient care, education and research. The effect of the hurricane on the third leg of that tripod — research — has gotten the least attention, partly because rescuing cell cultures just isn’t as dramatic as carrying an I.C.U. patient on a ventilator down flights of stairs in the dark.

But, of course, there is an incontrovertible link between those cell cultures and that patient. For every medication that a patient takes, someone researched the basic chemistry of the drug, someone designed the clinical trial to test its efficacy, and of course a volunteer stepped forward to be the first to take the pill. Scientific research has engineered the impressive advancements of medical treatment, and every patient is a beneficiary.

When the hospitals were hit by Hurricane Sandy, hundreds of experiments were obliterated by the loss of power. Precious biological samples carefully frozen over years were destroyed. Temperature-sensitive reagents and equipment were ruined. Medications and records for patients in clinical trials were rendered inaccessible. And sadly, many laboratory mice and rats perished (though 600 cages of animals were rescued during the night by staff members who used crowbars on inaccessible doors and carried the cages out through holes cut in the ceiling).

On a slushy, rainy day earlier this month, I sat in on a meeting of N.Y.U.’s research community. Hundreds of scientists packed the chilly lecture hall to discuss what the future might hold. It was clear that the damage to laboratories and samples would not be amenable to easy repair. Some 400 researchers were being relocated to a patchwork of temporary sites so that they could restart their work.

But scientists can’t just walk in to a new space with a lab coat and a notebook; they need centrifuges, deep-freezes, lab animals, electron microscopes, incubators, autoclaves, gamma counters, PET scanners. They come with graduate students, lab techs, post-docs and collaborating investigators. For clinical researchers, there are also the patients enrolled in their clinical trials, with their medications and voluminous records.

Even beyond their eagerness to get back to work, researchers felt a sense of loss, not just in time, money, momentum, samples and grants, but of a part of their lives. Some senior scientists lost decades of archived samples. Others lost irreplaceable mice with genetic mutations for studying how coronary plaques resolve, the role of inflammation in lymphoma and the development of neural networks. At the other end of the spectrum were post-docs whose nascent careers were suddenly up in the air. Some were in tears.

Walking down First Avenue after the meeting, I passed a young researcher pushing a cart laden with cages, transporting lab rats to their new home. There was a blanket over the cages to protect them from the rain, but it kept slipping. She slogged up the wet avenue, one hand pushing the cart, the other struggling to keep the cover over her charges.

The logistical efforts to relocate and reignite such a vast research enterprise are staggeringly complicated. But the administration has cataloged each person’s research needs to match them with available space elsewhere, and hundreds of researchers have successfully rekindled their investigations despite the prodigious challenges.

Bellevue and Tisch are returning to their clinical operations and will be able to admit patients shortly. But even after the hospital wards and clinics are bustling at full capacity, the ribbon won’t feel ready to snip until the researchers are restored to their homes as well. For many patients, the thrum of research within a medical center is invisible. But it is an integral — and very human — part of a hospital. When a hurricane disrupts research, it is a loss that resonates well beyond the laboratories.

Danielle Ofri, an associate professor at New York University School of Medicine, is the editor of the Bellevue Literary Review and the author, most recently, of “Medicine in Translation: Journeys With My Patients.”

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State of the Art: Android Cameras From Nikon and Samsung Go Beyond Cellphones - Review

60 Seconds With Pogue: Android Cameras:
David Pogue reviews the Nikon Coolpix S800C and the Samsung Galaxy Camera.

“Android camera.” Wow, that has a weird ring, doesn’t it? You just don’t think of a camera as having an operating system. It’s like saying “Windows toaster” or “Unix jump rope.”

But yes, that’s what it has come to. Ever since cellphone cameras got good enough for everyday snapshots, camera sales have been dropping. For millions of people, the ability to share a fresh photo wirelessly — Facebook, Twitter, e-mail, text message — is so tempting, they’re willing to sacrifice a lot of real-camera goodness.

That’s an awfully big convenience/photo-quality swap. A real camera teems with compelling features that most phones lack: optical zoom, big sensor, image stabilization, removable memory cards, removable batteries and decent ergonomics. (A four-inch, featureless glass slab is not exactly optimally shaped for a hand-held photographic instrument.)

But the camera makers aren’t taking the cellphone invasion lying down. New models from Nikon and Samsung are obvious graduates of the “if you can’t beat ’em, join ’em” school. The Nikon Coolpix S800C ($300) and Samsung’s Galaxy Camera ($500 from AT&T, $550 from Verizon) are fascinating hybrids. They merge elements of the cellphone and the camera into something entirely new and — if these flawed 1.0 versions are any indication — very promising.

From the back, you could mistake both of these cameras for Android phones. The big black multitouch screen is filled with app icons. Yes, app icons. These cameras can run Angry Birds, Flipboard, Instapaper, Pandora, Firefox, GPS navigation programs and so on. You download and run them exactly the same way. (That’s right, a GPS function. “What’s the address, honey? I’ll plug it into my camera.”)

But the real reason you’d want an Android camera is wirelessness. Now you can take a real photo with a real camera — and post it or send it online instantly. You eliminate the whole “get home and transfer it to the computer” step.

And as long as your camera can get online, why stop there? These cameras also do a fine job of handling Web surfing, e-mail, YouTube videos, Facebook feeds and other online tasks. Well, as fine a job as a phone could do, anyway.

You can even make Skype video calls, although you won’t be able to see your conversation partner; the lens has to be pointing toward you.

Both cameras get online using Wi-Fi hot spots. The Samsung model can also get online over the cellular networks, just like a phone, so you can upload almost anywhere.

Of course, there’s a price for that luxury. Verizon charges at least $30 a month if you don’t have a Verizon plan, or $5 if you have a Verizon Share Everything plan. AT&T charges $50 a month or more for the camera alone, or $10 more if you already have a Mobile Share plan.

If you have a choice, Verizon is the way to go. Not only is $5 a month much more realistic than $10 a month, but Verizon’s 4G LTE network is far faster than AT&T’s 4G network. That’s an important consideration, since what you’ll mostly be doing with your 4G cellular camera is uploading big photo files. (Wow. Did I just write “4G cellular camera?”)

These cameras offer a second big attraction, though: freedom of photo software. The Android store overflows with photography apps. Mix and match. Take a shot with one app, crop, degrade and post it with Instagram.

Just beware that most of them are intended for cellphones, so they don’t recognize these actual cameras’ optical zoom controls. Some of the photo-editing apps can’t handle these cameras’ big 16-megapixel files, either. Unfortunately, you won’t really know until you pay the $1.50 or $4 to download these apps.

E-mail: pogue@nytimes.com

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Family Is Jailed in England Over Forced Labor

DUBLIN — Five members of an Irish family who enjoyed lavish lifestyles from the proceeds of forced labor were jailed in England on Wednesday after a three-month trial.

Bristol Crown Court heard harrowing details of how the family enticed mentally ill, alcoholic and homeless men to work in their paving and patio business based in Bedford, England, for as little as $8 a day. They kept the men in filthy trailers and forced them to perform menial tasks like cleaning the family’s toilets. At times, the men were so hungry they resorted to scavenging for food in supermarket garbage and were subjected to threats and beatings if they tried to leave.

Some had worked in such circumstances for two decades. However, the judge ordered the jury to drop a second charge of conspiracy to hold a person in servitude.

William Connors, 52, was sentenced to six and a half years, and his wife, Mary, 48, was sentenced to two years and three months. One of their sons, John, 29, received four years, and another son, James, 20, was sent to a juvenile detention center for three years. A son-in-law, Miles Connors, 24, was given a three-year prison sentence.

The court heard testimony that the Connors family had made a fortune from the proceeds of their crimes. They drove expensive cars and went on luxury vacations. Some of the family lived in houses worth millions, had millions in bank accounts and owned several properties in Ireland. These are now subject to possible seizure as criminal assets.

The police began investigating the family after the body of one of their workers, Christopher Nicholls, 40, was discovered in 2008. They were placed under surveillance in August 2010, and evidence was recorded of men being assaulted. In April 2010, the Coroners and Justice Act was introduced, making it an offense to conspire to hold someone in servitude and require that individual to carry out forced or compulsory labor.

After sentencing, the officer who had led the investigation, Detective Chief Inspector Dave Sellwood, described the Connors family as “greedy, arrogant people” who preyed on the weak.

“This was a criminal enterprise from beginning to end,” he told RTE, the Irish national broadcaster. “They picked up vulnerable people, they offered them a new life and hope when they didn’t have any, and then they dashed that.”

The family maintained that the men were “free agents” able to come and go as they pleased. The family said they had acted as “good Samaritans” by providing them with food, work and housing.

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State of the Art: Android Cameras From Nikon and Samsung Go Beyond Cellphones - Review

60 Seconds With Pogue: Android Cameras:
David Pogue reviews the Nikon Coolpix S800C and the Samsung Galaxy Camera.

“Android camera.” Wow, that has a weird ring, doesn’t it? You just don’t think of a camera as having an operating system. It’s like saying “Windows toaster” or “Unix jump rope.”

But yes, that’s what it has come to. Ever since cellphone cameras got good enough for everyday snapshots, camera sales have been dropping. For millions of people, the ability to share a fresh photo wirelessly — Facebook, Twitter, e-mail, text message — is so tempting, they’re willing to sacrifice a lot of real-camera goodness.

That’s an awfully big convenience/photo-quality swap. A real camera teems with compelling features that most phones lack: optical zoom, big sensor, image stabilization, removable memory cards, removable batteries and decent ergonomics. (A four-inch, featureless glass slab is not exactly optimally shaped for a hand-held photographic instrument.)

But the camera makers aren’t taking the cellphone invasion lying down. New models from Nikon and Samsung are obvious graduates of the “if you can’t beat ’em, join ’em” school. The Nikon Coolpix S800C ($300) and Samsung’s Galaxy Camera ($500 from AT&T, $550 from Verizon) are fascinating hybrids. They merge elements of the cellphone and the camera into something entirely new and — if these flawed 1.0 versions are any indication — very promising.

From the back, you could mistake both of these cameras for Android phones. The big black multitouch screen is filled with app icons. Yes, app icons. These cameras can run Angry Birds, Flipboard, Instapaper, Pandora, Firefox, GPS navigation programs and so on. You download and run them exactly the same way. (That’s right, a GPS function. “What’s the address, honey? I’ll plug it into my camera.”)

But the real reason you’d want an Android camera is wirelessness. Now you can take a real photo with a real camera — and post it or send it online instantly. You eliminate the whole “get home and transfer it to the computer” step.

And as long as your camera can get online, why stop there? These cameras also do a fine job of handling Web surfing, e-mail, YouTube videos, Facebook feeds and other online tasks. Well, as fine a job as a phone could do, anyway.

You can even make Skype video calls, although you won’t be able to see your conversation partner; the lens has to be pointing toward you.

Both cameras get online using Wi-Fi hot spots. The Samsung model can also get online over the cellular networks, just like a phone, so you can upload almost anywhere.

Of course, there’s a price for that luxury. Verizon charges at least $30 a month if you don’t have a Verizon plan, or $5 if you have a Verizon Share Everything plan. AT&T charges $50 a month or more for the camera alone, or $10 more if you already have a Mobile Share plan.

If you have a choice, Verizon is the way to go. Not only is $5 a month much more realistic than $10 a month, but Verizon’s 4G LTE network is far faster than AT&T’s 4G network. That’s an important consideration, since what you’ll mostly be doing with your 4G cellular camera is uploading big photo files. (Wow. Did I just write “4G cellular camera?”)

These cameras offer a second big attraction, though: freedom of photo software. The Android store overflows with photography apps. Mix and match. Take a shot with one app, crop, degrade and post it with Instagram.

Just beware that most of them are intended for cellphones, so they don’t recognize these actual cameras’ optical zoom controls. Some of the photo-editing apps can’t handle these cameras’ big 16-megapixel files, either. Unfortunately, you won’t really know until you pay the $1.50 or $4 to download these apps.

E-mail: pogue@nytimes.com

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U.N. Suspends Polio Campaign in Pakistan After Killings of Workers

B.K. Bangash/Associated Press

A Pakistani woman administered polio vaccine to an infant on Wednesday in the slums of Islamabad. Militants have killed eight polio workers over three days.

LAHORE, Pakistan — The front-line heroes of Pakistan’s war on polio are its volunteers: young women who tread fearlessly from door to door, in slums and highland villages, administering precious drops of vaccine to children in places where their immunization campaign is often viewed with suspicion.

Now, those workers have become quarry. After militants stalked and killed eight of them over the course of a three-day, nationwide vaccination drive, the United Nations suspended its anti-polio work in Pakistan on Wednesday, and one of Pakistan’s most crucial public health campaigns has been plunged into crisis.

The World Health Organization and Unicef ordered their staff members off the streets, while government officials reported that some polio volunteers — especially women — were afraid to show up for work.

At the ground level, it is those female health workers who are essential, allowed privileged entrance into private homes to meet and help children in situations denied to men because of conservative rural culture. “They are on the front line; they are the backbone,” said Imtiaz Ali Shah, a polio coordinator in Peshawar.

The killings started in the port city of Karachi on Monday, the first day of a vaccination drive aimed at the worst affected areas, with the shooting of a male health worker. On Tuesday four female polio workers were killed, all gunned down by men on motorcycles in what appeared to be closely coordinated attacks.

The hit jobs then moved to Peshawar, the capital of Khyber-Pakhtunkhwa Province, which, along with the adjoining tribal belt, constitutes Pakistan’s main reservoir of new polio infections. The first victim there was one of two sisters who had volunteered as polio vaccinators. Men on motorcycles shadowed them as they walked from house to house. Once the sisters entered a quiet street, the gunmen opened fire. One of the sisters, Farzana, died instantly; the other was uninjured.

On Wednesday, a man working on the polio campaign was shot dead as he made a chalk mark on the door of a house in a suburb of Peshawar. Later, a female health supervisor in Charsadda, 15 miles to the north, was shot dead in a car she shared with her cousin.

Yet again, Pakistani militants are making a point of attacking women who stand for something larger. In October, it was Malala Yousafzai, a schoolgirl advocate for education who was gunned down by a Pakistani Taliban attacker in the Swat Valley. She was grievously wounded, and the militants vowed they would try again until they had killed her. The result was a tidal wave of public anger that clearly unsettled the Pakistani Taliban.

In singling out the core workers in one of Pakistan’s most crucial public health initiatives, militants seem to have resolved to harden their stance against immunization drives, and declared anew that they consider women to be legitimate targets. Until this week, vaccinators had never been targeted with such violence in such numbers.

Government officials in Peshawar said that they believe a Taliban faction in Mohmand, a tribal area near Peshawar, was behind at least some of the shootings. Still, the Pakistani Taliban have been uncharacteristically silent about the attacks, with no official claims of responsibility. In staying quiet, the militants may be trying to blunt any public backlash like the huge demonstrations over the attack on Ms. Yousafzai.

Female polio workers here make for easy targets. They wear no uniform but are readily recognizable, with clipboards and refrigerated vaccine boxes, walking door to door. They work in pairs — including at least one woman — and are paid just over $2.50 a day. Most days one team can vaccinate 150 to 200 children.

Faced with suspicious or recalcitrant parents, their only weapon is reassurance: a gentle pat on the hand, a shared cup of tea, an offer to seek religious assurances from a pro-vaccine cleric. “The whole program is dependent on them,” said Mr. Shah, in Peshawar. “If they do good work, and talk well to the parents, then they will vaccinate the children.”

That has happened with increasing frequency in Pakistan over the past year. A concerted immunization drive, involving up to 225,000 vaccination workers, drove the number of newly infected polio victims down to 52. Several high-profile groups shouldered the program forward — at the global level, donors like the Bill and Melinda Gates Foundation, the United Nations and Rotary International; and at the national level, President Asif Ali Zardari and his daughter Aseefa, who have made polio eradication a “personal mission.”

On a global scale, setbacks are not unusual in polio vaccination campaigns, which, by dint of their massive scale and need to reach deep inside conservative societies, end up grappling with more than just medical challenges. In other campaigns in Africa and South Asia, vaccinators have grappled with natural disaster, virulent opposition from conservative clerics and sudden outbreaks of mysterious strains of the disease.

Declan Walsh reported from Lahore, and Donald G. McNeil Jr. from New York. Ismail Khan contributed reporting from Peshawar, Pakistan.

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U.N. Suspends Polio Campaign in Pakistan After Killings of Workers

B.K. Bangash/Associated Press

A Pakistani woman administered polio vaccine to an infant on Wednesday in the slums of Islamabad. Militants have killed eight polio workers over three days.

LAHORE, Pakistan — The front-line heroes of Pakistan’s war on polio are its volunteers: young women who tread fearlessly from door to door, in slums and highland villages, administering precious drops of vaccine to children in places where their immunization campaign is often viewed with suspicion.

Now, those workers have become quarry. After militants stalked and killed eight of them over the course of a three-day, nationwide vaccination drive, the United Nations suspended its anti-polio work in Pakistan on Wednesday, and one of Pakistan’s most crucial public health campaigns has been plunged into crisis.

The World Health Organization and Unicef ordered their staff members off the streets, while government officials reported that some polio volunteers — especially women — were afraid to show up for work.

At the ground level, it is those female health workers who are essential, allowed privileged entrance into private homes to meet and help children in situations denied to men because of conservative rural culture. “They are on the front line; they are the backbone,” said Imtiaz Ali Shah, a polio coordinator in Peshawar.

The killings started in the port city of Karachi on Monday, the first day of a vaccination drive aimed at the worst affected areas, with the shooting of a male health worker. On Tuesday four female polio workers were killed, all gunned down by men on motorcycles in what appeared to be closely coordinated attacks.

The hit jobs then moved to Peshawar, the capital of Khyber-Pakhtunkhwa Province, which, along with the adjoining tribal belt, constitutes Pakistan’s main reservoir of new polio infections. The first victim there was one of two sisters who had volunteered as polio vaccinators. Men on motorcycles shadowed them as they walked from house to house. Once the sisters entered a quiet street, the gunmen opened fire. One of the sisters, Farzana, died instantly; the other was uninjured.

On Wednesday, a man working on the polio campaign was shot dead as he made a chalk mark on the door of a house in a suburb of Peshawar. Later, a female health supervisor in Charsadda, 15 miles to the north, was shot dead in a car she shared with her cousin.

Yet again, Pakistani militants are making a point of attacking women who stand for something larger. In October, it was Malala Yousafzai, a schoolgirl advocate for education who was gunned down by a Pakistani Taliban attacker in the Swat Valley. She was grievously wounded, and the militants vowed they would try again until they had killed her. The result was a tidal wave of public anger that clearly unsettled the Pakistani Taliban.

In singling out the core workers in one of Pakistan’s most crucial public health initiatives, militants seem to have resolved to harden their stance against immunization drives, and declared anew that they consider women to be legitimate targets. Until this week, vaccinators had never been targeted with such violence in such numbers.

Government officials in Peshawar said that they believe a Taliban faction in Mohmand, a tribal area near Peshawar, was behind at least some of the shootings. Still, the Pakistani Taliban have been uncharacteristically silent about the attacks, with no official claims of responsibility. In staying quiet, the militants may be trying to blunt any public backlash like the huge demonstrations over the attack on Ms. Yousafzai.

Female polio workers here make for easy targets. They wear no uniform but are readily recognizable, with clipboards and refrigerated vaccine boxes, walking door to door. They work in pairs — including at least one woman — and are paid just over $2.50 a day. Most days one team can vaccinate 150 to 200 children.

Faced with suspicious or recalcitrant parents, their only weapon is reassurance: a gentle pat on the hand, a shared cup of tea, an offer to seek religious assurances from a pro-vaccine cleric. “The whole program is dependent on them,” said Mr. Shah, in Peshawar. “If they do good work, and talk well to the parents, then they will vaccinate the children.”

That has happened with increasing frequency in Pakistan over the past year. A concerted immunization drive, involving up to 225,000 vaccination workers, drove the number of newly infected polio victims down to 52. Several high-profile groups shouldered the program forward — at the global level, donors like the Bill and Melinda Gates Foundation, the United Nations and Rotary International; and at the national level, President Asif Ali Zardari and his daughter Aseefa, who have made polio eradication a “personal mission.”

On a global scale, setbacks are not unusual in polio vaccination campaigns, which, by dint of their massive scale and need to reach deep inside conservative societies, end up grappling with more than just medical challenges. In other campaigns in Africa and South Asia, vaccinators have grappled with natural disaster, virulent opposition from conservative clerics and sudden outbreaks of mysterious strains of the disease.

Declan Walsh reported from Lahore, and Donald G. McNeil Jr. from New York. Ismail Khan contributed reporting from Peshawar, Pakistan.

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