Nigeria is on the verge of eliminating polio, but Boko Haram is standing in the way.
Using violence and misinformation, the ISIS-linked militant group has hampered efforts to get every child in the country vaccinated against polio, leaving nearly 66,000 children in remote villages in northern Nigeria without the vaccine, according to UNICEF estimates.
But public health officials are pushing back. They are teaming up with the military and volunteers who have put their lives on the line to get vaccines to everyone.
Boko Haram has controlled territory in northern Nigeria since around 2003. The aim of the militant group is to establish an Islamic Caliphate in the region.
As part of an effort to dispel Western views, the group — whose name roughly translates to “Western education is sinful”— spread vaccine misinformation. Boko Haram claims that the vaccine could lead to infertility and bone injuries.
The group has also used violence to deter vaccinators. In 2013, at least nine vaccination team members in the state of Kano were murdered. Witnesses pointed to Boko Haram as the culprit.
The group’s efforts worked.
In 2016, after nearly three years without an outbreak, polio resurfaced in the country. The development is a sobering reminder that public health efforts can be quickly undone. This reality is possible even when backed by strong leadership, millions of dollars in funding and years of planning.
“In 2016, we almost disrupted the transmission of polio. But our efforts were derailed by insurgency groups in the North-East,” said Dr Ngozi Nwosu.
Nwosu is the National Coordinator for the polio transition planning committee of the National Primary Health Care Development Agency.
Vaccinators have to reach kids in Boko Haram territory
“We don’t want that to happen again.”
That means public health officials need to get the vaccine to kids in remote villages. Some of these villages are in Boko Haram-controlled territory.
“Now, health care workers are accompanied by the military and vigilantes to keep them and the vaccines they carry safe,”Nwosu said.
“We also use satellite imagery to see where these hard-to-reach communities are located so we know exactly where to go.”
The vigilantes, also called community informants, sometimes go where health care workers cannot, because of threats of violence.
They are young men who were trained by the military. Their training has equipped them on how to de-escalate potentially dangerous situations. Further, they have been trained on how to properly administer vaccines.
Armed with this knowledge, they go family to family in remote camps, dispelling anti-vaccine myths for parents and providing vaccines to the children.
Their vaccination efforts have been invaluable in helping to achieve Nigeria’s 30-year goal of eliminating polio, said Pernille Ironside, UNICEF’s deputy representative for Nigeria.
Pernille Ironside
“We are fortunate to have informants within largely inaccessible areas of Borno,” Ironside told the media in a statement.
“Boko Haram has made it so we can’t reach 66,000 children.”
The vigilantes provide health care workers with on-the-ground information. These include whether any children show symptoms of polio. But without access to the areas, it’s difficult to know exactly what’s going on.
“We’re not quite sure of the full polio picture in these areas. If any children are experiencing paralytic symptoms, or how many kids remain un-vaccinated,” Ironside said.
“The inaccessibility to these children is a far bigger issue than even the misinformation campaigns that exist.”
Govt urged to explore other means of ending insurgency
One community informant asked to remain anonymous for safety concerns. He told reporters that the number of vaccinated children have increased in quantity. However, the informant added that thousands of children have likely been vaccinated, thereby conferring some level of herd immunity to those who are not vaccinated.
Herd immunity means that health workers vaccinate enough people against an infectious disease. This is to protect others in the community who are not.
The vigilantes also help educate the people living in these remote areas on proper hygiene and sanitation practices when they can, Ironside said.
“Polio is spread in the faeces, and Nigeria will soon overtake India as the No. 1 country in public defecation. That’s not a distinction you want to have,” she added.
Nwosu stressed that while global public health efforts and strong leadership by the Nigerian government have stemmed the anti-vaccine tide, it’s not time to let up.
“We have to remain vigilant in our vaccination and surveillance campaigns,” Nwosu said.
And polio isn’t the only safety concern in the area. Kidnappings, armed robberies and poor sanitation are also worsening the conditions in which people live, she said.
Ironside applauded Nigeria as a global public health success story. She noted that she is excited that this chapter in the fight against polio is coming to an end.
Still, she acknowledged that a conversation with Boko Haram leadership may be necessary to keep events, such as the resurgence of polio in 2016, from happening again.
“We know that Nigeria is doing everything in its power to check their influence,” Ironside said of Boko Haram, “but it is prudent to listen to their message and find new ways to address them.”
Source: National Geographic
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