Field Notes from Nigeria Day 2 – Highs and lows in the global Polio eradication campaign

(This young girl in Kano state, Nigeria is a polio victim.)

(HN, April 29, 2010) --- Today was a roller coaster ride of hope and despair.   Hope because we witnessed an entire community - mobilized by its traditional leader - rally around the cause of polio immunization. At a so-called flag-off ceremony at the remote settlement of Yalwa in Rimin Gado LGA - led by the District Head, Alhaji Shehu Mohammed Dankade - children thronged the polio vaccination point even before it opened.

Two local men beat drums and plucked at a string instrument, while another used a bull horn to announce that the polio vaccine had arrived and was ready to be dropped into the mouths of children.   "It's amazing there seems to be absolutely no resistance to this round of polio vaccination," said a health worker. District head Dankade and religious and political leaders lined up to administer the first double drops to young children while girls and boys thrust their younger siblings forward to receive the two drops of vaccine.  Health workers then drew a line on their fingers with a blue marker, handed them some sweets or a bar of soap and ticked off a box on a tally sheet that they had received the disease fighting treatment.

(Children in Kano state watch a polio vaccination campaign.) 

The enthusiasm and almost carnival-like atmosphere left us pumped up, elated. What we saw was the culmination of weeks and months of high-level advocacy - coupled with excruciating micro-planning at the local level – with a goal to ensure that all 6-million or so eligible children 0-5 years old in Nigeria are protected against polio.

It was during the ceremony that we were introduced to two young polio victims. Actually no one needed to point them out to us. I spotted them through the viewfinder of my SONY camcorder as I panned to capture the scene.  Their legs hung lifeless on the chairs. Their eyes full of sadness as they sat motionless while their friends rushed to the vaccinators for the drops and sweets. Because their parents had failed to get them vaccinated in the first crucial months of their lives they will be deprived of a normal life forever. That's the grim and cruel reality of the invisible polio virus as it travels indiscriminately from child to child - and across borders.

(This young boy is also, a polio victim. Vaccines came too late for him.)

I commented to a UNICEF colleague, Josephine Kamara that parents only need to see these victims first hand in order to take the necessary steps to protect their children. Indeed we are told by health workers that there are few, if any, so-called non-compliance cases in Yalwa. Covering the entire targeted group of kids should be, in theory, a no-brainer.

But then we come face-to-face with what I termed one of the few remaining "weak links" in the global, multi-million dollar effort to eradicate polio.

As we strolled deeper into the labyrinth of mud huts, we decided to conduct a spot check on the homes that had just been visited by vaccination teams. Elaborate codes had been scribbled on the front walls or doors of mud houses, indicating that they had been visited and that all the children inside vaccinated.

But just minutes into our tour, one by one, young children approached us showing the unmarked hands of their younger siblings (mothers - following tradition - stay inside). The further we went into the community, the more children came forward who were missed by the health workers.

Said one government health official, a medical doctor: "It's a miracle that we have been able to contain polio in Kano state. It seems almost 50 percent of the children here were missed."

Eerily there is no sign of the immunization teams but luckily our partners brought along a vaccine carrier and sweets to conduct a spot, unplanned mop-up campaign. A planning meeting later in the day looked into why the area was not properly covered. We later learned that remedial steps had been swiftly implemented and that a new team would be deployed to the area to follow up. I hoped so.

--- Reporting for HUMNEWS, Michael Bociurkiw is in Nigeria documenting polio eradication efforts for UNICEF.