Field Notes from Nigeria Day 3 – Scenes from the global Polio eradication campaign in Makarya Ward

("Sarkin Yaki" leads a sensitization session in Makarya Ward.)

(HN, April 30, 2010)  At first appearance, Alhaji Aliyu Wada is an imposing man.  As he sprints out of his souped-up Toyota Landcruiser, his people bow to him in reverence. 

Wada - the "Sarkin Yaki" (Hausa translation: people's warrior) is the traditional leader of this region of Nigeria – and takes us to witness a `sensitization’ session for village leaders in Makarya Ward; a pristine settlement in comparison to the others we have visited this past week.

By the time we arrive, people of all ages are sitting and standing patiently as the enormous dust cloud our 4x4 vehicles have kicked up, settles around them. I immediately noticed that the temporary immunization post had already begun vaccinating children though - well before Wada arrived.  Health workers seem not only to be conducting the process to the letter – but children's hands are marked immediately after receiving the drops and are given sweets and soap – and also an official vaccination card to help their parents keep track of future jabs of the vaccine dosings.

Later, we follow a vaccination team as they meticulously make their way through the village streets lined with simple mud huts and where goats and chickens compete for space along the sidelines. Again, in this village as opposed to others we’ve seen, everything is done according to the book by health workers - right down to marking the outdoor hut walls with white chalk to indicate that all children aged 0-5 years old have been vaccinated.

The heat at this time of day is absolutely punishing, and I make a mental note that I probably have another 20 minutes or so left before the searing heat does me in. I notice that even the local men are perspiring profusely. Yet the vaccination teams go about their business - one worker even carrying a young baby on her back.  The rest of the team of five carries the cold box with the vaccines, the case containing the so-called plusses for vaccination recipients (sweets or soap), and two of the five tasked with a marker and a tally sheet.

("Sarkin Yaki" speaks in the field.)

Earlier Wada spoke emphatically to his people, stressing in the local Hausa dialect the importance of vaccination for polio to the gathering of attentive parents. It’s an outdoor session, and even though it’s meant for the ears of male village leaders, people of all ages have come to see what the fuss is about. Young men sit on tree branches to get a better view of Sarkin Yaki, dressed in intricate blue and white robes, weigh forth on polio.

Listening even just a few minutes to Wada, you quickly realize why traditional leaders like him are such potent ammunition in the protracted fight against polio which has struck over 350,000 people in Nigeria, but is now close to eradication.

Wada bristles when asked about so-called non-compliant families who refuse to vaccinate their children. The head of the household should be threatened with legal action, and he authoritatively cites the exact number of a northern Nigerian states law (#138) which mandates this.

"It is the instruction of the Emir (of Kano) that no one should be spared," Wada said on camera, slowing down his words to emphasize the word "spared." He goes on: "If he tries to say 'no' well perhaps he should be taken away...and that house MUST be vaccinated. Maybe he should be locked up for a day or two. As a matter a fact, if you don't comply you can be locked up for up to two years. But we don't want to do that (lock people up). We start by talking and talking and we keep talking - convincing people of the need to get vaccinated.  We'll then tell them that if you are not vaccinated, you might possibly pick up the disease.”

"If we were able to vaccinate 200 people in this area,” he goes on, “and one single individual family refuses us to vaccinate his child, the child might pick up the polio. And you know once he has it, he can spread it to the entire population. Meaning, we are going five steps forward and ten steps back.”

"We will not allow this,” he says. “We have to protect the people. We will not allow any single individual to fall out of vogue and refuse to get vaccinated. And then, we allow him to go free with it. No way!  I promise you that in the next three, four or five months you will be seeing a much better performance."

Later, in his palace, Wada elaborates on his earlier statements on using tough justice for people who refuse to vaccinate.

"Sometimes you have to be cruel to be kind," he says, as he beckons us to help ourselves to a third serving of Nigerian pepper soup, pigeon and `roadrunner chicken’. (YUM!)

Wada says his words carry, by far, more weight than the average Nigerian politician because his position is inherited and he is with his people “twenty-four, seven”. He adds: "Even if I get a call in the middle of the night, I will go check into a problem for my people."

(A young boy receives a pair of polio drops in Makarya Ward.)

He said the night before he had received word of a non-compliant family.  He sent his driver with a group of vaccinators and the family immediately came around and allowed their children to receive the polio drops. "Even if the parents are not there, I will authorize the team to go in on my behalf and ensure that they vaccinate."

When an aid (who, by the way, has four wives and 24 children; Wada has only one) comes in to inform him of an urgent matter requiring his attention, Wada apologetically excuses himself and asks us to help ourselves to more home-cooked Nigerian food and talk about our efforts for tomorrow.

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