Editor’s Note: In August, two children were reported paralyzed from wild poliovirus in Borno state in northeastern Nigeria. This resurgence of the disease comes after more than two years without any cases of poliovirus. The two new cases occurred in an area plagued by violent conflict with the Islamist insurgency Boko Haram, where people are often displaced and humanitarian access can be limited. International Medical Corps is working with partners in Borno state to increase vaccination coverage. To learn more about the crisis in northeastern Nigeria and International Medical Corps’ response, click here.
Working in northern Nigeria as part of the CORE Group Polio Partnership Project (CGPP), International Medical Corps has played a key role in winning a major global health victory in the war against disease.
Working closely with the CGPP partners we have helped rid Nigeria of polio—and with it, make all of Africa polio free. It is an accomplishment that has brought the world to the brink of eradicating the crippling virus from the earth, with only Afghanistan and Pakistan still struggling to conquer the disease.
“This is a tremendous achievement,” said International Medical Corps Senior Health Advisor Paul Robinson, who has provided technical support to the project since his organization joined CGPP in 2015. “In the history of the world there has been only one other human disease eradicated globally and that is smallpox. Now we have a chance to add polio to that list.”
International Medical Corps’ contribution to the triumph was pivotal to the project’s success. It drew on its highly respected training expertise to join the fight in crucial areas of northern Nigeria. To prepare local government workers, non-government staff and volunteers who are part of the project, our trainers provided them the skills needed to increase polio vaccination rates--rates that had seriously lagged behind due to terrorist attacks and atrocities in a region that includes Boko Haram’s home areas.
We began our polio programming in Kano State in March 2015 and six months later expanded our polio and other vaccine efforts to Borno State--where Boko Haram is active. Our local partners in these two states are two Nigerian NGOs, Community Support and Development Initiatives (CSADI) in Kano and African Healthcare Implementation and Facilitation Foundation (AHIFF) in Borno. Despite the violence, our efforts succeeded, helping protect young children against polio and lifting vaccination rates from the 20-30% range to an impressive 99.96% rate in Kano and 96.8% in Borno.
Such high vaccination rates don’t just happen. They are the result of careful planning, organization and coordination—all skills that require a variety of training curricula. For example, we train supervisors how to use smart phones for tracking project activities at neighborhood and community levels, how to use registers filled out by Volunteer Community Mobilizers—known as VCMs—to assure no households are missed. We train the VCMs themselves on how to find and engage pregnant women and new mothers, how to encourage them to bring their children to immunization sites for vaccinations, and also on how to find and report young children suffering from paralysis—and possible polio.
International Medical Corps trainers also mentored and supported local government staff and volunteers on ways to address community suspicions about the vaccination campaigns—suspicions that can generate outright resistance to immunization.
One such example occurred when community residents in an area of one district –called a “ward”—resisted vaccination of their children against polio. For two subsequent rounds of monthly campaigns residents did not allow any of its children to be immunized, significantly increases the likelihood of children contracting polio.
In response, the local government formed a team with individuals from UNICEF, Rotary Club, and International Medical Corps, along with the local government health officer that met with community health officials, local council members as well as influential traditional, religious and other community leaders to engage in a dialogue to address the causes for resistance and ease concerns.
As this meeting progressed, it became clear the residents resented the importance outside authorities were giving to the polio campaign when other long-ignored community needs remain neglected. One resident pointed out the community lacked basic services, including proper healthcare, clean water and prevention against other diseases such as malaria and cholera that killed the children. Others noted that medicines were either not available or too expensive for them to purchase. They wanted to know why there were so many rounds of polio vaccinations taking place in their area; why their basic healthcare needs remained unaddressed while outside authorities focused solely on polio.
It was quickly clear from the government-led team that the concerns expressed by residents were genuine and had to be dealt with honestly. The team initiated a dialogue under the leadership of a local traditional leader, called an Emir, to resolve the complaints.
Once community residents could see their complaints were being addressed, the resistance ended. With a plan of action agreed, a house to house to house polio immunization campaign followed that reached every single child in that community.
It was only with countless similar dialogues, with explanations and persuasion on both sides, along with effective immunization strategies that those involved in the effort managed to rid Nigeria of polio—one household at a time—vaccinating one child at a time.
Today, International Medical Corps, as all CGPP partners, remain vigilant in Nigeria, focused on the steps needed to consolidate the public health victory once the World Health Organization certifies the country polio-free in 2017.