Amid Fear and Guns, Polio Finds a Refuge

wheelchair bike in Ungogo village

Jo Chandler travelled to Nigeria on a media delegation organised by RESULTS. Published by Undark on October 16 2017.

In a crowded square in the ancient Nigerian city of Kano, outside the palace of one of the Emir’s princelings, a menagerie of community leaders gathered this spring to combat an age-old foe. Mullahs, musicians, dignitaries, doctors, and traditional leaders, the last swathed in robes and turbans, are all enlisted in an elaborate public-service extravaganza — one orchestrated to both distribute and increase awareness of polio vaccine.

Young women draped in blue hijabs and armed with iceboxes full of life-saving, sugar-pink elixir, vanish into labyrinthine alleys and crumbling, crowded houses, as the citizenry watch the show from behind police barricades. They are men in the pale cotton tunics and finely-worked fula caps of the Hausa majority, women with bright veils tucked around their faces and babies in their arms, and scores of bug-eyed kids. Is the virus lurking among them?

It might well be. Poliovirus is so cunning, so contagious, so devastating, that a single case of Poliomyelitis, the paralysis-inducing disease it causes, sends up the flares as a public health emergency, which quickly ignites international concern. The disease occurs in only about one in every 200 cases of infection, so for every sick child — and infants and children are the most vulnerable — odds are there that hundreds more unwittingly carrying and spreading the pathogen.

By last summer, it had been almost three years since the last polio case in Kano state, and for a moment it seemed it might go down in history as the last in all of Nigeria. It wasn’t to be.

It hides out and multiplies in the human gut, and is excreted into the world through human waste. It can survive in the landscape for a few weeks, and in densely populated areas with little or no sanitation, as is the case in many neighbourhoods of Kano, it is carried about by flies and foot traffic. It can seep into the water supply, and it can be spread by coughing or kissing or sharing food or shaking hands. Peak season comes with the annual rains that send it coursing through the city.

Most tellingly, it is in the badlands of Boko Haram, the Islamist extremists of northern Nigeria, along with stretches of the Pakistan and Afghanistan border controlled by the Taliban, where the planet’s last nurseries of wild poliovirus are found: no-go zones where terrorists actively stop vaccine from reaching babies and children.

By last summer, it had been almost three years since the last polio case in Kano state, and for a moment it seemed it might go down in history as the last in all of Nigeria, and that the African region would finally be certified as polio free. Then in July of 2016, a two-year-old girl in northeastern Nigeria became paralyzed, and by August she was confirmed as the first of four polio cases in Borno, a war-torn state east of Kano. Genetic analysis indicated the outbreak had been festering undetected for at least five years, possibly spurred on by the horrific militancy of Boko Haram, which has scattered 1.9 million refugees across the country.

All of the most recent victims were children who had been huddling with their families in crowded, unsanitary camps where they had fled to escape the violent jihadists.


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