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Another obstacle to polio-free status



Another obstacle  to polio-free status

Despite the hard work and commitment from government, development partners, health workers and volunteers, the discovery of fresh polio virus in Kano State could, once again, dash Nigeria’s hope to be certified polio- free in about four months time, except if quickly contained. REGINA OTOKPA reports



Wild Polio Virus (WPV) has been in Nigeria from the colonial period however, after several sustained efforts, including domestic and international financing, the commitment of thousands of health workers, and new strategies that reached children who had not previously been immunised because of a lack of security in the country’s northern states, the case numbers declined drastically by the end of 2010, following a massive immunisation programme targeted at eradicating polio in the country.
On September 24, 2015, the World Health Organisation (WHO) announced the removal of Nigeria from the list of countries where polio is considered endemic, after 14 months passed by without detecting any new case of polio caused by the wild virus. This was a great news for the country, the last in Africa where polio was endemic, but it was a greater news for the continent as it looked forward to WHO’s certification of polio free Africa once three years passed without a case in WHO’s entire African region.
But in August 2016, that joy was shot lived and expectations shattered, as Nigeria’s proposed certification as polio free on 24 July 2017 suffered set back, after the federal government confirmed two new cases of polio in Jejere and Gwoza Local Government Areas of Borno State, detected during a surveillance of the North-East region by health officials. Before this re-emergence, Nigeria had not reported a polio case since July 24, 2014, however, with the increasing rate of insurgency by members of the Boko Haram sect n the North East especially in Borno State, the region became highly inaccessible for health workers to administer routine immunisation vaccines and ensure extensive surveillance.
The government swung into action deploying an emergency response team to the northeast to immunise about five million children in Borno State and adjoining states of Yobe, Adamawa and Gombe. Also, local health officials with the support of the WHO and the United Nations Children’s Fund (UNICEF) conducted a detailed risk analysis to clearly ascertain the extent of circulation of the virus, and to assess overall levels of population immunity in order to guide the response.
Towards the end of 2018, the Executive Director National Primary Health Care Development Agency (NPHCDA), Dr. Faisal Shuaib, had noted that the country had gone over 24 months with very strong surveillance without a case of wild polio virus which shows clearly that government was not missing any wild polio in the country.
“If this positive trajectory continues, then it is very likely that certification institutions will review the progress that Nigeria has made and the lack of wild polio virus transmission.
“Very likely, in the next few months, we will be certified a polio-free nation. It will be an unprecedented declaration in the life of Nigerians; a situation where no single child is paralysed due to wild polio virus,’’ he said.
Although full of enthusiasm, he had however expressed fears over the attitude of mothers and care givers towards routine immunisation programmes which helps to provide immunity against wild polio virus and other vaccine-preventable diseases.
“One of the greatest challenges we still face is around mothers and care givers bringing their kids to health facilities to access routine immunisation, even in the urban centres where places are accessible.
“We still have that challenge largely because folks have not realised the need for kids to take the full complement of routine immunisation vaccines let alone in the hard-to-reach areas.”
About two months ago, the ED had again noted excitedly that the country was still on the right track to be declared polio free, as no new case of WPV has been recorded in the past three years.
“Because we have been innovative and creative with routine immunisations, we are now at a point where we are just some six months away from being declared polio-free in Nigeria.
I have no doubt that with our very encouraging record of not having a single case of WPV in any part of the country in the past three years, we all shall soon celebrate a polio-free Nigeria of our dreams,” he said.
Sadly, after over three years of no reported case of WPV, Nigeria’s high hopes to finally clinch the certification for self and Africa after August 2019 is hanging in the balance, following a fresh discovery of polio virus in Tarauni Local Government, Kano State, which the state government has denied.
According to the Primary Health care co-coordinator in the LGA, Nura Haruna, the fresh case of Circulating Polio Virus (CPV) was discovered inside a sewage situated at Darmanawa Ward in Tarauni Local Government within the metropolis, even though it was suspected to have emanated from Zaria Local Government in Kaduna State where two cases of CPV were earlier discovered this year.
The heartbreaking part of the new development is that despite Dr. Shuaib’s consistent assurances on the safety of vaccines and his pleas to parents and caregivers to allow their wards be vaccinated to prevent disease epidemics and deaths caused by preventable diseases including the WPV, it has been discovered that a good number of elites including medical doctors, police and Immigration officers in Darmanawa, Hotoro and Danwanu wards out of ten wards under Tarauni LGA, have been preventing health workers from accessing their households to administer vaccines to their wards. Some of these workers have been said to spend hours at a particular house but were forced to leave when no one attends to them.
“Whether you are elite or not, we need your household to be vaccinated because if we vaccinate nine out of 10 houses, the remaining one will still put the entire community at polio risk,” Haruna lamented.
Another twist to this sad tale is the sickening fact that some polio vaccination workers have been compromising the immunisation process by finger marking some eligible children without administering the polio vaccine. Although some women who knows the importance of immunisation do not mark the fingers of their children to avoid their husbands who restrain them from presenting their children for immunisation get suspicious.
Only recently, the Kano State Government in the course of routine monitoring of the engaged ad-hoc staff, sacked 12 polio vaccination workers who were found to have finger marked some eligible children without administering the polio vaccine in their mouths based on the mutual agreement they had with some parents, who had reservation against the exercise.
“We have been sacking many ad-hoc workers found wanting of compromising the immunization process and we will not stop doing that until we sanitise the process and eventual certification of Nigeria polio-free. In fact, we just sacked four teams comprising of three members each among the ad-hoc staff when we investigated and found them wanting.”
These kind of challenges posed by some parents, care givers, vaccination officers and even health workers, could deny Nigeria a chance to get it right in the area of WPV. Unfortunately, children from most families in the north who do not practice safe hygiene face higher risk of coming down with preventable infectious diseases especially when they miss their vaccination.
As the count down begins, the solution lies in prioritising personal hygiene, environmental sanitation, self orientation to ensure eligible children are released for immunisation when due, so as to prevent any attempt by the WPV to resurface in Kano state, thereby denying Nigeria a chance to be certified polio-free in the next few months.

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