Polio: In Sokoto, zero cases but…

These communities which are  the ‘high number of chronic non-compliance communities and families’ as identified by UNICEF  Communication Specialist Boubacar   Souley in a presentation on  ‘Sokoto Polio/Routine Immunization Update at JAP orientation meeting for September  2014 Immunization Plus Days, IPDs have been recognised as a major threat to immunization.Other threats, he noted   included Wild Poilo […]

These communities which are  the ‘high number of chronic non-compliance communities and families’ as identified by UNICEF  Communication Specialist Boubacar   Souley in a presentation on  ‘Sokoto Polio/Routine Immunization Update at JAP orientation meeting for September  2014 Immunization Plus Days, IPDs have been recognised as a major threat to immunization.
Other threats, he noted   included Wild Poilo Virus (WPV) circulation in northern Nigeria (Kano, Yobe and Borno),on-going WPV transmission in Cameroon with high movement of Nigerians across the globe, persistent isolation of circulating vaccine-derived poliovirus CVDPV from environmental sample, poor team performance  leading to missing high number of children, not visiting households as well as  poor demand for routine immunization in communities.
Souley  also observed with concern that though administratively, records have shown high number of children being immunized, there were still un-immunized children in 10 local government areas of Sokoto.
According to him, poor community linkage of routine immunization services in some local government, poor awareness about immunization benefits, where to get the service and fear of side-effects are some factors stopping progress.
He identified critical issues with IPDs to include non-compliance among the elite and non-elite, poor team supervision, poor media coverage of Polio Eradication Initiative (PEI) activities including IPDs, poor team performance and inadequate counterpart funding among others.
In a polio risk analysis by local government area for the August 2014 Immunization Plus Days, IPDs,  the UNICEF consultant   categorised Ilela, Sokoto South and Wamakko local government areas  as Very, Very High Risk,(VVHR) LGAs.
Three others, Gwadabawa, Isa and Sokoto North, were noted as Very High Risk, VHR LGAs. Sixteen out of the remaining 17 local government areas in the state were said to be High Risk; only Binji was identified as Low Risk.
Though some reductions were recorded in  the last round of polio immunization held in September, cases of non-compliance to Oral Polio Vaccine (OPV) continue to resurrect across some local government areas in Sokoto.
Mallama Rabi, a middle -aged housewife at Makera, Kware Local Government Area of Sokoto insisted that  her children should not be immunized because if she allowed the vaccination, her marriage would be at stake.
“It is not my fault, it is my husband who is against it and he even swore to divorce me if I allowed any of his children to be immunized. I have four children and my mate has three, there are seven children in this house and they haven’t been immunized,” she told a team of Journalists Against Polio, JAP, in Sokoto State who monitored the just concluded 7th round of the National Immunization Days exercise.
Her husband, Alhaji Ila Hamza, was out at the time of the visit and she could not say why he maintains a stiff opposition against the immunization.
She, however, visits the hospital for treatments being hypertensive.
For Malama Azumi Aliyu, a mother from another non-compliant household in Sokoto: “We just don’t want the vaccine, I prefer N5 panadol for my child than polio vaccine.”
Yet another, Shehu Aliyu said: “We  are not interested in the polio vaccine because government has never given us anything free such as fertilizer, rice and other items that were distributed and nobody gives us free medical care, so why  should we accept polio vaccine?”
Shehu has two children. Though they had been once immunized, it was later he began to reject it due to the reasons he stated above.
He did not hold the view that polio had negative effects on children; he just didn’t want his children to be immunized.
Shehu Aliyu said he was aware that polio is deadly but believes that only God can destine if his child will be crippled or die.
However, there have been concerted efforts to check the trend.
 Souley  noted major strengths of the polio eradication initiative to include support from Northern Traditional Leaders Council (NTLC) pointing out that His Eminence, Sultan of Sokoto, called his council members and 85 district heads to a meeting in his palace to sensitise them on the need to be involved and participate in PEI activities.
There have been availability of development partners ready to provide support to the state and local authorities as well as availability of manpower to implement the PEI programme.
The use of health camps, ardos and Polio Survivor Groups ( PSGs) as well as senior supervisors and individual monitors carrying vaccine to immunize missed children were noted  to have boosted the polio immunization efforts.
During the just concluded rounds of immunization, some PSGs were seen participating as vaccinators.
 Zakari and Yahya were two of such PSGs at Bankano area of Sokoto.
Zakari told Daily Trust: “I am involved in the immunization work. I do administer  polio vaccine on children successfully. We enlighten people to allow their children to be immunised so that they don’t end up in a wheel chair like us.”
He added: “Sometimes people reject the vaccine but we persuade and enlighten them and at the end some allow us to immunize their children.”
For Yahya: “I just took interest in the work to enlighten children and people on the importance of immunization. We go to the streets on our wheel chairs.”
 Likewise, the introduction of health camps by UNICEF is said to have helped cut down non-compliance in some areas.
 A nurse, Linda Moses, told a team of JAP members at Ilela Local Government that the introduction of health camps in Sokoto State by UNICEF has helped to reduce rejection of the polio vaccine.
She stated: “These health camps have really encouraged parents who were hitherto rejecting the polio vaccine to accept it now.”
The health camp provides free drugs to children and adults for common ailments  treated at the camps including  cough, diarrhoea and malaria, among others, she explained.
Also, many local governments use dialogue, traditional, religious and opinion leaders to resolve the cases of rejection.
In Kware for instance, National Polio Immunization, (NPI) Manager for the area, Alhaji  Ahmed Jelani, said  cases of vaccine rejection have been reduced by about  90 percent  following the use of  dialogue.
He said though Kware was one of the high risk local government areas in Sokoto, the cases of non-compliance have reduced drastically.
“In Kware, about 12,000 children were previously missed due to non-compliance but it has reduced to 17 households with 29 children,” he stated.
However, the threat of non-compliance  still poses a challenge and this concern was raised in a number of localities in Sokoto during the just concluded immunization exercise  with some  NPI  managers saying they  would not hesitate to resort to the use of security agencies to arrest any parent with a non-compliance attitude.
In Sabon Birni Local Government Area of the state, its chairman, Idris Mohammed Gobir, instructed that any non-compliance should be arrested and “such   children be immunized even in the police station”.
The Journalists Against Poliomyelitis (JAP), Sokoto  had a one-day orientation course  on polio and routine  immunization and raised concern over the knotty issue of  non-compliance.
In its resolutions, it called on the  Sokoto State House of Assembly to enact a law that would allow the prosecution of those that are  non-compliant to Oral Polio Vaccine (OPV).