This blog post was written by Chizoba Unaeze, Program Manager, International Medical Corps Nigeria. International Medical Corps (IMC) is a global, nonprofit, humanitarian aid organization dedicated to saving lives and relieving suffering by providing emergency relief, health care training and development programs to those in great need. IMC is a Global Health Council 2017 member.
In August 2016, four children under five years old were reported paralyzed from wild poliovirus in Nigeria’s conflict-ridden Borno State. The resurgence of the disease came after more than two years without any cases of the poliovirus—a consequence of the seven-year Boko Haram insurgency, which has fueled instability and displacement and left thousands out of reach of humanitarian assistance.
Despite the security risks, International Medical Corps, together with local and international partners in the CORE Group Polio Project (CGPP), is making sure children are vaccinated against polio, despite the wide-reaching damage the conflict has had on the health system. Each immunization Plus Days campaign month, International Medical Corps and its local partners (AHIFF in Borno and CSADI in Kano) through social mobilization and house to house visits with the state vaccination teams in the focal areas vaccinate more than 180,000 children in Borno State and 85,000 in Kano State against polio—according to call in data as collated and analyzed by the Emergency Operations Centres in the states.
Such high vaccination numbers 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. The VCMs are also taught how to find and engage pregnant women and new mothers, how to encourage them to bring their children to immunization sites for vaccinations, and how to find and report young children suffering from paralysis—and possible polio.
As part of the CGPP Consortium, 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 a sub-unit 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 increasing 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 health care, 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 health care 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 a Bulama, 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 polio immunization campaign followed that reached every single child in that community.
It has been more than a year since a case of polio was detected in Nigeria. I believe that if we keep engaging in dialogue, with explanations and persuasions on both sides, and getting vaccines out to communities, we will once again rid Nigeria of polio—one household at a time, immunizing one child at a time.