We talk to Professor Rose Leke, Chair of the African Regional Certification Commission, to get her views on progress on the continent, and prospects for certifying the region polio-free in 2019.
News Category: Social mobilization
The Pakistan polio snapshot gives a monthly update on key information and activities of the polio eradication initiative in Pakistan.
In February:
- No new cases of wild poliovirus (WPV1) were detected.
- 39 million children were vaccinated against poliovirus by a team of almost 260 000 dedicated frontline workers.
- Teams at transit points and borders successfully vaccinated 1.4 million children.
The Afghanistan polio snapshot gives a monthly update on key information and activities of the polio eradication initiative in Afghanistan.
In February:
- No new cases of wild poliovirus type 1 (WPV1) were reported.
- 5.9 million children under five years of age were targeted during subnational immunization days across 22 provinces.
- Permanent transit teams successfully vaccinated 1 055 488 children against polio, whilst cross-border teams vaccinated 57 833 children.
For full update please click on pdf below.
Zulaihatu Abdullahi is well known in her community, particularly to the mothers. As a volunteer community mobilizer in Kaduna state, northern Nigeria, her mission is to ensure that no child contracts polio, or any other preventable childhood disease.
This is difficult, as immunization programmes are sometimes treated with suspicion in her part of Nigeria. As a ‘change agent’, Zulaihatu’s job is to go door to door, counselling parents about the importance of the polio vaccine.
This particular lunchtime, she is visiting an 18 year-old mother living in a compound in a densely-populated, urban district of Kaduna State.
The young mother puts down the pole she is using to pound millet and welcomes Zulaihatu, recognising her royal-blue UNICEF hijab. She sits, and pulls on a hijab for cover as she settles down to breastfeed her baby. She has three other small children at home, a fifth on the way and she is new to the area.
“Before I came here I was rejecting all vaccines,” she says, “but because of this woman, Zulaihatu, I decided to accept. She told me the usefulness and I was convinced to do it.”
Thanks to Zulaihatu’s patience, and her work to build trust with the younger woman through regular visits, four more children are now protected against polio who might otherwise still be at risk. The mother has also been encouraged to seek anti-natal care, and the youngest child has just received his routine immunization shots.
“Sister Zulaihatu was one of the first women I met when we moved here,” the mother recalls. “She came here every day. She told me how she takes care of her own children. What she feeds them. How they all take vaccines. Little by little I started to change my thinking.”
Zulaihatu is trained to make her community aware of important household and parenting practices to keep their children thriving. The list is extensive and includes tips to treat diarrhoea, the importance of basic hygiene and sanitation, how to protect the family from malaria, the benefits of neonatal care and breastfeeding for infants, and the importance of registering their births.
She is one of nearly 20 000 UNICEF-trained community mobilizers, influencers and communication experts spread across 14 northern ‘high risk’ Nigerian states. With the support of donor and partners including the Bill and Melinda Gates Foundation, CDC, Dangote Foundation, European Union, Rotary, GAVI, JICA, the World Bank and the Governments of Canada, Germany, Japan, and others, the mobilizers are a key part of UNICEF’s ongoing support to the Government of Nigeria’s immunization programme.
Despite their achievements, Zulaihatu and other mobilizers know that there is much is still left to be done in their communities. Tomorrow, Zulaihatu will continue her work, going from household to household to keep every child safe.
More stories about women on the frontlines of polio eradication
The Pakistan polio snapshot gives a monthly update on key information and activities of the polio eradication initiative in Pakistan.
In January:
- No new cases of wild poliovirus (WPV1) were detected.
- More than 39 million children were vaccinated against poliovirus by a team of almost 260 000 dedicated frontline workers.
- Teams at transit points and borders successfully vaccinated 1.5 million children.
The discovery of wild poliovirus in Borno and Sokoto states in Nigeria in 2016 after more than two years without any reported cases prompted a multi-country response in neighbouring countries of the Lake Chad basin, covering Cameroon, Central Africa Republic, Chad, Niger and Nigeria. Since the outbreak response started, coordinated vaccination campaigns have been taking place in all five countries, reaching tens of millions of children. This year, campaigns are planned for March, April and October – all of them synchronized between the neighbouring countries.
In Chad, vaccination activities for polio and other diseases are being carried out in priority districts, supplementing regional campaigns which aim to target the hardest-to-reach children.
As he climbs out of his car and walks across to the entrance of Bakassi camp for internally displaced persons in Borno, northern Nigeria, Dr Terna Nomwhange is met by a familiar sight. Standing at the gates, greeting a tired, dusty family laden with possessions, is a team of polio vaccinators. As families arrive at this sea of shelters following a long, hard journey, these people offering polio vaccines are the first sign that they have reached a place of protection.
Not only are families in northern Nigeria facing insecurity, a humanitarian crisis and the threat of polio, but since September they have also been at risk from an outbreak of yellow fever. By early January 2018, a total of 358 suspected cases had been reported in 16 states, with 45 deaths recorded for 2017. In Borno, the ongoing conflict means that the health infrastructure on the ground to respond to the outbreak is limited to local government and the polio eradication infrastructure.
At the camp gates, the polio vaccinators give two drops of vaccine into the mouth of every child; but they also tell the parents where to go to get their yellow fever vaccination. As Dr Terna, who works for the WHO Nigeria polio eradication programme, walks further into the camp, he catches sight of the distinctive blue that signifies the uniform of a polio volunteer community mobilizer. As she emerges from the door of a shelter, he hears her reminding the family within to get their children vaccinated against polio, but also for the whole family to be vaccinated against yellow fever.
With weakened health system in parts of north eastern northern Nigeria, the infrastructure that is already on the ground to stop polio is providing the volunteers needed to support the yellow fever vaccination campaign. More than eight million people are being targeted with yellow fever vaccines in the states of Borno, Zamfara Kwara and Kogi states in 2018.
Vaccinating adults
Regular polio vaccination campaigns reach children under five years of age with polio vaccines, as this age group is the most vulnerable to the virus. But reaching everyone between nine months and 45 years to protect them against yellow fever takes creative thinking. People who would not usually be vaccinated have to be mobilised to come to health clinics where they can receive that one shot of yellow fever vaccine that infers life-long protection.
This is where the polio infrastructure comes in. To prepare for the launch of the yellow fever vaccination campaign that took place at the beginning of February, polio experts supported the preparations by developing detailed microplans, mapping each community so that every individual can be vaccinated. Volunteer community mobilisers, well versed in educating communities about the risks of infection, used their skills to warn populations of the high mortality rates associated with yellow fever.
Surveillance
The polio surveillance system in Borno is already on high alert to identify any case of polio, even in conflict affected areas. “Surveillance remains everyone’s number one priority,” says Dr Terna. “While the polio infrastructure is doing everything it can to find any trace of polio, it is killing two birds with one stone by keeping an eye out for yellow fever as well. This is a win-win situation to stop both diseases.”
While surveillance focal persons move house to house, they are also raising awareness about the symptoms of yellow fever. When a potential case is found, the polio infrastructure is being used to collect blood samples and transport them to the national laboratory down the reverse cold chain, keeping samples at the correct temperature for testing.
Collaboration
“What makes this campaign special is not just the fact that the strong polio infrastructure is helping to control other diseases, but also that it underscores what can be achieved with intersectoral collaboration and partnership,” said Dr Wondimagegnehu Alemu, WHO Country Representative to Nigeria. “Without the polio eradication infrastructure, a campaign of this scale would not have been able to take place.”
“Everyone is pulling in one direction – the government, partners and volunteers within communities – to protect any and every vulnerable person against polio and yellow fever,” says Dr Aliyu Shettima, Polio Incident Manager at the Emergency Operations Centre (EOC) in Maiduguri.
Support for immunization to the Federal Government of Nigeria through the World Health Organization is made possible by funding from the Bill & Melinda Gates Foundation (BMGF), Department for International Development (DFID), European Union (EU), Gavi, the Vaccine Alliance, Global Affairs Canada (GAC), Government of Germany through KfW Bank, Japan International Cooperation Agency (JICA), Korea Foundation for International Healthcare (KOFIH), Measles and Rubella Initiative (M&RI) through United Nations Foundation (UNF), Rotary International, United States Agency for International Development (USAID), United States Centers for Disease Control and Prevention (CDC) and World Bank.
The Afghanistan polio snapshot gives a monthly update on key information and activities of the polio eradication initiative in Afghanistan.
In January:
- Three new cases of wild poliovirus (WPV1) were detected, two from Kandahar province, and one from Nangarhar province.
- 6.1 million children under five years of age were targeted during subnational immunization days across 24 provinces.
- Permanent transit teams successfully vaccinated 1 231 180 children against polio, whilst cross-border teams vaccinated 68 966 children.
For full update please click on pdf below.
The Pakistan polio snapshot gives a monthly update on key information and activities of the polio eradication initiative in Pakistan.
In December:
- No new cases of wild poliovirus (WPV1) were detected.
- More than 22 million children living in high-risk areas were vaccinated against poliovirus by a team of almost 143 000 dedicated frontline workers.
- Teams at transit points and borders successfully vaccinated 1 460 000 children.
The Afghanistan polio snapshot gives a monthly update on key information and activities of the polio eradication initiative in Afghanistan.
In December:
- Two new cases of wild poliovirus (WPV1) were detected, both from Shahwalikot district in Kandahar province.
- 5.5 million children under five years of age were targeted during subnational immunization days across 22 provinces.
- Permanent transit teams successfully vaccinated 1 121 074 children against polio, whilst cross-border teams vaccinated 80 543 children.
For full update please click on pdf below.
The Afghanistan polio snapshot gives a monthly update on key information and activities of the polio eradication initiative in Afghanistan.
In November:
- Three new cases of wild poliovirus (WPV1) were detected, two in Nangarhar, and one in Kandahar provinces.
- Over 6 million children under five years of age were targeted during subnational immunization days and a staggered districts campaign.
- Permanent transit teams successfully vaccinated 1,107,521 children against polio, whilst cross-border teams vaccinated 89,513 children.
For full update please click on pdf below.
The Pakistan polio snapshot gives a monthly update on key information and activities of the polio eradication initiative in Pakistan.
In November:
- Three new cases of wild poliovirus (WPV1) were detected, bringing the total number of WPV1 cases in Pakistan in 2017 to eight.
- More than 38 million children under five years of age were vaccinated against poliovirus by a team of almost 260,000 dedicated frontline workers.
- Teams at transit points and borders successfully vaccinated 1,260,000 children.
The Islamic Advisory Group for Polio Eradication has launched a new training manual for students of religious studies in support of polio eradication efforts. The manual provides practical guidance on how to engage with local communities to advocate for vaccination as well as other maternal and child health issues.
The launch of the training manual follows Islamic Advisory Group’s efforts to prepare students of religious studies at key universities in predominantly Muslim countries to act as advocates for critical health initiatives particularly in high-risk areas where marginalized and underserved populations reside. As future religious leaders and scholars the students will be well placed within their local communities to promote healthy behaviour and dispel rumours and misinformation that hamper the work of vaccination teams and deprive their community members of protection against polio and other vaccine preventable diseases.
“I was told that if the child was vaccinated against polio, he could one day become a great footballer like Drogba and Yaya Toure…Today, they have not yet become like Drogba and Yaya, but they are in good health.”
– Awa B., mother of five children, Côte d’Ivoire
Today, the countries most vulnerable to poliovirus outbreaks are those where the barriers to effective immunization are most acute. In high-risk countries like the Central African Republic and Côte d’Ivoire, populations are hard to access and persuading communities of the need to vaccinate can be difficult.
For polio workers in these countries, it is important to reduce outbreak risk through strategies that involve local people, and which are receptive to the local surroundings and culture. Not every child will grow up to be a champion footballer, but by persuading parents of the importance of immunization, they can grow up active and healthy, protected from the debilitating effects of polio.
The risk of polio outbreak
The Central African Republic and Côte d’Ivoire are both considered outbreak risk countries due to their difficult political and security situations, weak health-care systems, and regular cross-border population movement.
Geographically close to Nigeria, one of the last three polio endemic countries, the Central African Republic is currently at risk of virus spread from Borno state where there was a poliovirus outbreak in 2016. In 2011, Côte d’Ivoire experienced an outbreak of wild poliovirus type 3, also originating from Nigeria.
Outbreak prevention is a central part of the strategy to end polio, as the spread of the poliovirus through under-immunized populations could make eradication more of a challenge. In high risk countries where delivering vaccine can be difficult, different methods must be used to comprehensively immunize every last child.
Getting the local community involved
In Côte d’Ivoire, a round of National Polio Vaccination Days officially began on October 28th in Ebimpé, marked by a ceremonial gathering of vaccination partners alongside key members of the local community. Speaking at the event, the Minister of Health and Public Hygiene, Dr Raymonde Goudou Coffie, described the need to vaccinate every last child as a mission for everyone: “Traditional leaders, heads of households and communities need to be involved in this initiative.”
This is a powerful method of engagement – making sure that parents and local leaders, as well as health workers and volunteer vaccinators, are involved in the fight against poliovirus.
No one approach fits all
Vaccinators also understand that no single approach will fit every situation. Instead, the Global Polio Eradication Initiative partners and field workers must work hard to understand how best to communicate the risk of polio outbreaks to different communities.
For instance, to reach parents working in Nana Mambere prefecture of the Central African Republic, local radio station SIRIRI hosted a panel based radio discussion to mark the recent vaccination campaign. Featuring medical professionals and local politicians, the panel addressed community worries around vaccine, urging every parent listening to take their young children to be immunized.
The day before the October campaign in Côte d’Ivoire, an advance team of volunteer vaccinators in Grand-Bassam began vaccinating at the local weekly market. Knowing the routine of local women, they anticipated that there would be some children visiting the market with their mothers who might not be reached later in the week – making this gathering of the community too good an opportunity to miss.
Having an understanding of the communities targeted in campaigns, whether of their worries around vaccination, or even parents’ weekly schedules, is crucial to effectively reduce the risk of a polio outbreak.
Providing broader benefits
In Côte d’Ivoire, Dr Bamba Souleymane, Departmental Director of Health in Grand-Bassam, noted the quantity of different health interventions that his team was attempting to successfully deliver. Alongside the polio vaccine, the volunteers were distributing impregnated mosquito nets, de-worming medication, and vitamins.
Such combined efforts use the GPEI’s well-established infrastructure to deliver a variety of desirable health benefits in communities, not polio vaccine alone. In places where the health infrastructure can be weak, the polio programme’s ability to reach remote children can be a big advantage for many reasons.
For Awa, the dream of her son becoming a champion footballer was a persuasive reason to take him to be vaccinated. For others, receiving different health benefits or hearing information via radio are compelling reasons to vaccinate their children.
Lowering the chance of an outbreak is never a straightforward process, but instead requires understanding parents, children, and communities.
The best vaccinators and campaign planners are able to spot opportunities to keep campaigns relevant, access groups in different ways, and ensure that coverage is sustained.
This way, we can successfully protect every last child.
More
The Afghanistan polio snapshot gives a monthly update on key information and activities of the polio eradication initiative in Afghanistan.
In October:
- Two new cases of wild poliovirus (WPV1) were reported, one in Nangarhar, and one in Kandahar provinces.
- Nine new WPV1 positive environmental samples were reported in Kandahar, Nangarhar and Helmand provinces.
- Over 202,000 children under the age of 5 were vaccinated in two different case response campaigns.
- Permanent transit teams successfully vaccinated 1,177,616 children against polio, whilst cross-border teams vaccinated 125,326 children.
The Pakistan polio snapshot gives a monthly update on key information and activities of the polio eradication initiative in Pakistan.
October updates include:
- No new cases of polio reported – the total for 2017 remains five.
- Polio vaccination campaigns took place in priority areas of the country in October, successfully vaccinating around 22 million children.
- Around 1.7 million children were vaccinated at 376 Permanent Transit Points set up across country and district borders, as well as at transit points such as bus stops, railway stations and highways.
- On World Polio Day, observed on 24 October, Pakistan paid special tribute to the country’s valiant Sehat Muhafiz, or the “Guardians of Heath”, who set an inspiring example as dedicated frontline vaccinators in the fight against polio.
“I am the king of this village! Every child belongs to me and I will spread my poison to a new person every day,” screams the snake, bursting onto the stage.
In the audience, children gasp and jump backwards, their eyes wide.
Hamid, clutching his precious box of vaccines, attacks the snake, managing to defeat him. The crowd cheers.
“Vaccinating your children will destroy this disease!” cries Hamid. “Make sure your whole village takes these droplets and you will see how strong you and your children can be.”
This poisonous snake – mor zaharia as it’s called in Dari – represents the dangerous threat of polio, a disease that Afghanistan is fighting hard to eradicate.
Hamid leads a touring youth circus group made up of children and teenagers from all across the capital, Kabul, who performs juggling, acrobatics and theatre routines for local audiences around the city and beyond.
Today the circus is in Qargha, Kabul, Afghanistan. It was started 14 years ago by Mobile Mini Circus for Children and is supported by UNICEF.
The circus enables the children who join – often from internally displaced communities around Kabul – to go to school every day and then practise circus skills at their centre after school and on weekends.
Part of their impressive performance includes passing on vital messages about healthcare and social issues to the audience, who may otherwise not have access to this information.
“Our circus is entertainment and it is so much fun for the performers and for the audience,” says Hamid.
“We pass on these important messages in a fun way which people listen to and they understand. Giving a message without fun means people will not take that message away.”
This is especially true of the children, who flock to the circus the moment they see youngsters their own ages pull out their juggling sticks and begin clowning around on the makeshift stage.
“We often perform in the internally displaced persons camps,” says Hamid. “These areas are not peaceful and the people have no proper shelters, no electricity and no running water.”
These conditions provide the perfect environment for communicable diseases like polio to spread; yet a simple oral vaccination, just two drops in the mouth, can bring a child closer to a life without polio. Children in Afghanistan will be vaccinated against polio multiple times, until the disease is stopped for good.
During the August and September 2017 National Immunization Days 9.9 million children under five across Afghanistan were targeted with repeat doses of the oral polio vaccine.
The Pakistan polio snapshot gives a monthly update on key information and activities of the polio eradication initiative in Pakistan.
September updates include:
- No new cases of polio reported since the August update – the total for 2017 is five
- The first country-wide immunization campaign of the current low season for poliovirus transmission took place – 38 million children under 5 years were vaccinated.
- According to independent post-campaign monitoring, the September National Immunization Days has been one of the best campaigns this year.
- The September campaign set the foundation for eradicating the virus from the last remaining areas of Pakistan.
The Afghanistan polio snapshot gives a monthly update on key information and activities of the polio eradication initiative in Afghanistan.
In September:
- No new cases wild of poliovirus were reported.
- Two new WPV1 positive environmental samples were reported in Kandahar province.
- National vaccination campaigns were carried out across all 34 provinces, aimed at reaching over 9.9 million children under 5 with oral polio vaccine OPV.
- Permanent transit teams successfully vaccinated 1,131,231 children against polio, and cross-border teams vaccinated 101,784 children.
A force of determined women already involved in the fight against polio has been assembled to lead work to curb the spread of a cholera outbreak in northeast Nigeria. Displaced by conflict and themselves living in camps around the crisis region, these women are moving from tent to tent to help families understand the risks they face during the rainy season, and how to get help if they fall ill.
Volunteer community mobilisers are often the only way community members know how to keep their families healthy in the face of extreme hardship.
These dedicated volunteers provide their neighbours with this vital service while facing their own hardships brought on by displacement.
Read more on the broader benefits of the polio programme
The Afghanistan polio snapshot gives a monthly update on key information and activities of the polio eradication initiative in Afghanistan.
August updates include:
- One new case of wild poliovirus was reported, bringing the total number of cases to 6 in 2017
- National vaccination campaigns were carried out across all 34 provinces, aimed at reaching over 9.9 million children under 5 with oral polio vaccine OPV
- Over 155,000 children were reached in IPV-OPV campaigns across 8 districts in the Southern region
More information on the Syria outbreak
Throughout Kabul, on the many long, grey blast walls that line the city’s roadways, a splash of colour is helping to mobilize caregivers to vaccinate their children against polio.
Afghan NGO The Art Lords, supported by UNICEF, are in the process of painting 250 murals up to 30 feet high and 100 feet wide on high-visibility walls, portraying men and women vaccinating children against polio, accompanied by the slogan ‘Two drops of polio vaccination for every child, up to 5 years of age’.
The project started by Kabul but its popularity has seen it extended to priority cities across the country, with city officials, hospitals and schools approaching the polio programme to ask if their walls can be next.
The Art Lords typically take two days to complete the mural, starting at night by projecting an image against the wall and tracing it with pencil, before returning the next day to add colour. Children regularly join in to help with the painting.
See the video here on how The Art Lords are adding colour to the effort to eradicate polio from Afghanistan.