The crippling disease polio has nearly been eradicated worldwide. But the campaign to rid the world of the disease has hit a major snag in Nigeria. In the northern state of Kano, Muslim leaders say that the vaccine is tainted with chemicals that cause infertility, and other contaminants. Vaccination drives there have ground to a halt, causing an outbreak that has spread the disease to polio-free parts of Africa. Officials with the global eradication campaign know the infertility rumor all too well. They say it started in India, and spread especially among Muslim communities there, too. But now many Indian Muslim leaders are supporting the campaign.
The afternoon call to prayer fills the air over the northern Indian town of Sepah Ibrahimabad. A group of gray-bearded Muslim clerics in traditional dress has gathered outside the town mosque. They tell a visitor they support the polio vaccination campaign 100 percent. Imam Mohammed Azijulah says the town's Islamic school is helping to spread the word.
"We have seen children paralyzed by polio," he said. "When we found out the vaccine is effective, to benefit the children, we got involved."
With the clerics' help, this community has managed to put an end to rumors that the Hindu-run government, or the Americans, are plotting to sterilize Muslims through the polio vaccination program. The Muslim leaders' help has been essential in India, according to the government's program chief, Sobhan Sarkar.
"They have been able to percolate the need for vaccination more easily than individually attempting to break each individual reluctant group," said Mr. Sarkar. "So our attempt was more broad-based. And it did pay a rich dividend."
Polio cases are at record lows in India, most notably in Muslim areas that have historically been reservoirs for the virus.
But Islamic leaders have not always supported the eradication drive. Mohammed Khan has been practicing medicine in Sepah Ibrahimabad for years. He says the mosques used to be a source of rumors.
"In the past, the Muslim leaders might have spread wrong ideas that it's a government plan to control the population, or it was an American plot. But that's over now," he said."
Experts say it's over in part because the campaign has recognized why the rumors resonate among India's Muslims. And Islam is not a factor. The sterilization rumor strikes a chord in India in part because in the 1970s the New Delhi government ran an unpopular, coercive sterilization program. The bad memories still linger here.
And Michael Galway, polio communications director for UNICEF in India, says the rumors affect the Muslim community the most because they're a minority in predominantly Hindu India.
"It's because they're the poorest, they're the least served by the official public health system," said Mr. Galway. "They're the most marginalized people. So they have the least information, the least access to services. So of course these communities get left behind."
They're left behind for all kinds of public services. For example, people in many poor areas complain that the only time they ever see a government health worker is during polio drives. That breeds suspicion and resentment, and makes fertile ground for rumors to take hold.
Experts say the same is true of disenfranchised communities everywhere. The very same rumors about the polio vaccine that thrive among Muslims in India and Nigeria, are also heard among Coptic Christians in Egypt.
Mr. Galway says that when rumors take hold among these populations and parents refuse the vaccine, it's often not really because they object to the vaccine itself.
"It's because you never get to say no to anything," he explained. "It's power in your hand at that point. And you're frustrated because somebody comes back with polio one month, and they come back two months later. And what you want, really, is you want electricity, you want jobs, you want a clean environment, you want those services."
So India's polio eradication campaign has been adding services in a bid to win the trust of the underserved Muslim minority. Drains are being cleared, water pumps and streetlights installed, and health clinics held. Local public health officials say the efforts are making a difference. Harish Chandra is chief medical officer in Mau, a district of Uttar Pradesh state where resistance to the vaccination program has been high in the past.
"They're feeling the government is doing something for us. So they feel connected to these programs. This is the way we will approach it in the community to remove the resistance and refusal," he said.
This approach seems to be working. The number of households in Mau district refusing the vaccine has dropped from more than 4,000 last April to just over 100 this year.
Officials with the global campaign say lessons learned here could be applied in Nigeria. Providing more services in the underserved Muslim areas could make people there more trusting of the effort. But in the meantime, Islamic cleric Mohammed Azijulah of Sepah Ibrahimabad says Nigeria's Muslims should follow the lead of their fellows in India.
"In India, the campaign is at its peak. You should follow. We have erased the misconception. Taking the polio drops will not make your children infertile."
Officials with the polio eradication campaign hope the message gets through that the vaccine is not a plot against Muslims. They say paying more attention to neglected communities might help the vaccination program resume in Nigeria and wipe out polio forever.