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Niger Struggling to Deal with Increased Cases of Polio - 2004-09-22

Nigeria has been at the center of concerns about resistance to the United Nations-led program to eradicate polio worldwide. But there has also been resistance to the north in Niger, where religious leaders and local people in Islamic strongholds have been slow to accept the program. On a recent trip to Niger, VOA's Nico Colombant examined lessons that need to be learned and challenges that remain to wipe out the debilitating disease.

Health workers in Niger say it was this speech by President Mamadou Tandja in the Islamic stronghold of Maradi earlier this year that convinced local populations to abandon their mistrust of the polio vaccine.

The associate director of vaccination programs in Niger, Jadi Magaji, explains.

"He shouldered the responsibility if really this vaccine contains any disease or anything that may harm Nigerian children. He has sworn to them on Allah that this does not carry any problem and since then people have decided, sincerely speaking, to give up all this kind of resentment that we have so far observed," he said.

Like in Nigeria, imams in Niger circulated the rumor that the vaccine was laced with anti-fertility agents as part of a Western plot to depopulate Muslim areas. Such messages from imams, from both sides of the border, were broadcast on Niger private radio stations, to Mr. Magaji's dismay.

"The important radio stations often try to question people about their own role but sometimes if they happen to question these fundamentalists, sometimes they give out their own ideas, about the vaccination, about the poliomyelitis, whereas the real technicians who know, who should give the real situation of the poliomyelitis are not often the ones questioned, so we think it is much better if people who are competent in the matter are questioned so that they can give the real image of the situation, " he said.

Last year, hundreds of families near the border with northern Nigeria refused to have their children vaccinated. Some of them even fled to Kano state in Nigeria where the vaccinations were being banned.

The head of one of the main Islamic associations in Niger, Harouna Fodi, says the timing of the increased effort to eradicate polio sparked suspicion.

He says since the terrorist attacks of September 11, 2001, in the United States, Muslims have felt stigmatized by the West and that United Nations agencies come across as very rich, Western organizations. He says local populations felt attacked by the anti-polio campaign and didn't understand why they were being offered free vaccinations, while other medical care is very expensive.

University student Abdourahman al-Kassoum says many Nigerians don't even know what polio is, while they need help, which they aren't getting, to treat other diseases like malaria.

"In my area, there are no children who are sick from polio but you can see more than thousands and thousands of the population who are sick by malaria," he said. "Malaria is a reality but polio is not a reality. The people don't know what is polio."

He says local volunteers who arrive before U.N. workers to prepare vaccination rounds know little about the disease, and just tell villagers they have to be vaccinated. When aid workers from the children's aid agency, UNICEF, arrive, Mr. al-Kassoum says, they often scare people away.

"They don't think UNICEF is here for the care of the children," he said. " Now if you say UNICEF, they think of the vehicle, four by four, with air conditioning and so on. There is not anything they are doing for the children here. There is no reality. The people are not seeing anything that is the cause of this institution."

Niger health officials organizing the campaign dispute this criticism, saying its aid workers benefit from nice working conditions so they can be efficient.

One mistake, vaccination official Mr. Magaji admits is that religious leaders should have been involved much earlier in the process. He says he relied too much on elected and appointed government leaders, who often don't have much influence on local populations.

"The lesson is that there is more and more implication of religious and traditional leaders who are now actively helping out in carrying out social mobilization so that fewer people who are still resisting can come all out and bring their children so that together we'll be able to meet the end of the problem of this poliomyelitis," he said.

The next vaccination round, both in Niger and throughout Nigeria, will be in early October. Nigeria's northern Kano state ended a 10-month ban in July and organized meetings involving religious leaders this week to ensure the next round will be successful.

But with 19 new cases of polio registered in Niger this year and several hundred just across the border in Nigeria, the much publicized goal of polio eradication by year's end seems unattainable. Instead, the disease is spreading.

The strain originating from northern Nigeria has emerged in a dozen African countries, including war divided Ivory Coast, which has already accounted for 12 new cases in 2004, after being disease free for four years.