KANO, Nigeria — In 2003, imams in northern Nigeria promoted a boycott of polio vaccinations, claiming they were a Western plot to make Muslims infertile or infect them with AIDS. The result: The number of newly crippled children rose by more than double the following year, and there were fears that the disease would spread into a dozen neighboring countries.
Now, after another tripling of cases in 2008, a big new anti-polio push is under way in Africa's most populous country, and this time, some Muslim clerics have made themselves part of the solution, joining community leaders, health workers and the victims themselves in waging the war.
In the dusty streets of Kano, northern Nigeria's main city, town criers with bullhorns cut through the traffic and crowds, urging parents to take their children to one of hundreds of vaccination centers. Radio and newspapers are full of get-vaccinated ads.
One victim-turned-campaigner is 43-year-old Yusuf Umar, his legs withered by polio, propelling himself on hand-held blocks of wood. "Look at me," he tells parents of young children waiting to be immunized at a ramshackle Nigerian clinic, just in case any are having second thoughts. "Do you want your child to look like me?"
Once in receipt of their customized vehicle, association members scoot, pedal and drive around with vaccination teams to field clinics and schools, preaching war on polio.
Renewed fears of polio rise
Their outreach campaign seems to be bearing fruit. While new infections of children hit 788 last year, the World Health Organization reports that the number vaccinated in Kano State during the first half of 2008 rose 26 percent, compared with the same period of 2007.
Still, last year's spike has raised fears that the disease could be exported again to surrounding polio-free countries and threaten a multibillion dollar effort to wipe the disease from the globe.
"We thought we were winning," says Dr. Hamisu Walla, national surveillance officer with the WHO. "We were shocked and depressed at the same time to have done so much and then to have this upsurge."
The 2003 boycott lasted a year until its hard-line Muslim supporters were persuaded to drop it, and 2004 saw the number of newly crippled children jump from 355 to 792, according to the WHO. Even so, doubts about the vaccine have lingered and some religious leaders continue to say Islam forbids it, health workers say.
Newsweek: Why can't the world eradicate polio?At least one Muslim leader took unprecedented action against the boycott-supporters. The Shehu of Borno, the top Islamic authority in his state until his death in February, last September stripped a chief of his traditional title for divorcing his wife after she had their children immunized.
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"His excellency has zero tolerance for those who hinder the fight against polio," his spokesman, Usman Chiroma, explained at the time.
Muhammad Ali Pate, a senior Health Ministry doctor, says increased state funding and greater community engagement are responsible for last year's increase in vaccinations.
He says he now sees imams at Friday prayers urging worshippers to have their children immunized, and traditional leaders tracking kids who have not received the vaccination.
Campaign generates demand for vaccine
"Vaccination can't just be something we do to them, because it arouses their suspicion. We are trying to generate a demand for the vaccine," he says. "We want the community to understand polio, to make the link between paralysis and the disease."
Says the WHO's Walla: "It is unfortunate that it has to take a lot of people becoming paralyzed to convince people that the disease is real. But now there's a renewed sense of commitment across national, state, local government and community levels."
That's evident in Kano as Monday Tijani, carries his 10-month old daughter, Gift, across the road from church to a mobile clinic.
Gift, dressed in her Sunday best — an elaborate lace and satin dress — grimaces as the polio drops plop into her mouth.
"There was a time when we feared the polio vaccine," says Tijani, a 28-year-old shopkeeper, smiling down at his daughter. "But now we have seen what this disease can really do. I have seen the polio victims all around and I know it's better for Gift to get the vaccine."
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