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Chad Redoubles Efforts Against Polio

François Djékombé

N'DJAMENA, May 6 2010 (IPS) - The polio vaccination campaign under way in Chad has added significance in 2010. The country recorded zero polio cases in 2004, but 66 cases of wild polio were reported in 2009, according to the Global Polio Eradication Initiative.

Administering oral polio vaccine: resistance to vaccination in neighbouring Nigeria is suspected to be behind the spike in cases of polio in Chad. Credit:  Edward Parsons/IRIN

Administering oral polio vaccine: resistance to vaccination in neighbouring Nigeria is suspected to be behind the spike in cases of polio in Chad. Credit: Edward Parsons/IRIN

Polio is again considered to be endemic in Chad, with 12 cases recorded in the first quarter of 2010.

Chad shares a border with Nigeria to the south, where for several years resistance led by traditional and religious authorities in the north of the country prevented effective polio vaccination campaigns. Chad’s recent increase in polio cases could be due to contact across the frontier.

According to the coordinator of the Extensive Immunisation Programme, Dr Solomon Chang Garba, the Apr. 1 to May 15 immunisation drive targets more than two million children under the age of five (18 percent of the population).

Ardepdjoumal is a cosmopolitan area in central N’Djamena, the Chadian capital, populated mostly with Hausa and Borno communities. Diane Nelmall Koïdéré, a government nurse, has been working in a neighborhood health centre for five years. During each polio immunisation campaign, she leads a team of 5 to 10 vaccinators deployed to administer the vaccine to 5,000 children in the area.

Misconceptions abound. Some parents argue that the vaccine must not really be effective or there would be no need to administer it to the same child with every campaign. Other sceptics say that the vaccine isn’t free, since they have to pay for a pain-killer to treat the headache that’s a common side effect of the vaccine.

Most seriously, Koïdéré says that some parents refuse to vaccinate their children on the grounds that “vaccines make children sterile” or are “funded by sects” and therefore could give their children other diseases. If such prejudices gain currency, they could limit the reach of the polio immunisation campaigns.

This was the situation in Nigeria until recently, especially in the Muslim-dominated northern states. It fostered the proliferation of the polio virus in the country and its neighbors. But the World Health Organisation reports welcome progress made in vaccinating children against polio in Nigeria and in neighboring states in recent years.   When confronted with any of these arguments, the vaccinator calls in a supervisor for help. If they fail to persuade the parents to vaccinate the child, they often call the municipal police, which intervenes, often forcefully, to ”impose” vaccination.

This happened to Harine, an 18-year-old woman from the N’Djamena neighborhood of Moursal who was arrested by the police during the campaign because she refused to vaccinate her daughter. Her daughter was vaccinated by force in the presence of the Chief of Police and she paid a fine of 3,000 CFA francs – about $6.25 US.

Assabé Bimba, in her fifties, is councilwoman in Walia, a residential area of N’Djamena. ”Vaccinate your children, sisters; if I had played with my children’s health, of the nine that God gave me, maybe two or three would have been crippled…” she pleaded with the women who are reluctant to vaccinate their children.

It is Cherubin Ndiglengar’s third year as a vaccinator in the anti-polio campaign. He regrets that the campaign doesn’t run year-round. Thanks to the 5,000 CFA (about $10.40) earned for each day of immunisation, he’s able to pay his rent and part of his tuition. In the past he peddled fake medicine, but stopped after he learned what a health hazard they were for the community.

The new vaccination strategy is operated in the same way in both rural and urban areas. According to the vaccinators, in rural areas the village leaders contribute greatly to the success of the operation.

The United Nations Fund for Children (UNICEF) and World Health Organisation are the Chadian government’s steady partners in the fight against polio.

The campaign is highly visible: giant posters are displayed everywhere; public service announcements on radio and television show the extent of the mobilisation. After the setbacks in recent years, the main question remains: when will polio be eradicated in Chad?

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