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Nigeria once had the most cases of wild polio in Africa, but it has now been three years since the disease was last detected. And as health workers there continue looking for children who have not received polio vaccinations, the WHO may soon certify the country free of the crippling virus. Special correspondent Benedict Moran and video journalist Jorgen Samso report with U.N. Foundation support.
In this town on the outskirts of Abuja, the capital of Nigeria, community health workers are searching for children.
They're looking for anyone under five who hasn't yet been vaccinated against the wild polio virus. That means going street-by-street, and house-by-house, until every child gets the oral polio vaccine.
We are combing the border. We are ensuring that every child, eligible zero to 59 months, is vaccinated.
Unvaccinated children are immediately given two drops, orally and their finger is marked to show that they've been immunized. Polio is a highly infectious disease that mainly affects children. It can cause permanent paralysis, even death. There is no cure, so it can only be prevented by immunization.
There's one good thing about these people here: they are cooperative. When they see us, they are sure that they will bring out their children. We are known faces here.
But vaccinators have not always been known and trusted here. A generation ago, Nigeria had the second highest caseload of polio in the world, and the highest in Africa. Many, like 42-year-old Dangana Musa, were infected. As a young child, he lost the ability to walk.
I remember when I used to play with children they would run around and I would not be able to. I would just sit and cry and clean away my tears.
Musa now works for the polio campaign. His job is to teach his neighbors about the importance of getting immunized.
I was told it was important for me to tell my brothers and sisters to go with me to the hospital so that we can end this disease so that no one else gets it after us.
Musa may now have reason to celebrate.
After three years with no wild polio cases, Nigeria is set to be certified polio-free.
The World Health Organization will make the decision sometime this year after reviewing Nigeria's epidemiological data. If it can confirm the data and make the certification, it would mean that the entire continent of Africa would be clear of wild polio.
How the continent got that way is a long story that began when the first polio vaccine was introduced in the United States in the 1950s. The virus was last seen in America in 1979. But it remained devastating in much of the world, paralyzing more than 350-thousand people every year in one hundred twenty five countries as recently as 1988. In Nigeria, most cases of polio infection used to come from the north. Education here is lower than in the rest of the country. And misinformation about vaccines still exists here.
Just like in the United States, where you have vaccine-resistant groups, there are people that their religion would say, I don't want to access health services because I don't believe in vaccinations. There's a small group like that. There's another group that culturally they don't believe in western medicine, they don't believe in immunization. Then there's a group that is just not aware.
Another group working to thwart the vaccine effort is Boko Haram, the extremist militant group trying to overthrow Nigeria's government and establish an Islamic State. Opposed to anything that smacks of western education and values, Boko Haram militants attacked and killed two women in 2013 who were vaccinating children. That was when Boko Haram was active in half of Nigeria's states. After years of fighting, the Nigerian Government says they are now confined to remote areas of northeast Nigeria. But the region is still sometimes too dangerous for health workers. So, vaccinators have worked with the Nigerian military, to train soldiers to vaccinate children. They've also turned to radio and TV ads to counter vaccine resistance and encourage new parents to vaccinate children.
health workers have trained 20,000 women, who, because they know the local language and customs, became vaccine ambassadors. Training women was crucial, because northern Nigeria is conservative, and male health workers unrelated to family members often cannot access a household. But women health workers can, and they've been able to gain the trust of community members. Polio workers have also brought the pro-vaccination messages directly to traditional leaders and mosques, where some imams, instead of becoming obstacles, have become educators. Here on the outskirts of the northern city of Kano, Imam Yahaya Bello Abubukar is training a group of young women.
Are you following me, are you following me?
In turn, they will educate their villages about diseases including polio.
Mallam Yahaya Bello Abubakar:
We all have to put in efforts, we have to be involved to help create awareness about the dangers of this disease. We are putting a lot of energy into it. Together we will eradicate the disease.
Three years of being polio-free is a milestone Nigerian workers are proud of. Kabiru Rabiu has worked on eliminating the disease here for nearly three decades.
From all the signs we have been seeing, we are on the verge of getting out polio from Nigeria. I will be extremely happy. I will be euphoric. Because this is one of the longest public health interventions, compared to the eradication of smallpox.
Dangana Musa too would celebrate the end of the wild virus in Africa.
We will take it with gladness of heart because what we have worked for has now been achieved.
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