Amid Adversity, Dedicated Vaccination Teams Battle Polio Outbreak in Nigeria
Photo:In Sokoto, Nigeria, a child receives a dose of oral polio vaccine during a campaign in response to a polio outbreak. The multi-partner Global Polio Eradication Initiative (GPEI) conducts periodic evaluations to assess the quality of polio outbreak responses. Photo credit: UNICEF
By Meg Farrell, MPH, Polio Eradication Support, The Task Force for Global Health
I recently had the opportunity to travel to Nigeria to help assess the country’s ongoing response to a polio outbreak. In my role, I am posted to UNICEF where I support the multi-partner Global Polio Eradication Initiative (GPEI).
Nigeria has had a complicated experience with polio. In September 2015, the World Health Organization announced that polio was no longer endemic in Nigeria. About a year later, however, officials detected four new cases of wild polio in the northeastern state of Borno. Lab results from these polio cases suggested that the virus had been circulating in Borno undetected for several years.
This outbreak was not too surprising given the conflict in the area. A significant portion of this state is controlled by Boko Haram insurgents. The associated insecurity and inaccessibility make it difficult to reach children with vaccine and to monitor for cases of polio.
The Borno outbreak prompted government officials in collaboration with GPEI to implement a nationwide emergency outbreak response plan. Following any polio outbreak response, GPEI conducts periodic evaluations to assess the quality of the response and determine whether additional work is needed.
I was part of a GPEI team who assessed the outbreak response in Sokoto, a northwestern state on the border with Niger. As this was my first experience with a polio campaign in the field, I was naturally excited to observe these activities on the ground. Our work involved evaluating the quality of Sokoto’s targeted vaccination response aimed at stopping polio transmission and assessing the ability of the state’s monitoring system to detect any new cases of polio. Through translators, we also spoke with community members to determine their knowledge and perceptions of polio campaigns.
I observed and assessed several local vaccination teams administering oral polio vaccine to children less than five years old. Some walked from house to house in their villages while others vaccinated people from stations set up in busy areas such as markets and border crossings. The highlight of my trip was having the opportunity to vaccinate several children myself. The days were long, hot and exhausting, but the community vaccinators maintained energy, enthusiasm, and attention to detail, despite these harsh working conditions.
It is a testament to the strength and efficiency of Nigeria’s polio program that there have not been any cases of wild polio detected since those four cases in Borno last year. But GPEI’s assessment concluded that there is still room for improvement. We are continuing to work with our partners in Nigeria to help strengthen their outbreak response capability and will conduct a follow-up assessment later this year.
I admire and will remember the dedication of the Nigerian polio team. In addition to instability and insecurity, these frontline workers frequently face other public health crises and outbreaks but persevere nonetheless. They are the heroes of the polio eradication effort. I look forward to the day when we can celebrate together their victory over this disease.