Who will win? India vs.
By LISA A. SWENARSKI DE
Just three decades ago 350,000 Indian children were paralyzed from polio
each year. Parents throughout India woke up to discover their children's
legs suddenly floppy, unmovable, while fever took hold and changed their
lives forever. Millions of families are still caring for children and
adults who cannot walk.
Today, thanks to the enormous efforts of health care workers and
volunteers, only a handful of families suffer from new cases of polio.
After 10 years of intense eradication efforts worldwide, health care
workers knocking door to door, millions of vaccinations administered, and
billions of dollars spent, polio continues to haunt only four countries,
including just two states in India. Yet, the moment eradication efforts
weaken, India and the world could return to the dark days of the 1970s.
In fact, the four endemic countries of India, Pakistan, Afghanistan and
Nigeria are those that have never interrupted transmission of their
indigenous poliovirus. In recent years, many countries that had become
polio free were re-infected following importations from Nigeria and India.
Polio fighters say the greatest challenge remains in India.
"Western Uttar Pradesh is the hardest place in the world to eradicate
polio," says Dr. Hamid Jafari, project manager of the World Health
Organization's polio eradication program in India.
Poverty, population density, illness, poor sanitation, and people
susceptible to misinformation and rumor allow polio to continue to destroy
families. In western Uttar Pradesh and Bihar, the only two Indian states
where polio circulates, there was actually an increase in polio during
2006 because some communities refused the vaccine based on false rumors
that it was harmful. And now these communities are paying the price, with
676 children paralyzed by polio in 2006, a huge increase over the 66 cases
in 2005. So far this year, 281 children have become paralyzed by polio in
these two states, but the good news is that none have been stricken in the
core endemic districts of western Uttar Pradesh by Poliovirus Type One,
which is the most virulent strain. The pain of these families makes Indian
health care workers determined. In the highest risk villages, families can
expect a visit from a polio worker every month. Community leaders,
journalists and mullahs are urging families to get the vaccine. Why is
there some resistance?
"There are some very poor communities that refused the vaccine as a
protest," says Jafari. "It is an expression of frustration because,
understandably, they want clean water, sanitation and roads. Their refusal
has nothing to do with religion, although many of these poor families are
Muslim.?In fact, the vast majority of Muslim families and other minorities
do accept polio vaccination during every campaign round."
Also difficult to reach are the thousands of families in western Uttar
Pradesh and Bihar who migrate for months out of the year to work in other
states. Now, the government is focusing on these families so that their
children will not miss the vaccine even if they are not at home.
The Indian and U.S. governments, UNICEF and Rotary International are
working together to eliminate polio from India and the planet forever. If
they succeed, it would be only the second disease eradicated. (Smallpox
was eliminated in the 1970s.)
The U.S. government is the biggest donor to this effort. Why do Americans
care? "Americans have very clear, horrible memories of the pain and
suffering of polio in the U.S.," says Jafari. "Also, Americans are
humanitarians and they know it's a disease that can be eradicated and
there is a tool and the tool is? affordable and easy to use."
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