Health - Who will win? India vs. Polio

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Who will win? India vs. Polio

By LISA A. SWENARSKI DE HERRERA

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."

Courtesy: SPAN Magazine

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