Polio: A Fight in a Lawless Land

This article details some of the challenges polio eradiation coordinators face in their efforts to vaccinate children in Somalia. In 2002 polio transmission was ended in Somalia, but in 2005 a major outbreak from imported cases out of Nigeria swept through the country. Efforts to wipe out polio are hampered by two main trouble spots in Africa, say experts: Nigeria, where officials must overcome false rumours that vaccines are a Western tool to sterilise Muslims, and Somalia, where intertribal warfare threatens the safety of polio vaccinators. Other problem areas are India, Pakistan, and Afghanistan.

The article chronicles Dr. Elias Durry of the World Health Organization (WHO), who recently took over the coordination of the Somalia polio eradication campaign. Durry’s countrywide strategy involves going door to door and hut to hut multiple times during 2006. The article describes the strategies Durry has developed for dealing with the problems that often arise working in the war-torn land. These strategies range from cancelling vehicle contracts in a violent area (which means a loss of rental money for warlords), to asking elders and religious leaders for help with parents who refuse the vaccine, to widely reporting cases of children crippled from polio. Durry has found that with the latter strategy, parents are more willing to accept the vaccine when cases of polio have been reported in areas where they live.

The article concludes with an example of the role that personal stories can play in communicating the importance of vaccination in preventing polio.