Magazine article Geographical

One Drop at a Time

Magazine article Geographical

One Drop at a Time

Article excerpt

The Global Polio Eradication Initiative is the most ambitious public health programme ever undertaken. But with its historic goal in sight funding gaps, war and the killing of health workers threaten its success.

To the four-year-old Ethiopian girl standing barefoot in the doorway of a thatched mud hut, the burly white guy beckoning to her from his wheelchair must cut a curious figure. But with eyes wide and lips slightly parted, she steps towards him and opens her mouth as if to receive communion.

Steve Crane, 193 centimetres and 115 kilograms, holds out his hand and gives her a blessing in the form of a vial containing drops of oral polio vaccine.

Crane has come from Seattle to these villages in Yirgaalem, a province on Ethiopia's southern border with Kenya, to save children's lives, or at least to spare them from the disease that has so fundamentally altered the course of his own. I got it when I was 12 years old,' Crane recalls. 'It was 1955, just a few months before the Salk vaccine came out. Ethiopia isn't real wheelchair friendly. My friends had to pick me up to get over cracks in the dirt alleys, and haul me up and down stairs when we went to meetings in Addis Ababa. But I felt that I would do anything to prevent someone else from going through what I did.'

NEW CASES

Crane is part of a group from Rotary International, whose members have been travelling at their own expense for almost two decades as part of the global network's main humanitarian cause: polio eradication. Together with the World Health Organization (WHO), the US Centers for Disease Control and Prevention (CDC), and UNICEF, it makes up the Global Polio Eradication Initiative (GPEI), which has been running immunisation campaigns for almost 30 years.

Last year's National Immunization Day in November had new urgency after Ethiopia, which hadn't had a new case of polio in five years, had an outbreak of six cases earlier in the year. Neighbouring Somalia recorded 183 cases,- Kenya had another 14 cases.

Nor was the Horn of Africa the only flashpoint. To the north, Syria, where civil war reduced the proportion of vaccinated children to 68 per cent from a pre-conflict 90 per cent, had an outbreak of 17 cases, raising fears of reinfection in Europe. The virus also surfaced in Israeli sewage in two locations.

All this in a year when polio workers were targeted for assassination in Pakistan, Afghanistan and Nigeria, the three remaining countries where the disease is still endemic. Although no-one claimed responsibility, suspicion fell on radical Islamists.

To be clear, support for eradication has been mostly robust throughout the Muslim world. Saudi Arabia requires proof of vaccination for children younger than 15 as a condition of making the Hajj. The Islamic Development Bank has made financing available to Pakistan, and Malaysia, Qatar and Kuwait have helped with financing and technical assistance, while last year, Abu Dhabi hosted a major global vaccine summit.

But as they do in other spheres, the extremists remain a source of consternation to the polio community. I don't think that there's any question that those groups have had an impact on polio eradication,' says Carol Pandak, manager of Rotary's PolioPlus vaccination programme. 'Al-Qaeda, the Taliban and the Hakani network tin Southeast Asia], Boko Haram [in Nigeria] and al-Shabab [in Somalia] have all made it difficult to gain access to children.'

MONUMENTAL PROGRESS

Despite the headlines and setbacks, 2013 had its triumphs. Last month, India, once considered the disease's most intractable redoubt, marked 36 months without a new case--the WHO's mandatory period to certify it polio free. Of the endemic countries, Nigeria's cases fell by 60 per cent, and Afghanistan's 11 cases compared with 33 the year before. Afghanistan actually had no indigenous cases; all 11 infections were linked to cross-border transmission from Pakistan, whose situation worsened slightly. …

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