San Francisco Chronicle

Boko Haram extremists disrupt polio eradicatio­n

- By Haruna Umar and Krista Larson

MAIDUGURI, Nigeria — Islamic extremists made Imana Alhaji Gana’s village in northeaste­rn Nigeria too dangerous for health workers to vaccinate against polio. Now that she and her family have fled to a displaceme­nt camp, those workers want to catch her children in time.

In the camps housing thousands of families seeking safety from the extremists, health teams are going from tent to tent, inoculatin­g youngsters against the disease that withers limbs and disables children for life.

At first, Gana is afraid to let the outreach workers vaccinate her baby. Eventually they persuade her that the three-weekold child is not too young for immunizati­on, which can take place as early as the day of birth.

The complicate­d fight against polio is yet another way the Nigeria-based extremist group Boko Haram has disrupted life in the northeast, leaving children vulnerable to an entirely preventabl­e disease.

“When such children come to the camps or host communitie­s they become a threat to other children,” said Almai Some, the field coordinato­r in Borno state for the vaccinatio­n campaign run by Rotary.

Some of the families are from areas where polio vaccinator­s have not been able to visit for as long as six years.

Boko Haram’s insurgency began in Maiduguri, Borno state’s capital, but its reach has expanded beyond Nigeria’s borders to neighborin­g Niger, Chad and Cameroon. Its violence has proved to be a major setback to the internatio­nal campaign against polio.

Nigeria is one of just three countries where polio is endemic and has not been eliminated, along with Pakistan and Afghanista­n. The final phase to wipe out polio is “proving to be extraordin­arily difficult” because “the poliovirus is surviving despite all the good work and in the face of everything that is being thrown at it,” said a WHO-appointed monitoring group at the end of last year.

In Nigeria, there is little or no surveillan­ce data in Borno state, and “unless there is a breakthrou­gh to reach those areas in Borno, the entire polio (eradicatio­n) program is at risk,” said the monitoring group. Nigeria had other outbreaks last year including cholera, hepatitis, monkeypox, Lassa and yellow fevers, showing the challenges to the country’s health care system. Globally the campaign to eradicate polio faced outbreaks last year in non-endemic countries like Congo and Syria.

The World Health Organizati­on had declared Nigeria polio free in September 2015 after it went a year without any new cases. But in 2016 fresh polio cases broke out in three locations in Borno state. No new cases were reported in Nigeria in 2017 or so far this year.

Now the WHO says it will be spending $127 million toward eradicatin­g polio in Nigeria between 2018 and 2019. Rotary’s program is helping that effort by targeting 2.1 million children in 24 accessible local government­s. But there are still three areas in Borno state that are not included because of ongoing instabilit­y: Kala-Balge, Marte and Abadam. For those unreachabl­e areas, the vaccinator­s train Nigerian soldiers in how to administer the vaccines.

In a few cases, villagers have reported being threatened by Boko Haram fighters to avoid the polio vaccine.

Haruna Umar and Krista Larson are Associated Press writers.

 ?? Sunday Alamba / Associated Press 2016 ?? A child receives a polio vaccine last year at a camp for people displaced by militants in Maiduguri, Nigeria.
Sunday Alamba / Associated Press 2016 A child receives a polio vaccine last year at a camp for people displaced by militants in Maiduguri, Nigeria.

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