Author Umaru Pate, February 5 2014: Professor, Department of Mass Communication, University of Maiduguri and Kaigamma of Adamawa, reflects on his recent experience as an expert panelist reviewing Afghanistan's polio communication programme. Professor Pate has also participated in similar reviews of Nigeria's polio communication programme and draws analogies between nomadic groups in Afghanistan and Nigeria.
My short visit to Afghanistan in October 2013 as part of the Polio Communication Review Team has convinced me that like in my country, Nigeria, there is a determined national effort to kick out polio in the shortest possible time in the country. It has been a tough task considering the security challenges and the terrain of the environment. That notwithstanding, I have seen determination in the UN [United Nations] system and its partners, the willingness and cooperation of the local authorities, as well as the desire of the population to accept polio vaccination and raise healthy children. In spite of the security challenges in some parts of the country, it was clear that the fight against polio is receiving universal support on all sides. It is very reassuring that the program has maintained neutrality by purely focusing on the health of the child irrespective of location or the political persuasion of individual parents. Everyone from the state officials to community elders and religious leaders have admitted to the neutrality factor as being hugely helpful in upholding the credibility of the vaccination program and facilitating the access and guaranteeing the safety of the vaccination teams, particularly in the volatile parts of the country where the opposition is active. Creative strategies and the use of access negotiators have helped vaccination teams to access households in the highly volatile or insecure areas. The evidence of the success of the program in the difficult to reach or volatile areas is the absence of any polio case for over a year. However, the success might not have come so easily.
UNICEF [the United Nations Children's Fund] and WHO [the World Health Organization], being the frontline agencies in the eradication of polio in Afghanistan, have developed very robust working relationships and linkages with bodies like the International Red Cross Committee (ICRC), USAID [the United States Agency for International Development] and the World Food Program (WFP) to comprehensively eradicate polio in the country. It was evident that the established pattern of cooperation has contributed significantly in facilitating the effort of UNICEF and WHO in the process. Above all, I admired the strong will of the political and bureaucratic leaderships at the country, regional and district levels. At each level, the leadership showed determination and definitive commitment to save the children of the country and hasten the exit of Afghanistan from the club of polio endemic nations.
Perhaps, worthy of being acknowledged, too, is the willingness of the people to submit their children for vaccination. Groups that are often considered difficult to reach and hard to convince like the Nomads said they are genuinely interested in their children receiving vaccination. Like the Nomads in Northern Nigeria, the Afghani Nomads proved during our field visit to their neighborhoods that they have significant interest and willingness to submit their children for vaccinations. In our encounter, I saw genuine desire and justifiable concern on their wish to incorporate child survival matters into their immediate and long term wish for improved living conditions and easy access to health care, education and facilities for improved husbandry practices. The story is exactly the same when we interacted in similar circumstances with Nomads in Northern Nigeria.
The life of the Nomads is fluid and they live in culturally protective environments that are difficult to penetrate by non community members. They build confidence and trust in outsiders slowly and suspiciously especially in personal matters like the family. For them, local vaccinators who are insider community members or at least, those that understand them and their circumstances very well are the most preferred choice in the effort. In both Nigeria and Afghanistan, the wishes of the Nomads remain that of being incorporated into the process of development through the provision of welfare facilities and recruitment of their community members to reach them in their settings, in which they can easily access regular immunization against polio and other childhood killer diseases.
Based on the work done by UNICEF, WHO, the Afghan government and all partners, I am very optimistic that if the current effort is effectively maintained with the hope that the security situation will also improve in the volatile areas, the target of eradicating the endemic polio virus will be achieved in a very short time. Afghanistan presents a very hopeful scenario like the Indian case. I also think that my part of the world in Northern Nigeria can be enriched by learning from the experiences of Afghanistan in reaching Nomads and other seemingly difficult communities that have resisted polio vaccination. The only question perhaps is: how can that be done and how fast?
Image credit: EPA/Abdul Mueed via The Conversation