24 July 2006 -- The faint mark on the wall showing that no child in the house was eligible for polio vaccination was misleading. Idris Mohammed , motorcycle mechanic and head of this household in Kofar Kudu Quarters of Jama’are, headquarters of the local government area (LGA) of the same name, confessed that his two wives used to drive away vaccinators, based on his instructions. In order to play safe, the house-to-house team in the area simply marked the wall to please the supervisors till August 2003 when his son Mohammed Naziru suffered the paralysis of all limbs and was confirmed as a wild polio virus case. Before then, Naziru had only taken a dose of the oral polio vaccine (OPV).

It was the paralysis of his child that partially softened Mohammed. Today, the friendly Naziru, born on January 1, 2001, has only recovered the use of his upper limbs and still crawls, having lost the use of his two legs. He is now able to sit, a function he could not perform after the onset of paralysis. The detection and reporting of the case was typical of cases of concealment involving the vaccination teams, sometimes in collaboration with elements in the community.

A similar scenario played out in Chinade village in Katagum LGA, where Ahmed Auwalu, the four-year old son of Auwalu Ibrahim, a vulcanizer, became paralyzed in September 2005. Before then, the boy had not taken even a dose of OPV. According to Ibrahim, there was an understanding with the vaccinators to thumb mark the eligible children in the four households within the compound, and mark the house as completed, even without giving the drops. This happened in every immunization round till Auwalu was paralyzed and the reality of the polio scourge dawned on the family. The child was taken to the health facility where Memunat Mohammed, the focal person, drew attention to the problem. The discovery prompted the subsequent acceptance of the vaccine by the households of Ibrahim and his brother, while it took the two other households a little longer to start complying.

An active surveillance system is proving to be one of the key solutions to what was the major problem of concealment in Bauchi, a state which reported 188 acute flaccid paralysis (AFP) cases, 56 of which were confirmed as wpv in 2005 and had by June 23, 2006 recorded 73 AFP cases 20 of which proved to be wpvs. The detection of such cases exposes missed children and settlements and enables needed intervention.

Alhaji Bappa Makama, Secretary, Jama’are LGA, says the council administration had to address all health workers, warning that any connivance between them and the communities to conceal or encourage non-compliance during immunization rounds, would attract sanctions. Heads of department and Councilors moved into the wards to support required changes and reduce the problem, while the Emir of Katagum provided crucial support.

The LGA authorities in a renewed drive to increase routine immunization coverage is also supporting with logistics. During an unannounced visit to the cold store on June 14, the generator was working. It works for 24 hours daily.

- By Nosa Owens-Ibie