Maiduguri, 28 September 2016 - In response to the detection of wild polio viruses (WPV) in Borno in August 2016 after more than two years of maintaining a polio-free status, the government of Nigeria declared the outbreak as a national public health emergency. Equally, the governments of Cameroon, Central African Republic, Chad and Niger declared a regional public health emergency for the Lake Chad sub-region.

Following the declaration in Nigeria, plans were made to involve the military and civilian Joint Task Force (JTF) in accessing children in very vulnerable areas.

To underscore the military’s readiness to collaborate with the Federal Ministry of Health (FMOH) and Polio Eradication Initiative (PEI) partners in areas with extant insecurity, the Medical Corps Commandant, Major General Abimbola Amusu informed that Nigeria’s Chief of Army Staff had given approval for the Army medical corps personnel to support PEI activities in Borno State, adding that this information was relayed to the troops since 12 August, 2016.

General Amusu in a videoconference with the national and state Polio Emergency Operation Centers (EOCs) which was chaired by the Minister of State for Health, Dr Osagie  Ehanire, added that “the Army Medical Corps is also thinking about how to support in terms of additional security and medical personnel”.

Collaboration with Nigeria Military command

Accessing areas in previous stronghold of the insurgents to vaccinate children has been a challenge and underlying factor in the recent polio outbreaks in Borno state. Children were trapped for several years without contact to vaccination and other health services.

To rapidly stop the virus in its tracks, health authorities in Borno, in collaboration with the World Health Organization (WHO) and other partners, launched a robust outbreak response (OBR) starting with immediate emergency mass vaccination campaign in August 2016 using both the injectable polio vaccine (IPV) and oral polio vaccine (OPV).

Borno State EOC led a team of government and partners to two separate advocacy meetings held with the General Officers Commanding the 7th and 8th Divisions.

Major outcomes of the meetings include: Agreement by the Army formations in affected LGAs to freeze movement out of the town for two days to allow for every eligible child to be vaccinated and support teams to ensure that only those who have vaccinated their children will be allowed to go their farms. The Army also accepted to support the maintenance of the cold chain by freezing icepacks for both supplemental and routine immunization activities.

Polio vaccinators help search house-to-house

Abubakar Bello is a 53 year-old vaccinator who works hard to ensure that all children in the hard-to-reach areas of Bubali/Gwakane receive the vaccine against polio. He lives in Gwoza town, where the confirmed index polio case was detected, and where thousands of children are at high risk of infection with the WPV.

Abubakar and his teammates (recorder and mobilizer) move on foot every day looking for children to vaccinate during the campaign period. “For the past 28 years, I have worked with the PEI programme, vaccinating hundreds of children. I started my career as Community Health Assistant then worked as a community extension worker also known as CHEW.  Years later, I am still passionate about immunization particularly against the WPV, especially since a case was detected and the virus is circulating in my community once again.” 

The IPV requires trained health workers to administer injections, and Abubakar’s skills, experience and training background enables him to vaccinate children with IPV. Abubakar is also the focal person for Bubali/Gwakane ward. He believes that he has a key role to play to ensure that all children are reached.

“We move from house-to-house, in different locations, mobilizing parents to present their children for vaccination. In one day we move to an average of four locations and spend at least two hours before moving to the next one; in the past four days of this campaign, we have so far reached over 600 children in my location alone,” Abubakar explained. 

Just like Abubakar, vaccination teams in other locations also move round the market place, checking the fingers of all eligible children for marks that ascertain that they have been vaccinated. Those found not to have marked fingers are sent to the vaccination point.

Next steps

The EOCs at national and state levels with partners will follow-through with action points and recommendations on the discussion with the military to temporarily freeze movement to allow for the exercise vaccinate all the children and also filter those that have not been vaccinated so that vaccines can be provided.

Subsequently, an operational plan has been developed by the Borno EOC to reach newly accessible settlements, not reached in the past years, for vaccination services, with the support of the military. A maximum of five vaccination visits is planned to each of the targeted settlements by December 2016, to ensure the children are protected from polio virus.

WHO is supporting the government to expand disease surveillance in newly accessible areas for acute flaccid paralysis cases in order to rapidly detect and respond to any new virus.

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For further information, please contact:

Technical contacts

Dr Fiona Braka; Tel: +234 703 170 5252; Email: brakaf [at] who.int  "> brakaf [at] who.int   
Mr Charles Korir; Tel: 234 803 458 0498; Email:korirc [at] who.int  "> korirc [at] who.int   

Media contacts

Ms  Charity Warigon; Tel: +234 810 221 0093; Email: warigonc [at] who.int  "> warigonc [at] who.int   
Ms Pauline Ajello; Tel: +234 803 402 2388; Email:ajellopa [at] who.int ">  ajellopa [at] who.int
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01 Military personnel vaccinating a child with IPV in Monguno IDP camp of Borno State

02 Dr Braka supervising IPV health camp manned by military personnel

03 Abubakar Bello preparing to administer IPV in Gwoza LGA