The Politics of Polio in Northern Nigeria

Contents

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Acknowledgments

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pp. ix-x

In researching and writing this book, I have incurred many debts over the years. Colleagues at Ahmadu Bello University and Nuhu Bamalli Polytechnic— both in Zaria— have, from the beginning, been extraordinarily generous with their time and advice. They include Mairo Bugaje, Sheikh Dan Ladi, Clara Ejembi, Rabiu Mohammed Isah, Salihu Maiwada, Mairo Mandara, Musa Muhammed, S. O. Shittu, Ya’u Tanimu, Dakyes Usman, and A. M. Yakubu, as well as J. B. Familusi of the University of Ibadan, among many others who have helped me in myriad ways. ...

1. Introduction: Protesting Polio

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pp. 1-16

One day in early August 2005 in Zaria City, an anxious father approached me for advice about what he should do for his fifteen-year-old son whose left leg had become paralyzed. I suggested that he take his child to the nearby university teaching hospital, where surely they would be able to diagnose the cause of the problem. I also asked him if perhaps it might ...

2. Smallpox and Polio Histories

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pp. 17-32

In Nigeria, there have been two major disease eradication campaigns— one aimed at smallpox, which was begun in 1967 and concluded in 1970 (Fenner et al. 1988), and more recently one aimed at polio, which was begun in 1996 and is ongoing. How Western medicine was received, whether presented as prevention or treatment, depended on whether these campaigns coincided with or countered prevailing explanatory and classifi catory schemes of the disease in question, what Rosenberg (1992) refers to as “disease frames.” A comparison ...

3. Politics and Polio in Nigeria

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pp. 33-50

Following the successful eradication of smallpox, the World Health Assembly voted in 1988 to implement a campaign to eradicate poliomyelitis by the end of the year 2000 (WHA 1988a). While some public health specialists were skeptical about the possibility of accomplishing this goal because of the difficulty of identifying asymptomatic cases of wild poliovirus and of distinguishing wild poliovirus from other enteroviruses (Yekutiel 1980, 153), developments in genetic sequencing of viruses in fecal samples from children with acute flaccid paralysis have improved the identification of virus strains, allowing health personnel to identify ...

4. Islam and Immunization in Northern Nigeria

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pp. 51-67

While resistance to the Polio Eradication Initiative and to immunization more generally has often been attributed to the Islamic community in Northern Nigeria, Muslims have responded in a range of ways to immunization programs, reflecting different teachings and interpretations of Islamic texts as well as their different educational and socioeconomic backgrounds. Indeed, many Muslim parents consider both routine immunization and taking oral polio vaccine to be acceptable practices. ...

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5. Polio, Disability, and Begging

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pp. 68-85

Like concepts of disease and medicine, the perception and treatment of those who have been paralyzed by polio in Northern Nigeria reflects Islamic ideals and practices. Indeed, what it means to be disabled, as well as what it means to be “normal” (in the sociological sense used by Goffman [1963, 5]), reflects the larger social and cultural context of a community. In Nigeria, how a physical disability such as lameness is experienced is greatly influenced by ethnicity. ...

6. Polio in Northern Nigeria and Northeastern Ghana

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pp. 86-101

As these news reports from Nigeria and Ghana suggest, the Polio Eradication Initiative has met with variable success in West Africa. In Ghana, with its wellorganized program of routine immunization and high levels of immunization overall, there were no wild poliovirus infections between 2004 and 2007, although eight cases of polio were confirmed in 2008. In Nigeria, there have been no such breaks in polio transmission, although in 2006, with the implementation of Immunization Plus Days, the total number of cases had declined considerably (see chapter 3). ...

7. The Ethics of Eradication

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pp. 102-118

As William James (1891, 200) has observed, “Various essences of good have thus been found and proposed as bases of the ethical system,” although no one “essence” prevails everywhere; there are many ethical frames in the world. While this relativistic position on the constitution of ethical systems sits well with the concept of cultural relativism familiar to anthropologists,¹ it counters the tendency to assume that one’s own standards of conduct are the proper, ethical ones. ...

Epilogue

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pp. 119-126

In 1967, the CDC launched a nationwide immunization campaign to eradicate measles in the U.S. After an initial sharp decline in cases of measles the following year, their number more than doubled in 1970, and by 1971 it had tripled. Public health officials acknowledged that the measles eradication initiative was foundering. As one infectious disease specialist noted, part of the problem was that ...

Notes

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pp. 127-140

Bibliography

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pp. 141-157

Index

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pp. 159-169