The Politics of Polio in Northern Nigeria

1. Introduction: Protesting Polio

1. Introduction: Protesting Polio Poliomyelitis did not attract medical attention in West Africa until the last 20 years. Because it was considered rare, Gelfand and Miller (1956) recommended that prophylactic polio-vaccination was not necessary in the indigenous population. —Familusi and Adesina, “Poliomyelitis in Nigeria” Polio has spread to two more countries in West Africa, further jeopardizing the World Health Organization’s goal of wiping out the crippling disease by next year. . . . WHO officials are placing the blame squarely with Nigeria, which is Africa’s most populous nation and home of 300 of the new polio cases in 2003, nearly half the world total. —Altman, “Polio cases in West Africa may thwart W.H.O. plan” Many aspects of our own contemporary culture might be called premonitory shivers: panicky renderings of unreadable messages about the kind of society we are creating. —Kuhn, Soulstealers 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 be polio, not certain whether he had had his son immunized against the disease. He assured me that he had and that, furthermore, wasn’t he too old to contract polio—or Shan Inna, as it is called in Northern Nigeria? I said I wasn’t sure but that he should take his son to the hospital as soon as possible.1 When I saw him later that week, he said that they had taken an X-ray of the boy’s leg at the hospital but were unable to determine the cause of the paralysis. He thought that perhaps it was typhoid fever, but they had dismissed this possibility and said instead that the child must have injured the leg somehow. They then gave the child an injection which seemed to make things worse. He would cry all night because of the pain, and the tablets they gave him did not seem to help. A few days later, I was leaving the house to visit a retired government official and ran into the man again. This time, he was with his wife and another woman, both dressed in long, dark hijabs. One was carrying the boy, whose left leg dangled limply down her back. When I asked where they were going, the husband 2 The Politics of Polio in Northern Nigeria explained that they were taking the boy to a traditional healer in Kano to find a cure for his leg. When I stopped by their house a few days later, they had not yet returned. The following week, when my neighbor returned from Kano with his son, he explained that the malam or Muslim teacher to whom they’d taken the boy said that it was a spirit that was causing the problem. He prayed, and within two days after they returned to Zaria there was a darkening near the child’s ankle and a boil formed. When he saw the boil, he called the malam on his cell phone to ask if he should bring the boy back to Kano. “No, no,” the malam said, “take him to the teaching hospital for them to lance it and that will be the end of it.” He did so, the wound healed, and the boy was able to walk again. * * * The uncertain cause of this young boy’s paralysis and the apparent inability of Western medicine to cure it captures a sense of the confusion and fear which surrounded the international effort to eradicate poliomyelitis in Northern Nigeria. Paralysis of one or more limbs is a characteristic symptom of polio, yet paralysis may have other causes as well. Indeed, the difficulty of conducting laboratory tests to distinguish cases of polio from other cases of acute flaccid paralysis (paralysis in one or more limbs), has been one of the major challenges of its eradication . In The Politics of Polio in Northern Nigeria, I examine the Polio Eradication Initiative as it was conducted from 1988 to mid-2009, focusing on the ways that this campaign has been viewed by men and women living in Northern Nigeria, where some, but not all, parents have refused to have their children immunized against the disease. In 2006, Northern Nigeria had the largest number of...