The story of Mohammed Umar, a 13-month old boy, the second of three children, was admitted for two days at the Comprehensive Health Centre, Sandamu in Katsina State, Nigeria is not uncommon. He looked pale, eyeballs paper-white while his skin, with papular rashes running the length and breadth of his body, did not look as fresh as a child’s should be. He had been running temperature, his lips chapped and he was restless throughout. His eyes were bloodshot red, swollen from an opportunistic bacterial infection. His parents, visibly worried, hovered over him restlessly. His mother, Zainabu Umar from Kwadagai village, held him tight to her bosom breastfeeding him openly, a rare sight in a typically Muslim-dominated environment. She is a full time housewife who makes some local snacks, groundnut cakes, to complement her cattle-rearer of a husband.

That was the horrid picture of measles. The Senior Community Health Extension worker, SCHEW who oversees the daily running of the hospital, Umar Suleiman explained,

‘He is the 5th child we have admitted this week so far. It is normal during the hot weather for us to record increased cases of measles.’

The story of Mohammed Umar, a 13-month old boy, the second of three children, was admitted for two days at the Comprehensive Health Centre, Sandamu in Katsina State, Nigeria is not uncommon. He looked pale, eyeballs paper-white while his skin, with papular rashes running the length and breadth of his body, did not look as fresh as a child’s should be. He had been running temperature, his lips chapped and he was restless throughout. His eyes were bloodshot red, swollen from an opportunistic bacterial infection. His parents, visibly worried, hovered over him restlessly. His mother, Zainabu Umar from Kwadagai village, held him tight to her bosom breastfeeding him openly, a rare sight in a typically Muslim-dominated environment. She is a full time housewife who makes some local snacks, groundnut cakes, to complement her cattle-rearer of a husband.

That was the horrid picture of measles. The Senior Community Health Extension worker, SCHEW who oversees the daily running of the hospital, Umar Suleiman explained,

‘He is the 5th child we have admitted this week so far. It is normal during the hot weather for us to record increased cases of measles.’

Admitting that attempts at mobilization and routine immunization had yielded some appreciable results, much needed to be done. The Federal Government of Nigeria, rattled by the increase in childhood killer diseases, polio, measles and other infectious diseases, targeted 19 million children in 11 low performing States of Northern Nigeria for immunization. The States, according to the Minister of State for Health, Dr. Mohammed Ali Pate, are Zamfara, Borno, Yobe, Katsina, Kaduna, Bauchi, Kano, Jigawa, Kebbi, Sokoto and Niger. This rise in polio and measles consequently, is not unconnected with the security challenges in the region where 10 polio vaccination workers were recently shot to death.

In addition, some Islamic scholars have spread teachings about the vaccines, claiming the vaccines are meant to make children infertile thereby reducing their population. Others allege the vaccines contain pork, an animal abhorred in Islam. Voicing his concerns, the father of Mohammed urged a continuous advocacy to be carried out to religious leaders to help douse unfounded rumours and beliefs.

 

A closer look at the child however showed he had amulets or charms tied around his ankles and around his waist. On probing further, this reporter was told these were meant for troublesome teething.

‘No!’, someone countered. ‘These charms are meant to ward off evil spirits and all diseases.’

So why would they wear these for protection and yet fall sick?

‘These charms are not foolproof. They sometimes fail. When that happens, as in Mohammed’s case, the parents rush the children to the clinic,’ he clarified. ‘Look at his nails. He only just recently received the oral polio vaccine, and the health workers marked his nails with ink to indicate his vaccination.’

Mr. Umar Suleiman narrated the success story with respect to treating the cases of measles. The clinic had recorded three hundred and seventy-five (375) cases between January and mid May 2013. Of this number, 200 were males while the 157 were females. Only seven deaths were recorded. The drugs used are antibiotics, analgesics and skin preparations such as calamine lotion or gentian violet. These reports are compiled and handed over to the Medicine Sans Frontier, MSF who provide logistic support and later share their findings with the Ministry of Health. The Field Officer of MSF in Katsina State, one Francis would not oblige data for comparative analysis.

In the words of the WHO Technical Consultative Forum on the Eradication of Polio, Walter Orenstein eradicating polio is critical in eradicating other diseases, such as measles. “I think the polio effort has the potential to draw in a lot of expertise to tackle other diseases in the future,” he told AFP.

Fighting measles and other infectious disease of childhood would require a joint expertise. That would also require a bottom-up approach of advocacy and community mobilization and attitudinal change. Charms and evil spirits may not be scientifically proven but they are e reality of people’s beliefs even nowadays. Anthropological studies would do more to unravel the setbacks in immunization coverage and entrench behavioural change.

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A Measles-Polio mix: Of evil spirits and failed charms!

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