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Kicking Polio out of Afghanistan


Kicking Polio out of Afghanistan

My short visit to Afghanistan in October 2013 as part of the Polio Communication Review Team has convinced me that like in my country, Nigeria, there is a determined national effort to kick out polio in the shortest possible time in the country. It has been a tough task considering the security challenges and the terrain of the environment. That notwithstanding, I have seen determination in the UN [United Nations] system and its partners, the willingness and cooperation of the local authorities, as well as the desire of the population to accept polio vaccination and raise healthy children. In spite of the security challenges in some parts of the country, it was clear that the fight against polio is receiving universal support on all sides. It is very reassuring that the program has maintained neutrality by purely focusing on the health of the child irrespective of location or the political persuasion of individual parents. Everyone from the state officials to community elders and religious leaders have admitted to the neutrality factor as being hugely helpful in upholding the credibility of the vaccination program and facilitating the access and guaranteeing the safety of the vaccination teams, particularly in the volatile parts of the country where the opposition is active. Creative strategies and the use of access negotiators have helped vaccination teams to access households in the highly volatile or insecure areas. The evidence of the success of the program in the difficult to reach or volatile areas is the absence of any polio case for over a year. However, the success might not have come so easily.

UNICEF [the United Nations Children's Fund] and WHO [the World Health Organization], being the frontline agencies in the eradication of polio in Afghanistan, have developed very robust working relationships and linkages with bodies like the International Red Cross Committee (ICRC), USAID [the United States Agency for International Development] and the World Food Program (WFP) to comprehensively eradicate polio in the country. It was evident that the established pattern of cooperation has contributed significantly in facilitating the effort of UNICEF and WHO in the process. Above all, I admired the strong will of the political and bureaucratic leaderships at the country, regional and district levels. At each level, the leadership showed determination and definitive commitment to save the children of the country and hasten the exit of Afghanistan from the club of polio endemic nations.

Perhaps, worthy of being acknowledged, too, is the willingness of the people to submit their children for vaccination. Groups that are often considered difficult to reach and hard to convince like the Nomads said they are genuinely interested in their children receiving vaccination. Like the Nomads in Northern Nigeria, the Afghani Nomads proved during our field visit to their neighborhoods that they have significant interest and willingness to submit their children for vaccinations. In our encounter, I saw genuine desire and justifiable concern on their wish to incorporate child survival matters into their immediate and long term wish for improved living conditions and easy access to health care, education and facilities for improved husbandry practices. The story is exactly the same when we interacted in similar circumstances with Nomads in Northern Nigeria.

The life of the Nomads is fluid and they live in culturally protective environments that are difficult to penetrate by non community members. They build confidence and trust in outsiders slowly and suspiciously especially in personal matters like the family. For them, local vaccinators who are insider community members or at least, those that understand them and their circumstances very well are the most preferred choice in the effort. In both Nigeria and Afghanistan, the wishes of the Nomads remain that of being incorporated into the process of development through the provision of welfare facilities and recruitment of their community members to reach them in their settings, in which they can easily access regular immunization against polio and other childhood killer diseases.

Based on the work done by UNICEF, WHO, the Afghan government and all partners, I am very optimistic that if the current effort is effectively maintained with the hope that the security situation will also improve in the volatile areas, the target of eradicating the endemic polio virus will be achieved in a very short time. Afghanistan presents a very hopeful scenario like the Indian case. I also think that my part of the world in Northern Nigeria can be enriched by learning from the experiences of Afghanistan in reaching Nomads and other seemingly difficult communities that have resisted polio vaccination. The only question perhaps is: how can that be done and how fast?

Editor's note: Professor Umaru Pate, is a member of the Department of Mass Communication, University of Maiduguri and as the Kaigamma of Adamawa is a Nigerian traditional leader. In this blog entry he reflects on his recent experience as an expert panelist reviewing Afghanistan's polio communication programme. Professor Pate has also participated in similar reviews of Nigeria's polio communication programme and draws analogies between nomadic groups in Afghanistan and Nigeria.

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Dr Pate's comments point to

Dr Pate's comments point to lessons that can be learned between programmes in different countries and with people's of very different cultural and historical backgrounds but who nevertheless share some important things in common - they are nomadic, they tend to be marginalised from other ethnic groups, they receive relatively few services and they often look upon the outside world with suspicion.

Below is the report for the Afghanistan Review that Dr Pate refers to in his Kicking Polio Out of Afghanistan opinion piece.

Afghanistan Polio Communication Review - October 22 to 29 2013

I have also attached the full document.

We will also be posting a new

We will also be posting a new opinion piece from Dr Danjuma Gambo a Nigerian communication expert and colleague of Dr Pate who has also been involved in reviewing polio communication programmes in Nigeria and as an international expert in India. Dr Gambo's piece will look critically at some of the key challenges he feels the Nigerian programme faces. Look for Dr Gambo's early next week and in the meantime any comments you have on Dr Pate's piece are most welcome.

Dr Upate - many thanks for

Dr Upate - many thanks for your very interesting observations on the Polio Communication efforts and challenges in Afghanistan after your recent mission there.

I would very interested to know what were the 3 or 4 major learnings you took from Afghanistan for the polio communication work in Nigeria?

Thanks - Warren

Dear Warren, Thank you very

Dear Warren,
Thank you very much for the kind comments on my short piece about the trip to Afghanistan. I feel encouraged and remains appreciative to your team for the opportunity.
One of the lessons I have brought back to Nigeria from Afghanistan is that with singular commitment and cooperation in the course of work, the polio virus can be defeated. The approach must be holistic, sustained and effectively monitored. No one should be underestimated in the chain of implementation, just as no chance should be allowed in form of delays or bureaucratic incompetence and sluggishness.

Secondly, I have noted that to achieve instant and credible results in a
culturally diverse and educationally disadvantaged, in fact, hugely challenged society, there must be a deliberate system that involves the locals who share cultural and psychological affinities with the target communities. The Afghan Nomads like the Nomads in Nigeria insisted that they feel freer to relate with vaccinators from their communities than dealing with 'outsiders'. The trust level and willingness to submit would be higher when they interact with individuals closer to them. 

The third lesson is that the implementation strategy should be divorced from local intrigues and politicking for credibility. For instance, the vaccination succeeded in security challenged communities of Afghanistan where penetration was difficult because of the effort of the officials to maintain neutrality and treat the polio war as a pure survival/health issue. That has helped to prevent
 the campaign from being perceived as a government or politicized activity. Nigeria can learn an important lesson in this.

Finally, I have also learned that governments should maintain a participatory and fair system of distributing welfare and infrastructure facilities to all communities, particularly to those in the rural and disadvantaged locations. Where the people feel cared for, they are least likely to resist or suspect government backed initiatives like the polio campaign. Like in Nigeria, the complain in the disadvantaged communities of Afghanistan was similar. All of them asked: why was government seriously interested in polio eradication and remember them only on such occasions  but abandon them all other times?

The above are some of the lessons that I believe my country can learn from the Afghani situation and

On Wednesday, March 5, 2014 3:05 AM, Development Networks <> wrote:

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