Health

Zambia declared polio free

By Doreen Nawa

ZAMBIA’S drive to banish polio is now a reality and the country has been declared polio free.
When Zambia started the ‘Kick Polio Out’ immunisation, little did people know that the ambition would yield positive results and see Zambia declared polio free.
Nobody enjoys injections, so it seemed particularly wonderful to place the sugar cube on your tongue, a quick suck, and hey presto, you’re protected for the next 10 years from a crippling disease without realising that this disease would be history in Zambia.
The power in that sugar coated cube has now saved the Zambian Government from huge costs involved in combating the epidemic.
With the current economic difficulties and competing priorities for health, the immunisation programme experienced several difficulties including lack of transportation especially for conducting out reach services, lack of health worker training, broken cold chain equipments, inadequate supervision and shortage of staff.
But with all these, Zambia managed to kick polio out and secure a future for the children, as polio is known to affect children who later become physically challenged.
The World Health Organisation (WHO) confirmed the last cases of polio in Zambia some years back. Polio remains a once upon a time thing for Zambia.
Recently, Minister of Health, Brian Chituwo said in an interview that the WHO had declared Zambia Polio free.
Dr Chituwo described the immunisation programme as a ‘’mop up operation’’ and the final stepping-stone into a new millennium free of the dreadful disease called polio.
The Health minister says emergency vaccination was planned after polio cases were diagnosed on the Zambian border with Angola where an outbreak of the disease was first recorded in April 1996.
Dr Chituwo recalls that regardless of the challenges that the health authorities were faced with, the remained optimistic that Zambia would still achieve the original aim of a polio-free Africa.
Polio (also know as poliomyelitis) is a contagious viral disease that attacks the central nervous system and that can cause temporary or permanent paralysis and weakness.
Polio is a viral illness that, in about 95 per cent of cases, actually produces no symptoms at all (asymptomatic polio).
In the four per cent to eight per cent of cases in which there are symptoms (symptomatic polio), Polio virus affects mostly children who, as a result of the scourge, have become physically challenged.
A more serious form associated with aseptic meningitis called nonparalytic polio (one per cent to five per cent show neurological symptoms such as sensitivity to light and neck stiffness).
Polio is transmitted primarily through the ingestion of material contaminated with the virus found in stool.
The polio virus lives in the throat and intestinal tract of infected persons. The virus enters the body through the mouth, usually from hands contaminated from an infected person, or not washing hands after using the toilet and drinking contaminated water are common culprits in the transmission of the disease.
Although the acute illness usually lasts less than two weeks, damage to the nerves could last a lifetime. In the past, some patients with polio never regained full use of their limbs, which would appear withered.
Those who did fully recover might go on to develop post-polio syndrome (PPS) as long as 30 to 40 years after contracting polio.
In PPS, the damage done to the nerves during the disease causes an acceleration of the normal, gradual weakness due to aging.
Two types of the polio vaccine are available and they are oral polio vaccine (OPV) and inactivated polio vaccine (IPV).
OPV is made with a live, but weakened, virus. OPV protects vaccinated persons directly. OPV also protects other susceptible persons who care indirectly vaccinated as the vaccine spreads in the community.
Because of widespread OPV no cases of paralytic polio caused by naturally circulating polio virus have been reported in the United States since 1979.
In Africa, the continent where the polio epidemic has been most difficult to control, efforts at disease eradication often work against a backdrop of civil unrest and war.
In some countries, the end of years of fighting has led to a new push for public health measures, including widespread vaccination.
Elsewhere, conflict continues to complicate vaccine delivery; temporary cease-fire agreements must be negotiated to allow vaccination and prevent serious outbreaks from occurring. When the system breaks down, the results can be disastrous.
Among polio-endemic countries in Africa, Zambia and Ethiopia has probably made the most impressive strides toward implementing the WHO plan for the virus eradication.
The campaign, which took place at hospitals, health centers, local government offices, schools, churches, mosques and marketplaces across this southern African country, involved vaccinating over million children against polio and distributing vitamin A capsules to one million children under the age of five and 300,000 lactating mothers.
In addition, almost 350,000 children less than five years old in selected towns were vaccinated against measles, which the WHO has targeted for eradication after the completion of the polio campaign.
The effort represents the kind of integrated healthcare programme that many advocates of disease eradication have advocated.
As with other WHO polio vaccination efforts in less-developed countries, the Zambian campaign relied on national immunisation days, in which vaccination of an entire population takes place on one or a few days, rather than trying to deliver vaccines throughout the year.
In June 1996 - when the first anti-polio drive was launched under the slogan “Bye Bye Polio” with under-five children symbolically waving away the disease on national television, a lot of mothers were trapped in the web of lies and unfounded tales.
Among these lies peddled then was that the vaccines used were drugs meant to create impotent baby boys.
Also, the struggle against polio in Zambia had also been held up by traditional beliefs and malicious gossip.
The first of a two-phase immunisation programme for the victims and Zambian children in 38 districts was carried out from 23-24 July and 20-21 August.
Violet Banda, a 40-year-old housewife, in Kamanga Township of Lusaka, sadly recalls how her son became a victim of Polio in early 1995.
Ms Banda had believed that the disease was associated with witchcraft after her neighbour narrated to her how her daughter was bewitched and became crippled.
She says by then, she was living in Shang’ombo with her husband. She believed that there was nothing better than African medicine for such a disease and opted to visit an African doctor who gave her a concoction of roots, tree bark and leaves.
Ms Banda was told to bath the baby half way (from the lower back up to the feet) early in the morning daily before anyone was up and about in the village.
The roots failed to keep away the alleged evil spirits and her little boy was savaged by polio. Today he is unable to walk without a shoe with calipers on the right leg.
“The secret to polio eradication is in all children under five in the entire country receiving these two extra drops of polio vaccine,”
In spite of these setbacks, Zambia has continued to soldier on, with an eye placed on the possible eradication of polio by 2000.
The WHO confirmed the last cases of polio in Zambia in the year 2002. Polio remains a problem. The reason for the growing number of polio cases confirms the problem of the so-called “imported polio infections”.
This refers to the cases occurring when the polio virus is imported from countries with polio incidence to countries without polio incidence (e.g. by travellers, immigrants, etc.).
Persons without polio immunity run the risk of being infected by the virus and developing polio.
The risk of importing the polio virus will continue until the disease has been eradicated worldwide.
A polio vaccination is therefore strongly recommended for travellers in the current polio risk areas in Africa and Asia as a means of protection against the disease.
Basically this means spacious regions of the tropical parts of Africa and several countries and regions in Asia.