Polio cases increase, follow-up vaccinations planned

The Ministry of Health in Yemen has announced the completion in July of two rounds of a nationwide campaign to immunise children following a polio outbreak in May, and reported a high level of success in reaching vulnerable children. Yemen now has 369 confirmed polio cases, but the rate is slowing, according to World Health Organization (WHO) figures. As of early July, there were 300 cases. Polio is a highly infectious disease which invades the nervous system and can cause paralysis in a matter of hours. The outbreak in Yemen was initially confirmed in mid-May after a routine national immunisation programme in April. The Ministry of Health said this week it was able to determine that the two rounds of vaccinations in July had reached at least 97 percent of the target population of five million children under the age of five. The ministry, along with the WHO, United Nations Children’s Fund (UNICEF), US Agency for Development (USAID), US Centers for Disease Control (CDC) and other participating organisations, expects to conduct three more rounds of vaccinations between now and the end of the year. Yemen is one of 17 countries previously determined to have been polio-free, but which have been struck by recent outbreaks. Of those countries, Yemen has the highest number of confirmed cases. The current outbreak is believed to have spread from Nigeria across Africa to Yemen, after some local officials in Nigeria had refused to facilitate vaccinations for months, claiming that they were part of a plot by western countries to make Muslim children infertile. During the second round of vaccinations in Yemen in July, there were also reports of refusals to cooperate by both doctors and clerics, but, according to UNICEF and Ministry of Health officials, they had only a minor impact on the overall success of the campaign. Most of the reports of refusals were based on the fact that there were cases of polio confirmed following the first round of vaccinations in April, according to experts conducting the emergency campaign. This outbreak, despite vaccination having taken place, caused suspicion among some Yemenis. “It was the families that first made the link between the vaccinations and the disease,” Dr Kamel Ben Abdallah, health and nutrition officer with UNICEF in Yemen, said. The fact that it was the campaign that identified the presence of the disease – not caused it – was not understood by some people in the community. Dr Ali Al-Mudhwahi, director of family health at the Ministry of Health, who had sent his own doctors and religious leaders around the country to convince skeptics during the last round, told IRIN that things had changed this time around. “It was the active participation of communities that convinced those who were refusing,” he said. The door-to-door aspect of the last campaign had built up the trust of families, he said, and this campaign had seen far fewer reports of refusal to cooperate. Al-Mudhwahi did, though, report difficulties in the northwestern governorate of Al-Jawf, a region where the tribal and local leaders have historically distrusted the central government. During the previous round of vaccinations, the ministry enlisted the help of the USAID-sponsored Adventist Development Relief Agency (ADRA), an international NGO, which had built up the trust of tribal leaders in the past three years through its work in the region. According to Al-Mudhwahi, ADRA had stopped working in the region in recent weeks after threats from local groups following the country’s recent unrest over the dramatic rise in fuel prices. Ministry of Health vehicles were then attacked while transporting supplies for the vaccination programme in the region. The campaign was brought to a halt after completing the vaccination in just six of the governorate’s 12 provinces. Al-Mudhwahi said that government troops had been sent in to secure the area, but that the ministry is now negotiating with the governor and local tribes for guarantees and protection in order to complete the vaccinations in the remaining provinces. Al-Jawf is currently reported to have one confirmed case of polio.