Govt and UN take quick action to curb the spread of polio

Angola's latest nationwide polio immunisation campaign has come too late for 15-year-old Artur Emilio Cassinda. His skinny legs are useless, totally paralysed from the crippling virus he contracted as a child. Living on the outskirts of the isolated village of Sungui, on the shores of Lake Ulua in the northern province of Bengo, he is destined to spend the rest of his life in a makeshift wheelchair. Artur is disappointed to learn that the highly infectious disease, for which there is no cure, has again reared its ugly head in Angola, where there has not been a single case since 2001. As he bumps along in the unique form of transport he built from bits of an old wheelchair and a child's bicycle, a UN Children's Fund (UNICEF) vehicle - part of a campaign to vaccinate five million Angolan children under five against the disease - appears in a cloud of orange dust. Artur is happy that youngsters today stand a chance of being protected against the disease. "I was sick as a child but my mother didn't know it was polio, and I don't think there were any vaccines at that time," he told IRIN. "It is great that other children will be vaccinated, but for me, I don't feel very good. My arms ache from 'pedalling' my chair, and I have no air in the tyres and no money to buy new ones," he said. The Ministry of Health, supported by the World Health Organisation (WHO) and UNICEF, has just completed a campaign to immunise five million children against the disease, which mainly affects children under five and can cause total paralysis in a matter of hours. The US $3.74 million campaign - which ran from Friday to Sunday, involved 12,500 vaccination teams who went from house to house, and visited markets and churches - had been scheduled before the emergence of three new cases: two in the capital, Luanda, and one in the coastal province of Benguela. "We are concerned that if this is not confronted very quickly, polio could reimplant itself inside the country," Mario Ferrari, UNICEF's representative in Angola, told IRIN. "These three cases are of concern, and it is fortunate we already had this campaign planned." The new cases were caused by a different strain to the type of polio Angola saw prior to 2001, and is believed to have been imported from India. UNICEF quickly brought in a monovalent vaccine, which is 90 percent effective in fighting the type-1 strain of polio reported in Luanda and Benguela; the more common but less effective trivalent vaccine, which produces antibodies to counter all three polio strains, was distributed in Angola's 16 other provinces. Ferrari said the children's agency, the ministry of health and WHO had planned a second campaign for the end of August, and were considering a third national immunisation round in response to the outbreak. Several doses of the vaccine are needed to fully protect a child from polio. Angola has been battling an outbreak of the Ebola-like Marburg fever, which has so far killed more than 300 people, and news of this latest health scare travelled fast. In Bengo province, adjoining the province of Luanda, the local radio station and health workers armed with loud hailers informed people about the re-emergence of the disease and the immunisation campaign. "These two cases in Luanda have made us very concerned, because Luanda is our neighbour," said Zhenzo Makonda-Mbuta, head of Bengo's public health department. "There has been an intensive fight to eliminate polio - it's a sickness which is relatively easy to prevent and we haven't seen a case in four years, but the appearance of these cases now means that we had to launch an offensive. Polio is very contagious. We don't want it here, so we need to react to make a barrier," he observed. Makonda-Mbuta's department dispatched 166 three-person vaccination teams, equipped with oral polio vaccines kept cool in special thermal containers, to every corner of the province. A heightened awareness of the risks of polio prompted worried mothers to line up to get their children immunised, and vaccination teams received a warm welcome from parents. Children were dragged away from their play, often kicking and screaming, to get a dose of oral vaccine. "The idea of going house-to-house is much more effective than administering these vaccines at a health post. We cannot guarantee that people will turn up at the health posts, and the queues and the waiting deter a lot of people," Makonda-Mbuta remarked. "This way we reach a lot more children." Teams also visited local markets and churches to capture as many of the under-five population as possible. In Caxito, the provincial capital of Bengo, shoppers and stallholders brought their offspring to the vaccination teams in their crisp white t-shirts and caps. "We heard about the new cases on the radio, so we are very happy that these teams are coming here," said Lucia, whose 10-month-old daughter was vaccinated. "Every mother fears the return of polio and wants to protect her child." The Angolan cases - hot on the heels of an outbreak in Indonesia - dealt another blow to WHO's goal of halting the spread of the crippling illness by the end of this year, but Luis Gomes Sambo, WHO's Regional Director for Africa, was confident that the measures would keep a lid on the virus. During a visit to Angola, Sambo noted: "We are still planning to stop the circulation of this polio virus during 2005, but with the appearance of imported cases in certain countries, we are concerned."