Polio, that long dreaded disease, is almost but not quite eradicated. The global
polio eradication campaign (a joint effort of the World Health Organization, UNICEF, and the Rotary Foundation) was launched in 1988, with the target of ending polio by the year 2000. It has achieved remarkable success: by 1994, polio was officially declared eliminated in all the Americas. But now, in 2010, polio is still a threat in eight countries, and the campaign's hopes for defeating polio by 2012 hang on success there. What does it take to wipe out an ancient scourge like polio? Vaccines and dogged monitoring and a drive to track down all cases and stop transmission.
A fascinating radio program put together by America Media Abroad (you can listen
here) explores the ins and outs of religion and health in Africa: what's happening, why it is sometimes controversial, and why religion is so important. Titled Africa's Holy Healers, it vividly demonstrates how deeply religious institutions are engaged in health care. In Kenya, Uganda, Nigeria, and Ethiopia, an amazing range of faith-inspired healers are part of the backbone of the health care system. Last week, at the Berkley Center at Georgetown University,
we discussed some of the challenges that emerge from that fact. Is there a way out of the poisonous AIDS debates? (The group thought that in this area, reason is starting to beat back anger and fear). Is proselytizing causing tensions? (The group was sharply divided.) Do we know enough about what's going on? (The view was unanimous that we do not.)
In Nigeria, the roles that religious leaders have played in the polio vaccination campaign clearly shows that any successful approach to health in the world's poorest countries must take religion into account. Nigeria is one of the eight remaining countries where polio is still a threat, especially to children, so it is a focus of the global campaign. But when the campaign started, rumors began to spread that the vaccine was part of a western plot to sterilize Nigerians and that the vaccines were tainted. Religious leaders did not start the rumors, but neither did they stamp them out. Indeed, some imams contributed to a wave of fear that brought the campaign to a temporary halt. Polio cases in Nigeria soared and spread to at least 20 other countries.
A first, important lesson is that it's not smart policy in a place where religion is vitally important to omit religious leaders from the planning. Where there is a combustible situation of religious tensions (Christian/Muslim tensions in Nigeria and the shadow of post 9/11 suspicions dividing Muslim communities and the west), neglecting the religious dimension is potentially disastrous.
The next chapters of the story are much more heartening. From top to bottom, religious leaders were brought into the campaign. Information was a first critical step. Health officials met religious leaders and listened to their concerns. They explained the campaign and how the vaccine worked, including safeguards. Religious leaders visited countries which had successful campaigns and where the vaccine was manufactured. The political Organization of the Islamic Conference was brought into the act and helped in getting fatwas from respected Muslim scholars (especially from other African countries) that highlighted parents' responsibilities to vaccinate their children.
So ending the de facto boycott of the polio campaign was not sufficient. Real success came only when religious leaders became actively involved in helping to organize and support the campaigns. As the program evolved, skeptics became advocates. Leaders had their own children vaccinated in public. The program was back on track. Last week, only two cases were reported.
It's sad but hardly surprising that the countries where polio is still a threat are the world's most troubled countries, all facing terrible poverty and many mired in conflict: Afghanistan, Pakistan, Democratic Republic of the Congo, Chad, Sudan... And in each and every one, religion is vitally important, with a powerful potential to contribute to solving problems--or to make them worse. The lessons from the Nigeria polio story seem pretty clear: take religion into account and work to find or make allies before it's too late.
