Thursday, April 25, 2013

Tackling vaccines’ rejection in Northern Nigeria





HAUWA Ibrahim is a Muslim from Kano State; she resides in one of the villages in the federal capital territory that is fast becoming an urban slum.  She is in our early forties with six children the third of which is a polio victim.  She is married the Islamic way to a man who already had two wives so Hauwa is the third and for now the youngest of her husband’s wives.  She is not sure yet if her husband, a security guard would not marry a fourth wife, because Islamic injunctions entitles him to four wives.
Hauwa would not disclose the total number of children her husband has, in her innocence she said she did not believe her polio infested child is as a result of her not exposing him to the vaccines to stop the virus in its track.  Her husband would hear none of that she confessed.   After all there are other children in the family and they are all on their feet except her third child.  The condition of the child must be the will of Allah she reasoned.

The child could neither go to school nor do anything on his own, he has to rely on the help of his siblings to do almost everything while he crawl on four.  None of his able bodied siblings were in school anyway.  The female among them sells fura de nunu (a local yoghurt made from fresh milk of cow) in and around their neighbourhood.  The boys among them are not doing anything tangible.
The story of Hauwa is replicated in most states of Northern Nigeria with families turning out innocent children who had been struck down by polio, most of whom are beggars on the streets with no hope for the future.  What is mind burgling is the way they stay in the scourging sun all day begging for alms.  This on its own is enough to cause other ailments in the body.
There has been concern about the spate of non-acceptability of vaccines meant to militate against communicable diseases in Nigeria especially rejection by conservative Muslims in the far North who are skeptical about the intent behind the federal government of Nigeria giving their children immunization.  

Most of them are not sure of the source of the vaccines especially when it is a known fact that Nigeria import these vaccines wherein other smaller Africa countries are already manufacturing these all important vaccines locally. So the greater percentages of these people are more than convinced that these vaccines are meant to sterile their young one thereby controlling their birth rate. These beliefs are causing preventable infant and maternal mortality. They do not trust the government enough to believe that the vaccines are meant to do what they are said to be meant for- militating against child killer communicable diseases like polio, measles, Tuberculosis, Lassa fever, malaria, cerebrospinal meningitis and tetanus.  A recent statistics indicated that 67 per cent deaths in Nigeria are as a result of these preventable diseases especially as it relates to children.
Experts have put the maternal mortality in Nigeria at 840/100,000 on the average.  They said this was the situation in the United States in 1910 before the introduction of penicillin.  The figure in the US today is put at 8/100,000.  And of the special focus zone, the Northern Nigeria, the figure is put at a staggering 2420/100,000, they said this was what it was like in the USA in 1800 before hand washing was discovered to cause infection at childbirth.
Experts are convinced that the core reason for non-acceptability of modern healthcare in many part of rural Nigeria, urban centres inclusive is lack of adequate medical communication between the orthodox provider and the client.  This they said could be linked to health illiteracy and ignorant.  In Nigeria of today access to healthcare cannot be said to be an issue because there are many orthodox roadside providers.  

Government had even made it possible for healthcare providers to go from house to house just to immunize the young folk.  Some of these health workers had been abused, maimed or killed in the process of carrying out this noble duty.  A recent occurrence was the killing of women on immunization duty in the ancient city of Kano.  Muslim women most of whom are in (pudah) seclusion found it more convenient to allow women into their compound, so most of the time in the North, it is women that are engaged to carry out immunization.
As it relates to availability, personnel and technology providers are just all over the place and in terms of affordability; Nigerians are more than willing to pay for the kind of treatment they understand.  In recent years also, government had incorporated the populace especially those in the formal sector into health insurance scheme, and only recently the federal government set to capture the informal sector as they make for over 80 per cent of the populace.  This is a contributory scheme that allows citizens to contribute just a small token to their health bill while the government takes care of the bulk of the payment.
Mero Mohammed who spoke on why her children had the opportunity of being immunized said it was as a result of the free dose of the vaccine available to children.  “Going by the lack of money in my family, I do not think I will be able to afford immunization for my children if it had attracted paying money for it.  The health workers knocks on our doors and since it is free and I don’t have to transport myself and my child anywhere for it, I took advantage of the service.  My husband said he does not believe the vaccine has anything to do with our children being healthy but that is his own opinion, it does not cause us anything, that is what is important.”

Even as the world celebrates the World Immunization Week (April 24 to 30), a professor of Medicine, Uchenna Nwosu, at an event in Igbo-Ukwu Anambra State South East Nigeria said it is imperative for medical literacy to take centre stage as illiteracy and ignorance has continued to be the bane of healthcare practice in Nigeria.  To enhance modern healthcare, Nwosu said communication need to be improved between the provider and client through the medical language understandable to the client.
He suggested: “Secondary school curriculum could be reviewed to accommodate topics like immunization, vaccinations and things like that.”

Prof. Abdulsalami Nasidi, Director of Nigeria centre for disease control hinted that 67 per cent of deaths in Nigeria are due to preventable causes which immunization can easily take care of.  He said a two-day symposium organized by the Nigeria field epidemiology and laboratory training program (NFELTP) that Nigerians has no business dying when vaccines can stop such deaths.  He called on the federal government as a matter of urgency establish vaccine producing factories that would cater for the needs of the people as importing such important desirables has cost the country more than necessary in terms of fund and besides, Northern Nigerians are skeptical of the source of the vaccines they are being given as a result of their religious believe.
According to him, “The government should as matters of urgency begin to look into the possibility of establishing plants where vaccines can be produced locally.  This will help in no small measure to alley the fear of those with a wrong conception about the work of the vaccines.  Apart from this, it would reduce fund flight as the money spent on import can be made to circulate inwardly and more importantly, jobs would be created for the growing population of the unemployed which had been put at 23 per cent and still growing,” Nasidi reiterated.

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