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A terrible childhood disease that was thought to have been finally eliminated throughout Africa is back. Less than a year ago, Nigeria, along with the entire continent, was declared polio-free by the World Health Organization. Now, several new cases of polio have been confirmed in areas recently liberated from the Islamist terror group Boko Haram. NPR's Jason Beaubien reports.
JASON BEAUBIEN, BYLINE: The world had never appeared closer to eradicating polio than it did this summer. There had been fewer than two dozen cases anywhere in the world in 2016, and all of them were clustered in Pakistan and Afghanistan. Then, health officials found three paralyzed kids in Borno State in the northeast of Nigeria. Chima Ohuabunwa, an epidemiologist who's been working with the Centers for Disease Control and Prevention in Nigeria for the last five years, says Boko Haram had cut off much of Borno State from the rest of the world.
CHIMA OHUABUNWA: There's been no direct in-and-out movement of persons or access to healthcare for the past two to three years.
BEAUBIEN: Earlier this year, he says, half of Borno was a no-go zone. Government health care workers and international relief groups, including polio vaccination teams, would be attacked if they tried to enter those areas. At the same time, Boko Haram was pillaging residents' farms and destroying local health clinics.
OHUABUNWA: To give you an example, out of about 38 secondary health care facilities, 16 were totally burnt down by these insurgents.
BEAUBIEN: Ohuabunwa says that it's only after the Nigerian military drove the Boko Haram fighters out of the areas of Borno State that health officials were able to find the three kids who'd been paralyzed by polio. But parts of the state remain under the militants' control, so polio immunizers have had to set up vaccination posts on the roads just outside the Boko Haram territory.
OHUABUNWA: When they get access to the children when there's some encroachment by the military and they come out, we have prepared health teams called border post teams who sit and wait. And as soon as they come out, we get them, assess them and administer vaccines, and other partners provide other health services and humanitarian services to these children.
BEAUBIEN: Including giving them food because, he says, many of the kids are severely malnourished. In addition to these roadside vaccinators, Nigeria is conducting three mass polio immunization campaigns across the accessible parts of Borno State. The goal is to vaccinate every child they can find under the age of 5. One of the mass campaigns was held in August. Another starts next week, and a third will be launched in October.
WALT ORENSTEIN: One of the problems with polio is that the infections that lead to paralysis are the tip of the iceberg.
BEAUBIEN: Walt Orenstein is a professor of medicine at Emory University, and he's worked for years on polio eradication efforts.
ORENSTEIN: Generally, less than 1 in 200 infections actually leads to paralysis.
BEAUBIEN: So there's probably a lot more poliovirus floating around in that area than has been detected. The World Health Organization is concerned about the virus spilling over into Cameroon, Chad and Niger, so the WHO is also planning additional polio vaccination campaigns in those neighboring countries. The security situation makes it nearly impossible to eradicate polio while militants control those parts of West Africa. But Orenstein says the virus has been eliminated in most other conflict zones around the world. And he's confident that eventually it'll be defeated in northern Nigeria, too. Jason Beaubien, NPR News.
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