The plus in PolioPlus

We’re doing so much more than eradicating polio

By Vanessa Glavinskas Photography by Andrew Esiebo

Musa Muhammed Ali, a farmer in Borno state, Nigeria, has had to deal with the many ways polio has affected his life. For instance, he used to have to pay for transportation when he needed to buy feed for his animals. But after receiving a hand-operated tricycle funded through Rotary’s PolioPlus grants, Ali (pictured above) can now spend that money on other necessities. His life was changed by the “plus” in PolioPlus.

When we talk about PolioPlus, we know we are eradicating polio, but do we realize how many added benefits the program brings? The “plus” is something else that is provided as a part of the polio eradication campaign. It might be a hand-operated tricycle or access to water. It might be additional medical treatment, bed nets, or soap. A 2010 study estimates that vitamin A drops given to children at the same time as the polio vaccine have prevented 1.25 million deaths by decreasing susceptibility to infectious diseases.

In these pages, we take you to Nigeria, which could soon be declared free of wild poliovirus, to show you some of the many ways the polio eradication campaign is improving lives.

Preventing disease

Polio vaccination campaigns are difficult to carry out in northern Nigeria, where the Boko Haram insurgency has displaced millions of people, leading to malnutrition and spikes in disease. When security allows, health workers diligently work to bring the polio vaccine and other health services to every child, including going tent to tent in camps for displaced people. The health workers pictured here are in Maiduguri, the capital of Borno, where the insurgency began 10 years ago.

The Global Polio Eradication Initiative (GPEI), of which Rotary is a spearheading partner, funds 91 percent of all immunization staff in the World Health Organization’s Africa region. These staff members are key figures in the fight against polio — and other diseases: 85 percent give half their time to immunization, surveillance, and outbreak response for other initiatives. For example, health workers in Borno use the polio surveillance system, which detects new cases of polio and determines where and how they originated, to find people with symptoms of yellow fever. During a 2018 yellow fever outbreak, this was one of many strategies that resulted in the vaccination of 8 million people. And during an outbreak of Ebola in Nigeria in 2014, health workers prevented that disease from spreading beyond 19 reported cases by using methods developed for the polio eradication campaign to find anyone who might have come in contact with an infected person.

Children protected from polio still face other illnesses, and in Borno, malaria kills more people than all other diseases combined. Worldwide, a child dies of malaria every two minutes. To prevent its spread, insecticide-treated bed nets — such as the one Hurera Idris is pictured installing in her home — are often distributed for free during polio immunization events. In 2017, the World Health Organization, one of Rotary’s partners in the GPEI, organized a campaign to deliver antimalarial medicines to children in Borno using polio eradication staff and infrastructure. It was the first time that antimalarial medicines were delivered on a large scale alongside the polio vaccine, and the effort reached 1.2 million children.

Rotary and its partners also distribute soap and organize health camps to treat other conditions. “The pluses vary from one area to another. Depending on the environment and what is seen as a need, we try to bridge the gap,” says Tunji Funsho, chair of Rotary’s Nigeria PolioPlus Committee. “Part of the reason you get rejections when you immunize children is that we’ve been doing this for so long. In our part of the world, people look at things that are free and persistent with suspicion. When they know something else is coming, reluctant families will bring their children out to have them immunized.”

Rotarians’ contributions to PolioPlus help fund planning by technical experts, large-scale communication efforts to make people aware of the benefits of vaccinations, and support for volunteers who go door to door.

Volunteer community mobilizers are a critical part of vaccination campaigns in Nigeria’s hardest-to-reach communities. The volunteers are selected and trained by UNICEF, one of Rotary’s partners in the GPEI, and then deployed in the community or displaced persons camp where they live. They take advantage of the time they spend connecting with community members about polio to talk about other strategies to improve their families’ health. Fatima Umar, the volunteer pictured here, is educating Hadiza Zanna about health topics such as hygiene and maternal health, in addition to why polio vaccination is so important.

Nigerian Rotarians have been at the forefront of raising support for Rotary’s polio efforts. For example, Sir Emeka Offor, a member of the Rotary Club of Abuja Ministers Hill, and his foundation collaborated with Rotary and UNICEF to produce an audiobook called Yes to Health, No to Polio that health workers use.