Jun 29, 2012

Religious resistance to the polio vaccine

In DR Congo, communications efforts are turning back religious resistance to the polio vaccine

By Natacha Ikoli
KINSHASA, Democratic Republic of the Congo, 27 June 2012 – Though polio has been eradicated from much of the world, it remains a tragic reality in the Democratic Republic of the Congo (DRC), where transmission of the virus was re-established in 2006. Since 2010, it has affected nearly 200 people.
UNICEF correspondent Natacha Ikoli reports on efforts to promote polio vaccination among religious communities opposed to the vaccine in the Democratic Republic of the Congo.
With the support of UNICEF, the World Health Organization (WHO) and their partners, the country initiated emergency action plans to address the situation through immunization campaigns and public health programmes.
Yet in spite of multiple countrywide polio vaccination drives in 2011, wild poliovirus remains a threat, in part because some parents continue to refuse to vaccinate their children. Many resisters are fearful of rumors about the vaccine’s side effects or distrust health provider, and in some provinces, parents decline to vaccinate their children out of religious beliefs.

Religious resistance
While Christianity is the predominant religion in the country, many still follow traditional religions, and numerous groups merge Christian tenets with traditional beliefs. Some of these groups strongly resist immunization.
© UNICEF video
A polio vaccination campaign in the Democratic Republic of the Congo. Though polio has been eradicated from much of the world, it remains a tragic reality in DRC.
Such religious resistance to immunization is notable in Nyunzu, a remote, hard-to-reach area. In Mukwaka, on the outskirts of Nyunzu, spiritual leader Marco Kiabuta strongly discourages his followers from using modern health care.
“When there’s a health issue, first and foremost you’ve got to call on the village wise men who will pray over the ill,” he said. In explaining this position, Mr. Kiabuta points to the bible he carries with him at all times. Adherents who don’t improve with prayer are allowed to seek assistance from a doctor, but they often decline certain treatments.
“We refuse to be treated for a disease we don’t recognize,” he said.
Ending vaccine refusal
Those refusing vaccination are only a small segment of Nyunzu’s population, said Mr. Abderrahmane Bocar, an immunization specialist with UNICEF. But it is a wide window of opportunity for poliovirus to enter the community and thrive.
© UNICEF video
A polio vaccination campaign in the Democratic Republic of the Congo. Polio remains a threat in the country in part because some parents continue to refuse to vaccinate their children.
In remote areas, said Dr. Isaac Mpambu Malanda, a health zone director, people often attribute polio disease to evil spirits. Yet communication and education efforts can have a tremendous impact.
Reaching out to representatives of resistant groups and to community members can dispel negative ideas about the oral polio vaccine. Identifying resistant groups and engaging them in frequent dialogues can prompt them to change their ideas about vaccination and life-saving health care.
In Bas-Congo province, where Dr. Malanda operates, four groups refused vaccination in early 2011. Today, thanks to intense communication efforts, only one religious group continues to stand firm against the polio vaccine.

More than 500,000 children across Mauritania

In Mauritania, healthcare campaign aims to save children from preventable diseases

© UNICEF Mauritania/2012
A girl holds her sister and her sister's vaccination certificate in a poor suburb of Nouakchott, Mauritania.
By Fadila Hamidi and Anthea Moore
M’BOUT and NOUAKCHOTT, Mauritania, 28 June 2012 – More than 500,000 children across Mauritania have benefited from a two-month campaign organized by the Ministry of Health, with support from UNICEF and the World Health Organization (WHO), that provided an integrated package of immunizations (including measles and polio vaccinations) and vitamin A supplementation for all Mauritanian children under 5 years old.
This preventative care is essential to building resilience in Mauritania’s children, who are highly vulnerable to malnutrition and illness this year due to the Sahel nutrition crisis, which currently affects 700,000 people in the country.
Expanding life-saving care

Immunizations were undertaken at health centres and specially designated sites in urban centres. Some 1,000 health workers went door-to-door, providing oral doses of vitamin A and deworming medicine, from remote desert communities to the shanty settlements around the capital Nouakchott. In addition, more than 1,000 community outreach events promoted hand-washing with soap, birth registration and positive parenting practices.
The campaign, part of the second African Immunization Week, was launched on 28 April at the opening of a new health centre in M’Bout. Officials from the Government of Mauritania, the WHO, Counterpart International and UNICEF were welcomed with traditional music, singing and dancing as the community celebrated the prospect of improved health care.
© UNICEF Mauritania/2012
UNICEF Representative in Mauritania Lucia Elmi administers a vitamin A supplement to a child during the country's two-month health campaign.
Fatou Mint Samba, 27, attended the opening of the health centre with her youngest son Abbass, who is 7 months old, and her mother Dola Mint Masa, who laughed and said she is too old to remember her age.
Many women like Ms. Mint Samba brought their children to the health centre to receive vaccinations and vitamin supplements. They were also eager to learn more about immunization and to receive insecticide-impregnated mosquito nets to protect against malaria-carrying mosquitoes.
Ms. Mint Masa lost a 5-year-old niece to measles, and has since been a strong community advocate for improved health care. “Last year there was a measles epidemic in this area. I went from door-to-door telling people to have their children vaccinated. I did this because I remember the death of my niece eight years ago,” she said.
“Many of the diseases that existed during my childhood don’t exist here anymore because of vaccination,” she added.
© UNICEF Mauritania/2012
Children attend the opening of a new medical centre in M'Bout, Mauritania.
Communities central to change
Preventative public health measures like immunization are both life-saving and cost-effective.
The logistical challenges of reaching remote communities in sparsely populated Mauritania are immense. And yet, excluding the cost of the vaccines and supplements, delivering this integrated package cost just 40 cents per child.
These services are particularly important during the current nutrition crisis, as malnutrition and childhood illnesses can create a vicious cycle, each increasing children’s vulnerability to the other.
After the official opening of the health centre, a radio programme was broadcast from a nearby tent. The presenter asked women from the community questions about immunization and awarded prizes for correct answers. The exchanges were accompanied by smiles, laughter and more music, signs that positive change is being embraced in the community, and that community members are proud to be at the centre of that change.
México a la vanguardia en el Síndrome de Post Polio

Jun 26, 2012

Polio Vaccinations in Protest at US Drone Campaign

Taliban Leader Bans Polio Vaccinations in Protest at US Drone Campaign

- Common Dreams staff
Taliban officials in Pakistan have banned a polio eradication campaign taking place in South Waziristan in an attempt to force an end to increased US bombing raids in the tribal areas that run along the Afghan border.
Samiulah, 15, who contracted polio, receives rehabilitation at a clinic in Kabul. Cases of the disease are increasing in Afghanistan. (Photograph: Anja Niedringhaus/AP)Pakistan is one of only three countries left in the world where polio has a significant foothold, but efforts to control the disease have been hampered by local mistrust of medical officials since it was revealed that the CIA fabricated a fake vaccination drive in an attempt to confirm the whereabouts of Al Qaeda leader Osama Bin Laden in 2011.
Leaflets distributed on behalf of Mullah Nazir, the leader of the Federally Administered Tribal Agencies (FATA) accused health workers who administer anti-polio drops of being US spies, reports The Guardian.
"On the one hand, they are killing innocent children in drone strikes, while on the other hand they are saving their lives by vaccinating them."
"In the garb of these vaccination campaigns, the US and its allies are running their spying networks in Fata which has brought death and destruction on them in the form of drone strikes," the leaflet said.
It also questioned the sincerity of international efforts to tackle the highly infectious disease. "On the one hand, they are killing innocent children in drone strikes, while on the other hand they are saving their lives by vaccinating them," the printed mot said"
México a la vanguardia en el Síndrome de Post Polio

Jun 22, 2012

UNICEF: 2.7 million kids have never received polio vaccine

About 2.7 million children in six countries have never received a single polio vaccine dose, the United Nations Children's Fund (UNICEF) reported yesterday. 

"This is a clarion call to accelerate all efforts to reach these unreached children," UNICEF Executive Director Anthony Lake said in an agency press release. The report singled out the Democratic Republic of the Congo, northern Nigeria, and northwest Pakistan as areas of ongoing internal conflict that are of particular concern. Lake added, "The polio campaign is dangerously under-funded. But we are on the 
verge of victory."
Jun 20 UNICEF press release

In one of those conflict-torn areas, Pakistani officials said they will try to persuade militants in a northwestern tribal area to lift a ban on polio vaccination launched to protest US drone strikes, Agence France-Press (AFP) reported today. Local warlord Hafiz Gul Bahadu several days ago banned vaccination teams in North Waziristan, a Taliban and al-Qaeda stronghold area bordering Afghanistan. A senior government official said authorities have asked the provincial governor to open a dialogue with the militants. He said the government was concerned about more than 161,000 unvaccinated children in the region and about the safety of vaccination teams.
Jun 21 AFP story

Finally, today the WHO European Region, which includes parts of Asia, celebrated 10 years of being declared polio-free. Despite challenges, such as a 2010 outbreak of polio imported into Tajikistan and three adjoining nations that was quickly addressed, WHO Regional Director for Europe Zsuzsanna Jakab said in a press release, "We have had many successes in the past 10 years, and we should recognize and applaud them."
Jun 21 WHO news release

México a la vanguardia en el Síndrome de Post Polio

Jun 17, 2012

Taliban ban anti-polio drive in Pakistan tribal area

Pakistani militants in a Taliban and Al-Qaeda infested tribal region Saturday banned anti-polio vaccination teams, to protest US drone strikes saying the attacks were killing civilians.


  • A Pakistani child receives anti-polio vaccine drops in 2004. Pakistani militants in a Taliban and Al-Qaeda infested tribal region Saturday banned anti-polio vaccination teams, to protest US drone strikes saying the attacks were killing civiliansView Photo
    A Pakistani child receives anti-polio vaccine drops in 2004. Pakistani militants in a Taliban and Al-Qaeda infested tribal region Saturday banned anti-polio vaccination teams, to protest US drone strikes saying the attacks were killing civilians
"Anti-polio vaccination teams will not be allowed to administer polio drops among children in North Waziristan," local warlord Gul Bahadur said in a statement.
Bahadur, who is allied with Afghan Taliban fighting US-led troops across the border, said the ban will remain effective until the US stops drone attacks in the tribal region.
"On the one hand they are killing innocent women, children and old people in drone attacks and on the other they are spending millions on vaccination campaign," the statement distributed in the region's main town Miranshah said.
It said "the day and night US drone flights in Waziristan are causing mental illness in the local population which is more dangerous than polio."
Residents said people would respond to the call as Bahadur commands influence in the region.
Pakistan's northwestern tribal region, known as a hotbed of Taliban and Al-Qaeda militants, is witnessing increasing drone strikes amid a stalemate in US-Pakistan talks to end a blockade on NATO supplies crossing into Afghanistan.
Pakistan shut NATO supply lines in anger over US air strikes on a border post on November 26 that killed 24 Pakistani soldiers.
The statement, citing the case of Pakistani doctor Shakeel Afridi jailed for helping the CIA find Osama bin Laden, also slammed the immunisation campaign saying that it may be used for espionage purposes.
Afridi was arrested after US troops killed bin Laden in May 2011 in the northwestern town of Abbottabad where he set up a fake vaccination programme in the hope of obtaining DNA samples to identify the Al-Qaeda leader.
He was sentenced to 33 years in jail on May 23.
Pakistani authorities whipped up anti-American sentiment after the bin Laden raid calling the drone strikes a violation of national sovereignty.
But US officials consider the attacks a vital weapon in the war against Islamist extremists, despite concerns from rights activists over civilian casualties.
UN High Commissioner for Human Rights Navi Pillay recently called for a UN investigation into US drone strikes in Pakistan, questioning their legality and saying they kill innocent civilians.

México a la vanguardia en el Síndrome de Post Polio

Jun 9, 2012

Physical Medicine and Rehabilitation at the University of Michigan

The Michigan Difference: 
Theme song for the University of Michigan Health System
Listen to the University of Michigan Health System's version of Hail to the Victors.

Post-Polio Syndrome

Post-polio syndrome affects about 50 percent of people who have had polio. Even those who managed to work their way out of braces and spent 20 years or more without the need for assistance can start experiencing extreme fatigue, joint pain and muscle weakness. Our Post-Polio Clinic, part of the Department of Physical Medicine and Rehabilitation at the University of Michigan, utilizes the skills of a multidisciplinary group of experts to comprehensively treat people struggling with post-polio syndrome, from physical issues to emotional challenges.
Physical issues connected to post-polio syndrome include:
  • Joint pain
  • Loss of balance
  • Fatigue
  • Weakened muscles
  • Scoliosis
In addition, many people experiencing symptoms also deal with frustration, depression and fear. Because of this, we make sure to treat the emotional as well as the physical issues.
During your first visit to the Post-Polio Clinic we gather as much information as possible to get a clear picture of your health history and current conditions. We look at your range of motion, where you’re experiencing weaknesses, your lifestyle and any other concerns.
A variety of testing is conducted, including a muscle test and a gait evaluation. Once the entire history is collected and all the test results are in, our team creates a complete plan that may include orthotics, physical rehabilitation and referrals to other clinics within the University of Michigan, from Nutrition to the Sleep Center, Pulmonary medicine, Orthopaedic surgery and Neurosurgery.

An Experienced Team with Cutting-Edge Technology

The goal of treatment is to help our patients maintain their lifestyle as much as possible by helping them control their biomechanical issues, such as increasing balance by introducing an orthotic intervention, or using physical therapy to increase strength and stability. However, what’s most important is having the experience with studying and treating this syndrome so the prescribed interventions help the patients, not make their situation worse. For instance, sending a patient to physical therapy to work on a muscle that had been affected by polio can make the muscle more fatigued instead of making it stronger, resulting in a worsened instability problem.
A wide variety of orthotics – equipment used to support or correct moving parts of the body – is available, depending on each patient’s needs, from crutches and walkers to braces and scooters. Some orthotics also help decrease energy consumption while keeping the patient mobile, such as stance control systems – a type of long-leg brace that stabilizes the knee to prevent it from buckling, so while the patient moves the leg, the knee automatically unlocks to flex it during the swing phase.
Our polio research history is rich and we are continuing that tradition today, working on a number of orthotics improvements, such as working with carbon fiber to make braces stronger and lighter. Eligible patients are welcome to participate.

Schedule an appointment by calling us at 734-936-7175

México a la vanguardia en el Síndrome de Post Polio

Jun 4, 2012

Have wheelchair, will travel

MY introduction to wheelchairs came early in life (I was barely in my teens) when my brother had to use it after he had several operations on his leg to correct damage caused by polio.

Then came another phase, and another form of the wheelchair — baby strollers. There are several types, and the choices available are quite dizzying. With four kids of my own, and countless nieces, nephews and friends’ children, “driving” and “dodging” with an occupant in the chair, albeit a small one, became second nature, like driving a car or riding that bicycle.
Looking back, it seems as though I had pushed someone in a wheelchair or stroller nearly my entire life. When my son Omar could not walk until he was five years old, we had to progress from baby strollers to push-chair and later, wheelchair.
It was easy when he was a baby. It was still fine when he became a toddler. It was when he was past three that finding the right chair became difficult. Those available became too small. There were no strollers big and sturdy enough for him. The regular wheelchairs, on the other hand, were too big. I felt like I was caught in the story of The Three Bears. We finally found the perfect one but we had to wait as it had to be specially ordered from Australia.
Omar is 21 now. Though he can walk, he still needs his wheelchair on those long, tricky trips. We always have to be mindful and remember that Omar is hemiplegic and tires easily.
Then came the time when my parents needed to use the wheelchair too. I became even more adept at it. My late parents loved to travel, and we went on many trips together. When their knees started giving them problems and walking distances became a chore, they were depressed about the possibility of not being able to travel anymore. At that time, using the wheelchair was not an option because they felt it was a blow to their image. It embarrassed them to be seen as weak and old. Public use of a wheelchair was not a common sight.
I bought one for them anyway and left it at the house so that they could get used to the idea and to let them have a feel for it. We had several practice runs around the house. It became like a game for them and they took turns at it. I also showed them how easy it was to use, and how they could be wheeled right to the dining table. They liked that.
Then I persuaded them to use it at the hospital during their check-ups. It was always a long walk to the hospital and sometimes there weren’t enough chairs for everyone. My parents took a liking to the fact that they didn’t have to walk so far, that they had an easy ride at the hospital, that they had a ready seat anywhere while waiting for their turn at the clinic, and that they received preferential treatment as an elderly in a wheelchair.
Our first venture out with a wheelchair was a trip to Beijing, China. We joined a tour group with 30 strangers, lugging along a wheelchair shared between my parents. In those days, the use of a wheelchair for someone who was not paralysed or had a leg in a cast was a rare sight. My parents looked hale and hearty and thus caused quite a stir wherever they went. Besides, it was unusual for an infirm person to be out and about in public.
In one incident when I was pushing my mother in a wheelchair along a row of shops, a shopkeeper excitedly exclaimed to his neighbours that a miracle had just happened because a “paralysed” person was able to walk just to buy something from his shop. He later realised that mum was not paralysed but just being practical about her weakened legs. We had a good laugh, and this became the group’s standing joke for the entire trip.
During this trip, my father took a liking to the wheelchair too. Not only did he enjoy similar attention wherever we went in Beijing, but also because it did not tire him out as he had anticipated. The wheelchair was a blessing, he claimed.
He actually felt liberated and was so happy that he could still travel and see the world. All they needed was someone to accompany them on those trips, which my siblings and I took turns to follow.
My parents went to many more places and had grand adventures with their wheelchair in tow. All of us became skillful with the wheelchair, how to manoeuvre it safely.
Some people still have hang-ups about using a wheelchair. I’m just glad my parents didn’t as it gave them many years of being able to life their lives to the fullest. I guess this is what quality of life is all about.
(Next week: How to use the wheelchair safely) Read more:
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