Infos Santé of Tuesday, 19 May 2015

Source: Global Press Institute

Religion hindering polio vaccination in Cameroon

Magdalene Swiri says her faith does not allow her or her children to use modern medicine.

"God heals all diseases," she says, sitting by the door of her kitchen reading her Bible as a pot cooks on the nearby three-stone fireplace. "There is no need looking for human cure for diseases."

Wearing a blue headscarf and a loose brown gown that covers her up to her wrists and down to her ankles, Swiri says she and her children stopped going to clinics and taking medication once she joined a small sect called the True Church of God 11 years ago in Bamenda, the capital of Cameroon's Northwest region.

Swiri is confident that polio, which has re-emerged in Cameroon after having been virtually eliminated, will never attack her children provided they continue to trust in God.

"God did not create the world with diseases," she says. "Human beings brought diseases upon themselves. So, then, if you believe and trust in the Lord, he will not inflict you with diseases. If for some reason the diseases come, he will heal you."

And so Swiri and other Cameroonians who share her faith refuse to let public health care providers vaccinate their children amid the re-emergence of a disease that has disabled millions of people around the world in the 20th and 21st centuries.

Polio is a crippling and potentially deadly infectious disease caused by the poliovirus. The virus enters the body through the mouth, according to the U.S. Centers for Disease Control and Prevention. It is spread through contact with feces of an infected person, and possibly through oral and nasal secretions.

Polio can be deadly. Two to 10 percent of people paralyzed by polio die from loss of the use of breathing muscles.

The poliovirus can lie dormant for decades after a childhood bout of the illness, causing new weakness and paralysis in adulthood.

The polio vaccine prepares a body to fight the virus. Ninety-nine percent of children who receive all the recommended doses of the vaccine are protected from polio.

Polio has re-emerged in Cameroon after the country nearly wiped it out and kept it out for several years. Cameroon recorded three polio cases in 2009 but none in 2010, 2011 or 2012.

The government reported nine new cases in 2013 and 2014 amid an outbreak in West Africa and other parts of the world.

As long as one child remains infected, children all over the world are at risk of contracting polio, according to the World Health Organization, or WHO.

But as the government intensifies its immunization efforts, members of the True Church of God declare their resolve not to immunize their children, saying that to do so would signify a lack of faith in divine healing.

Cameroonian law does not bar unvaccinated children from attending school, says Roger Ayuk, a barrister with Fraternity Chambers in Kumba, in southwestern Cameroon. The law does not penalize people who refuse to have their children vaccinated.

The spread of the poliovirus is a worldwide problem, according to the WHO. In May 2014, after the disease had been detected in West Africa, Central Africa, the Horn of Africa and Asia, the WHO declared international spread of the virus a public health emergency. It issued recommendations to prevent further infections.

Cameroon, Syria and Pakistan were named polio-exporting countries. The WHO recommends that long-term visitors to countries with polio get the vaccine four weeks to 12 months before traveling abroad. In addition, polio-infected countries are required to vaccinate residents and long-term visitors before they depart for other countries.

Today, Nigeria, Afghanistan and Pakistan are most affected by polio. Other countries remain at risk of importing the virus, according to the WHO. Within 10 years, failure to eradicate polio could result in 200,000 infections a year worldwide.

In Cameroon, health workers diagnosed new polio cases in the country's West and Center regions, according to John Fung, a spokesman for the Ministry of Public Health's Northwest Regional Delegation of Health.

Those cases, the first to be detected in Cameroon since 2009, were initially thought to have been imported from neighboring Nigeria, which had 53 cases in 2013, Fung says.

However, the WHO determined that the infection originated in Chad. In 2013, Cameroon set out to vaccinate all children under 5, Fung says. The Ministry of Public Health first vaccinated children in communities where polio cases had been detected. It rolled out the program countrywide in 2014, targeting 5.6 million children.

The ministry carried out 10 rounds of national immunization in 2014 and one each in January and February 2015, he says.

In the Northwest region, the ministry has conducted immunizations in 226 health areas, Fung says. Health workers move from house to house vaccinating children. They also go to strategic places where they can find children, such as markets and churches.

The Ministry of Public Health does not keep nationwide statistics on the number of children vaccinated, Fung says.

The WHO recommends three rounds of national immunization when a polio case is detected, Fung says. Cameroon conducted additional rounds after external health surveyors determined they were needed.

But the repeated rounds of immunizations sparked a rumor that they were a ploy to sterilize children, Fung says. The ministry stepped up its public awareness campaign to dispel that rumor.

"Some people literally locked up their children in the houses, claiming that they don't have children below 5," he says. "This was because they didn't want their children to be immunized."

Representatives of the regional delegation appeared on about four radio stations to stress the importance of polio vaccination, Fung says.

They also visited women and men in meeting halls to listen to their concerns. In those meetings, women told the representatives of their fear that their children would be sterilized.

"With that information, we reinforced sensitization, focusing on the fact that polio vaccine is not for sterilization purposes but for protection of our children," he says.

Happily, Fung says, many parents these days voluntarily present their children for vaccination.

Emmanuel Igwe, the pastor of the True Church of God in Small Mankon, Bamenda, says the church is about advocating faith rather than forbidding medical care. The church believes in the power of the Holy Spirit, he says.

Christians generally believe that God manifests as three persons - the Father, the Son and the Holy Spirit. Some believe faith in theHolySpirit, who is said to live within Christians, is a near guarantee of healing.

"We, the Christians of the True Church of God, believe in divine healing," he says. "However, for one to encounter divine healing, his faith must be strong and steadfast."

As he ministers to his congregation, he expects everyone to hold strong to their faith so that God can work miracles in their lives, Igwe says. The church doesn't coach Christians not to vaccinate their children but rather instructs them to focus on their faith, Igwe says.

"Vaccination is an option," he says. "But if an individual holds strong to his or her faith, he or she can decide whether or not to vaccinate his children."

Igwe says he tells his congregation that God heals those who believe strongly that he can.

Mirabel Mangwi, a member of the True Church of God, has chosen not to vaccinate her two children, who are under 6, she says.

"I am holding strong to my faith, believing that God is the miracle worker," she says.

Mangwi has been a Christian for several years, she says. During that time, God has healed her and her children of their illnesses, she says.

"No amount of talk can force me to vaccinate my children," she says. "It a matter of decision, and the strong believe that healing is divine."

Mary Lum, a housewife in Bamenda, says a rumor circulating in her neighborhood made her fearful of having her child immunized.

"People said it was a strategy to sterilize our children," she says. "But after listening to sensitization campaigns on radio, television and in our meeting groups, I saw the need to have my child vaccinated frequently."

Lum says she would never forgive herself if her 3-year-old child were paralyzed by polio while the country is struggling to eliminate it.

"I will be worried sick all my life if my child becomes handicapped by polio because I would have prevented it by having her vaccinated," she says.

RuthAcheinegeh, 35, knows the pain and disability wrought by polio.

She had not been vaccinated against polio when the virus struck in early childhood, partially paralyzing her legs. Polio immunization was not common in Cameroon at the time, she says.

"My parents told me that I was a strong and healthy baby until I was suddenly knocked down by polio at the age of 3," she says.

Her parents struggled in vain to help her walk again.

"I can remember my parents took me from one hospital to another, one traditional healer to another, one prayer house to another, all in a bid to make me walk again," she says, turning around and staring at her father, who is sitting about five meters (16 feet) away from her shop. She then breathes heavily and smiles.

If she had a microphone, Acheinegeh would shout out, telling parents in Cameroon to have their children vaccinated.

Members of the True Church of God are the biggest opponents of the immunization program, Fung says.

"Ministry officials have tried to talk to church members and their leaders, but they have refused to take immunization seriously," he says.

As immunization rounds continue, Fung calls on families to practice good hygiene.

"Every individual should wash their hands after using the toilet," he says. "People should also learn to wash their hands before and after every meal."

Jean Laurent Onana, the national communication consultant at UNICEF, calls on parents and teachers to support UNICEF and the Ministry of Public Health in their efforts to vaccinate every child under 5.

UNICEF conducts media campaigns to educate Cameroonians on the importance of polio vaccinations.

"We want to eradicate the polio virus from Cameroon," he says. "It is bad news that Cameroon is one among the four polio-exporting countries in the world. We would want to change that in Cameroon and every other polio-exporting country in the world."