Monday February 25, 2013 – Abuja

It is our first full day in Nigeria and our goal for the day was to understand more about the Nigerian program and commitment to END POLIO NOW.

But first, the human element.  Our hotel room is definitely unique. While the hotel is relatively new, it is not been well-maintained… The shower gives only scalding hot water (better than only cold), and power can be intermittent throughout the day. and throughout the country. The security is excellent with security guards at the entrance to the hotel from the street and also security guards on every floor.

T-I-A This is Africa and different it is. But then again, we came for the experience and to help those in need.

A word about our team … They are great and dedicated. One woman’s luggage just arrived one day late, but we already had Plan B in development for everyone offered to pitch in and help her manage. And Donna, our final team member, arrived this afternoon from Tanzania (by way of Ethiopia – look at a map!).

Today was a learning day. We began at WHO – the World Health Organization. Last year in India our first stop in India last year was also WHO. We met Dr. Rui Gama Vaz, the WHO Representative for Nigeria, together with Dr. Alex (sorry we did not get his full name), two well spoken doctors who shared current information. There are approximately 15 million children 5 and under in the country.  Nigeria is divided into states with governors and assistant governors. WHO has 46 country coordinators and 2600 staffers who work on polio eradication.

Nigerian President Goodluck Jonathan has expressed his support for the elimination of polio and has met with not only the state governors, but has sent this message to local traditional and religious community leaders.  According to what we heard, polio eradication in one of the President’s top priorities with a goal to make Nigeria free of polio by the end of 2013. He has endorsed increased funding for the polio eradication initiative at the federal level to US$60 million in 2013 and has stressed the fact that routine immunizations are vital for the children. However logistical problems exist as well as trying to provide clean water and environment. We were told that cholera and polio are often found together in the slums due to lack of fresh water and sanitation.

As we know security is an issue but it was made clear to us that this is a major factor in the north where there have been three recent polio cases. Communities must lead the process we were told and awareness must come from the bottom up. But it is hoped that once again, religious leaders need to endorse these health care programs. And of course education and awareness are also part of the equation. We were told that there is even a pop singer in the north who is lending voice in support of vaccinating children.

It was stressed that in Nigeria the entire health system must the strengthened and polio is only the first stepping stone. It was emphasized that families must be given support to improve healthcare so that even diseases like malaria can be curbed. Nutrition is vital for the children to grow and even for their bodies to absorb the vaccines.

Again, in the north, there is a greater nomadic population and then again makes immunization challenging. For as these people move their herds from north to south in response to the changing seasons (wet season, dry season, etc.) they can bring disease with them again due to lack of proper sanitation. If these migratory workers send some kind of a message that they are arriving, health care workers can provide for them

We will be working in the south, where security and support for health care have been positive. One doctor told us that we might even find educated mothers running to us to please vaccinate their children. We heard that our presence adds support and encouragement to these families.

The primary Nigerian government agency working with WHO and partner agencies is the National Primary Health Care Development Agency.  We were briefly introduced to the Executive Director, Dr. Ado Muhammad (he interrupted a morning meeting to greet us).  For those in Rotary, it is interesting to note that Dr. Ado Muhammad was just awarded a Paul Harris Fellow by a local Rotary Club as recognition of his contribution to Rotary’s participation in the END POLIO NOW program.  It is truly an honor from Rotary to receive a Paul Harris Fellow.

We then visited the polio Emergency Operations Center where all of the partners in the program (WHO, UNICEF, CDC and others) are working together to learn from past polio immunization campaigns (including those in other countries like India) and structuring the ongoing immunization drives to maximize effectiveness.  They are still trying to determine why some children are still being missed..There is ongoing research working with the health minister to find out…who? why? and where? are those individuals. We heard that Nigeria is learning microplanning from India such as counting households instead of just trying to count children, and Nigeria is introducing technology such as GPS map and manage the routes taken by health care workers in neighborhoods and using the data to improve efficiency.

Nigeria has a challenging task … In 2011, there were 62 polio cases and in 2012, there was an increase up to 122. In 2013, there have already been 3 cases of polio in country. We are here to help bring that number of cases to zero.

Early tomorrow morning, we leave to go south to the city of Owerri.

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