It is possible, once in a while, to guess the point at which paranoia and policy intersect. In a place where suspicions abound about anything “Western” — education, medicine, religion, music, fashion, you name it — in a place like northern Nigeria, it isn’t much of a guessing game to identify potential flash points
News reports on Friday said that in two separate incidents in the city of Kano in northern Nigeria, gunmen on motorbikes attacked two health clinics. In all, they killed at least nine people.
The dead, all women, were either working in a polio vaccination campaign or waiting at the clinic for the vaccine.
The attacks have been blamed on Boko Haram, a militant fundamentalist Muslim group that for the past several years has terrorized the country, conducting guerrilla warfare against the government and anyone and anything that stands in the way of its goal of strict Muslim governance and law. Those targets include all vestiges of “foreign” influence on traditional life, from churches and schools to programs that promote immunizations.
Of the triumphs in global public health in the past quarter-century, the near-eradication of polio certainly ranks among the highest, the result of governments embracing a global immunization initiative to stop transmission of the virus.
The World Health Organization in December reported the lowest-ever recorded number of polio cases, 181, and the lowest number of countries experiencing polio — four: Nigeria, Chad, Pakistan and Afghanistan. Except for Chad, the WHO classifies the other three as the last remaining countries where the virus is endemic.
The report expressed particular worry about Nigeria, where case numbers increased last year despite evidence of improvements in vaccination programs. The fear, the report noted, was the risk that the paralyzing virus could migrate into other West African countries (and who knows where else, given the ease and range of international travel) that have successfully halted infections.
What makes the fear so palpable is that it is not overblown. It rests at the point where a policy to protect against a devastating and preventable illness runs headlong into paranoia.
About a decade ago, very influential clerics and political leaders in several states in northern Nigeria mounted a counter-campaign against polio immunizations in the region. They spread fear in the largely uneducated population. For a year or so, these leaders shut down the vaccination programs with preposterous conspiracy theories, claiming among other things that the program was a Western plot to destroy fertility in the predominantly Muslim north.
The consequences were not pretty. The number of polio cases rose sharply in Nigeria during the mid-2000s, and the viral strains were transmitted to more than a dozen countries.With the results of their ignorance evident, and under national and international pressure, some of the leaders backed off and agreed to support the health campaigns.
The WHO’s December report is indicative of the progress that has since been made, progress that can be derailed swiftly by the outrageous brutality of attacks such as the incidents in Kano last week.
The fear that now could threaten the anti-polio campaign and the lives of thousands of children is the fear of fanatics whose brutality may intimidate health workers and their clients.
The reports on the Nigerian attacks last week took note of their similarity to attacks in which at least 16 vaccination workers have been killed in Pakistan since December on claims that the workers were spies.
In the spring of 2011, international groups that provide humanitarian aid in some of the most volatile regions in the world were dismayed to learn that among the tactics to verify the identity of Osama bin Laden in his Abbottabad hideout, the Central Intelligence Agency had set up a cover of a hepatitis B vaccination campaign, using a Pakistani doctor and nurses to gain entry into the compound to collect blood samples.
In that highest of modern spy games, an immunization team provided a false front — and the example paranoids need to water the roots of conspiracy theories and vile acts of violence.
Ofobike is the Beacon Journal chief editorial writer. She can be reached at 330-996-3513 or by email at firstname.lastname@example.org.