By: Bahikire Daraus
While Uganda and the African continent were celebrating the eradication of polio as declared by WHO’s Independent Africa Regional Certification Commission for Polio Eradication, another variant of the polio virus that occurs in under immunized communities with poor sanitation is spreading across parts of Asia and Africa.
31 African countries including Uganda have recorded 1,069 polio cases over the past one year. Uganda’s Health Ministry has warned that 4.6 million children 5 and younger are at high risk of contracting poliovirus.
The Uganda Ministry of Health confirmed a polio outbreak from two samples collected on June 21 from the sewage plants of Bugolobi and Lubigi in Kampala.
According to the US-based Centres for Disease Control and Prevention, polio, or poliomyelitis, is a disabling and life-threatening disease. The virus is transmitted through oral faecal route from one infected person to another. The virus also spreads through contaminated water or food, can infect the spinal cord, causing paralysis, leading to permanent disability or death
The Global Polio Eradication Initiative (GPEI) was formed in 1988 when leaders at the World Health Assembly collaborated to confront polio. At the time, there were 350,000 cases of polio every year and polio was endemic in more than 125 countries around the world. The of the initiative goal was initially to eradicate the disease by the year 2000, and while they did not meet that target, progress since then has been significant.
Thanks to global health efforts, polio is 99.9% eradicated and remains endemic in only three countries in 2019: Afghanistan, Pakistan, and Nigeria. Nigeria has not yet been declared polio-free, but is on track to achieve the goal.
There were 140 diagnosed Wild Polio Virus cases worldwide in 2020, a decrease from 2019’s 5-year high, an 81% reduction from the 719 diagnosed cases in 2000 and a 99.96% reduction from the estimated 350,000 cases when the eradication effort began in 1988.Suh trends are a positive indicators of successful global interventions in dealing with polio.
The Ministry of Health, Uganda pointed out certain interventions in dealing with the polio outbreak which included: stepping up routine vaccination, cross border surveillance, engagement with stakeholders, water, sanitation and hygiene issues that are key in eradication efforts were left out.
The government of Uganda with support from partners invests heavily in routine and campaign mode of vaccination with the most current being the polio campaign organised between 14th -16th January 2022. This campaign targeted immunizing 8.7 million children within five years, or some 20% of Uganda’s total population.
These two vaccination approaches have since created a mentality that vaccination is the absolute and final measure of preventing polio infections. However much it is true that vaccination offers adequate protection against the polio virus, neglecting the transmission channels such as contaminated water and food, poor sanitation and hygiene renders weakens vaccination as this implies a likelihood of polio resurgence time after time.
Examining the progress made towards polio eradication, it can be gauged that improved sanitation played an important role in eradicating polio from the United states of America (USA) in the 1960s, when only about two thirds of the population was immunised. Poor sanitation and crowding have permitted the continuous transmission of polio virus in certain poor countries in Africa and Asia.
World Health organisation reports that Urban sanitation and Hygiene action (USHA) project started in 2007 in India is one such unique example that contributed to polio eradication campaign.
According to the MWE sector performance report 2019, whereas sanitation coverage was increasing, handwashing rates in different regions fell behind.
Behaviour change is the key to increasing the practice of hand washing with soap and ending open defecation. The change can be accomplished through motivation, information and education
Latrine product attributes like perception of cleanliness and durability are critical factors in determining use of latrines. For example, if someone feels that the facility is not clean, the likelihood of using it diminishes drastically. Other influencing factors are the social norms around open defecation, perceived latrine affordability, self-efficacy to build latrines (versus reliance on masons) and competing household expenditure priorities.
The practice of ‘hand wetting’ instead of handwashing remains one of the undesired practices that steer the spread of disease causing germs. Even in the instances where it is practiced, some are in such a rush that they simply wet their hands instead of going through all the motions that ensure germs are killed.
Covid19 has given us assurance on the importance of handwashing in prevention of diseases.
For Uganda to have firm grip on keeping polio out, it is important to compliment vaccination with handwashing with soap very often; promote use of appropriate sanitation facilities and promote safe, clean drinking water
It is total denial to think that government will provide funds for vaccination, pay health workers and also reach to every household to enforce sanitation hygiene or even ensure water is boiled.
It is our sole responsibility to compliment vaccination efforts by removing all avenues of child exposure to the polio virus, some of which include – Consistent use a toilet for proper disposal of human wastes that expose children to polio virus; monitoring child movements to avoid getting in contact with infectious materials that expose the child to polio virus; ensuring that a child uses a pot while defecating to avoid open defecation that spreads polio causing germs; cleaning homes every day to remove rubbish and all forms of wastes that contain polio causing germs; boil water for drinking and home use to kill polio causing germs; making sure that your child eats properly washed fruits and vegetables to remove germs that cause polio disease; draining any stagnant water that serve as playing places yet exposing children to polio viruses. And lastly, always wash our hands with soap under running water before handling a child to remove polio causing germs.
With all this done, we shall be convinced that the journey to eradication of polio is covered for good.