Tackling Measles in Nigeria

Good things don’t come cheap and victory isn’t freely given but demanded for. This seems to be the case in federal government’s quest to end measles in Nigeria. Kuni Tyessi writes

“Some of their husbands travelled and immediately they heard about the measles vaccination programme, these husbands quickly called their spouses and instructed them never to release their children for the exercise, with claims that the vaccine will be given on the head and abdomen of the ‎children and this will in turn kill or have adverse effects on their development.

“Some parents also complained about the state governments refusal to live up to its responsibilities and promises of providing free school uniforms for their children. ‎They said since other children were given uniforms and theirs were not, they will not release their children for the measles vaccination with the belief that the state government was playing smart and will be the beneficiary.”

These were the words of a Community Health Extension Worker (CHEW‎) saddled with the responsibility of giving measles vaccines in Balago Ward, Kiyawa LGA of Jigawa State. He said the above were the challenges encountered at the ward which has several families living in houses built with clay and straws, and with a dominant livelihood on farming.

Although, a town crier, a male, could be seen with his mega phone as well as a house-to-house mobiliser, a middle aged woman making announcements and going from doo‎r-to-door appealing and encouraging parents to release their children and wards, others saw those who complied to the appeals as not smart enough to understand the state governments dis-service to them.

In response to the challenges, the CHEW said they were able to liaise with the community leader, Mallam Lawal Shuaibu and the representative of the village head, Mallam Isa Halliru in enlightening the people about the unfounded rumours and emphasising that the measles vaccine has the potency of protecting the children from the disease which is capable of affecting their early childhood development and with adverse effects in adulthood.

He said: “The community leader and representative of the village head were able to assist us in talking to the doubting parents. ‎We told them that their speculations were mere assumptions which were unfounded and built on rumours. We also apologised to them for their children’s inability to access free school uniforms with the claim that materials have been bought and sent to tailors for sewing, but due to the infallible nature of humans, the uniforms were yet to be ready.

“We told them that the issue of vaccine is completely different from the issue of school enrollment and uniforms. We also went ahead to assure them that their children and wards would be served with the ‘inducement’ in form of school uniforms once the contractors were done with sewing the materials.However, for the first allegation, despite our efforts, we met with stiff resistance as the wives of some of the men who had travelled would not comply despite the fact that we had to speak to their spouses on phone and enlighten them about the benefits of the measles vaccine.‎”

At Jigawa Kaura, under Katuka ward in the same state, compliance to receiving the vaccine was positive. ‎The CHEW in person of Malama Fatima Shettima and Hajiya Kaltume Idris revealed that the turn out was massive and encouraging. They said even though there were rumours about the vaccine being given on the head and abdomen, convincing members of the community about its falsehood was not difficult.

By 1:15 p.m. on the third day of the exercise, ‎they had given 151 doses of the vaccine as against the 125 which was their set target, even though 20 vials were given to them for 200 doses. They were seen sitting under a tree shade and waiting for more children who had followed their parents to their farms.

Were there challenges encountered? The women said yes.”The exercise has been successful and the turnout is very encouraging. We had no issues whatsoever and we were able to quell the rumour on the parts of the body to which the vaccine is administered.

“The vaccine is not given on high temperature‎, especially when the body temperature of the child is above 38 degrees.

“In the past, government made provision of incentives such as soaps, biscuits, sweets, etc in order to encourage parents and children to participate in the exercise. The provision of such was usually on the first day and that was all.‎ With this practice, the community members whose children could not be vaccinated on the first day became suspicious of us. There was hardly any explanation that would convince them that we had not sabotaged the efforts of the government by hoarding the incentives in our homes. With this, some of the parents deprived their children from participating.”

Shettima and Idris said the incentives were not provided this year and that had helped reduce the rate of suspicion. However, the Local Immunisation Officer, Alhaji Husaini Alhassan, debunked their claims by presenting to them, a packet of balloons with whistles attached which he said were incentives for the children who would encourage others to participate.

‎At Kiyawa ward, the story was not any different as children could be seen taking the vaccines even though with loud screams. Aisha A. Sani, one of the CHEW recalled that the exercise was successful even though a father of five initially proved difficult. She said he bombarded the team with several questions and to which they willingly gave answers.

“It is only one person that tried to prove difficult but after our explanation, he went in and brought out his children, five in number and we gave all of them the injection. Initially he had hidden them when he got wind of the fact that we had come with the mission of vaccinating children between the ages of nine months and five years with the measles vaccine.‎”She said the suspicion and lack of trust ‎by parents can be tackled when more publicity and enlightenment is carried out in order to make the work of CHEW easier.

“Before we started giving the vaccines, we tried as much as possible to create awareness within the community. This is not the first immunisation exercise taking place in this community and yet people are still not so exposed to it until more enlightenment has been done. We do ours but I wish to call on the government to do more in terms of publicity before we come as this will ease our work.”

A mother, Zaliha Musa, whose children had just received the vaccine, could not hide her joy. Though she spoke in Hausa, Malama Zaliha said she has seen the benefits of measles vaccine as well as other vaccines over the years.
She said: “Even when we are unable to take the children to health facilities for immunisation, the health workers still follow us to our homes in order to ensure that our children get vaccinated. I am yet to see any child who got vaccinated for measles contacting the disease which I know is capable of killing a child.”

The Local Immunisation Officer, Husaini Alhassan in his remarks, said even though the exercise recorded a huge success within and around the state, there were some setbacks that if handled adequately, would add more colour in future success stories. He said more investment can be made and should be channeled in the area of requirement need. He said they include man power, provision of more drugs, especially anti-malarial drugs, as well as school uniforms which were promised without fulfillment.

He said: “government should provide all the requirements needed and this will help solve many of the problems encountered. Some of the requirements include the provision of more vaccine carriers as the ones available are not enough and cannot go round.”

The exercise in the state has recorded success. However, Nigeria cannot come out of the doldrums and proudly sit amongst the comity of nations that have succeeded in ending the measles malaise if listed challenges continue to spring up. Though on the right path, it is not yet ‘uhuru’ as investment and more investments are needed to end measles in Nigeria.