Polio in the 21st Century: Case of missed chances
Just as Kenya prepared to celebrate the health feat of becoming polio-free, the disease has reared its ugly head in the north, particularly in Garissa, where officials believe it has been silently ravaging the population for months now.
The northern frontier is a particularly troublesome zone for health experts as, because of its close proximity to Somalia and the role it plays as the first base for fleeing refugees, it is likely to also play host to a number of diseases, which then spread across the country and beyond as those refugees traverse the nation seeking a livelihood.
This time round it is polio, that dreaded disease that took a concerted global effort to tame, that has medical experts on tenterhooks.
Last week Kenya embarked on a five-day campaign, estimated to cost Sh500 million and targeting 22 counties, in a bid to complement previous efforts to keep the disease at bay by offering booster doses to all children under five years. Adults in Garissa and Wajir counties were also targeted for immunisation.
Somalia, the war-torn nation to the north of Kenya, is suspected to be the source of the current outbreak that has so far killed a 23-year-old man.
Twelve others have tested positive for the virus and are under state watch. While some four million people have been vaccinated, getting drugs to more than 600,000 children in southern and central Somalia — areas partly under control of the Al-Qaeda-linked Al-Shabaab who block vaccination efforts — is “extremely challenging”, the United Nations says.
While over 100 cases of children have been recorded there, “the fact that this number of children show symptoms of paralysis means that there are probably thousands more with the virus, who do not have symptoms, but are capable of spreading it,” the UN adds, the sentiments explaining the worrying situation Kenya now finds itself in.
Polio is spread by person-to-person contact, exacerbated by poor sanitation and a lack of clean water. What makes the disease a major global headache is that it has no cure, even though it can be prevented through immunisation.
Most victims (90 per cent) show little or no symptoms of infection and therefore go a long time untreated, even though the World Health Organisation lists fever, fatigue, headache, vomiting, stiffness in the neck, and pain in the limbs as initial symptoms.
And so, three years after Kenya became ‘polio-free’, a man has died within its borders of the disease. Were there any lapses? Could that death have been prevented? How about the thousands of religious fanatics who do not believe in the gospel of vaccination?
To answer those questions, we sought five Kenyans who are the personification of all that is wrong with this disease.
Their experiences, we hope, will inform the choices of everyone who reads this story and the actions of the men and women in whose hands the collective health and security of the nation are vested.
Kenyatta National Hospital staffer
His competitive spirit has won him admiration from colleagues at Kenyatta National Hospital, where he has worked for the last 19 years at the telephone communication services department.
Samuel was confirmed as suffering from polio at nine months when his parents noticed he could barely stand firmly and sought medical advice. He has thus lived with the disease practically all his life.
He studied at a special-needs primary school in Ol Kalou, Nyandarua County then proceeded to Njabini Secondary School, where he sat his KCSE exam in 1989.
He then joined Machakos Technical College, where he studied electrical and electronics engineering for two years before landing his current job at KNH.
“I had to accept my condition as a young boy so that the community would stop feeling sorry for me,” he says. He is married to childhood sweetheart Tabitha Wambui, even though “some wondered how such a beautiful girl could get married to a man who was physically challenged”.
The two have been married for 22 years and are blessed with three sons, aged 22, 18 and 12.
“I contracted polio at the age of four,” he says, “and I remember my life changed because I was no longer active and could not play with my peers.” What started as a weakness in the legs ended up rendering him immobile, prompting family members to seek medical help.
After years of speculation and medical theorisation, he was eventually informed that he would never walk again. And life took a bitter turn for him.
Upon completing primary school, he joined Lenana School, where he went through both ‘O’ and ‘A’ levels before enrolling for a Bachelor of Arts degree in Development Studies at Kimmage College for Development Studies in Dublin.
He is currently undertaking postgraduate studies at the same institution and has worked as an untrained teacher, is a Youth Advocate and, of course, a politician. He has been married to Dorothy Targok for 24 years and the couple have three sons; Hillary, 22; Dennis, 17; and Moses, 11.
News Producer, QTV
Mutegi contracted the disease at the tender age of seven months, just as he was out and about, learning how to crawl and walk.
“When, eventually, I started standing with the support of seats and tables, my aunt and mother noticed that my legs were weak and, after seeking medical attention, I was diagnosed with polio,” Mutegi says.
After secondary school, he studied broadcast journalism and investigative journalism at the Kenya Institute of Mass Communication and at the Africa Virtual University through Kenyatta University.
Then his breakthrough came in 2004, when he joined the Nation Media Group as a news reporter and graduated through the ranks to become the News Producer at QTV, the Kiswahili TV station of the Nation Broadcasting Division.
“There are varied versions of how I may have contracted polio, but today I choose to focus on ensuring that every child in Kenya gets vaccinated against it by sharing my story,” says the man married to Mercy Mutua and blessed with a one-year-old boy, Santa Gennaro Mukennia.
Hawker at Muthurwa
Like most businessmen at Muthurwa Market, James braves chilly Nairobi mornings to beat the city traffic every day and is at work by 6.30am. His wheelchair enhances his mobility and while at work at the hawkers’ market, he is a veritable health ambassador, grabbing every opportunity to urge all to take their children for immunisation.
He contracted polio at seven years and describes that moment when he learnt he would be wheelchair-bound as a “difficult phase”, especially because he could no longer play football with his friends.
“According to some of our family friends, polio was caused by witchcraft and, as a result, I was discriminated against because of my condition,” James told DN2 in an interview at Muthurwa Market this week.
He has struggled to make ends meet since he became of age, and even though the systems have improved of late to accomodate the needs of the disabled, he still feels more could be done to make his life, and those of many like him, a bit more comfortable.
“Life as a disabled person is very expensive and dehumanising, especially when accessing public utilities and using public utilities, but we face them bravely every day,” he says.
James is married to Nancy Wanjiku and the two have six children aged between 25 and nine years. “All my children have been vaccinated against polio because I believe that is very important,” he says. “I have worked as a hawker since 1992 in Nairobi and all my children have all studied using proceeds from this business.”
Bishop Jackson Kipkemboi Kosgei
Born in a family of 12 children, he contracted polio at the age of five, and from then on he endured myth after myth about the cause of his disability.
“Polio was associated with superstitious stuff,” he says. “For instance, someone once told me that it was caused by ancestors, who punished me because they could have foreseen that I would become a naughty boy and thus weakened my lower limbs.”
The Bishop is forever indebted to his mother, who defied calls from the community to throw him away as a baby to be mauled by wild animals due to his condition.
“My mother loved me unconditionally and treated me like any other child, introduced me to visitors and even reprimanded me whenever I was wrong,” he remembers. “This built my self-esteem and today I am quite outspoken, especially to families that have neglected or hidden their disabled children.”
Because the condition was discovered too late, it affected his schooling debut, and so the man eventually joined Standard One aged 20.
With his eyes fixed on a dream, though, he made it to high school, graduating in his time among the top performers from Kabarnet Boys High School then proceeding to Pan-African University to study Education, Social Science and Theology. “Polio is a disease that only affects the muscles, not the brain,” he explains.
“Thus I chose to exploit my potential to the fullest despite my physical condition.” He met his wife Rose while serving in church and the two are blessed with four children, one of whom is gospel artiste Emmy Kosgei.
Israel struggles with similar outbreak
Even as Kenya struggles to contain the current crisis, a rare outbreak of the polio virus spread through northern Israel this week, forcing Tel Aviv to begin a nationwide campaign to inoculate children with booster drops.
The World Health Organisation Wednesday reported that the polio virus had been detected in sewage systems in southern Israel a few months earlier, and that since then the health ministry had been vaccinating children from the area using a dead version of the virus which prevents infection but allows carriage of the virus.
“WPV1 has been detected in 67 sewage samples from 24 sampling sites in Israel, collected from February 3, 2013 to August 4, 2013,” the global health body said in a statement dated August 15.
Early this month the WHO issued a stark travel advisory, warning tourists to make sure they were properly vaccinated before visiting Israel.
The polio strain discovered in southern Israel several weeks ago is believed to be identical to the one prevalent in Pakistan.
“It is important that all countries, in particular those with frequent travel and contacts with polio-affected countries, strengthen surveillance for cases of acute flaccid paralysis in order to rapidly detect any new polio virus importations and facilitate a rapid response,” the global health body warned in a statement early this week.