DR Congo

In the Democratic Republic of the Congo, a powerful ally in the fight to end polio: Part 1 - Meeting the Elephant King

PP2 is a charismatic pastor of the Kitawala Filadelphie sect in the Democratic Republic of the Congo. In the past, he has counseled his followers to refuse vaccination against polio. Recently, he has begun to change his approach.

But the road to acceptance has been neither short nor easy. From hours spent passing a Swahili Bible back and forth in search of the final word on vaccinations to a surprising decision to send young members of the sect away for medical training to secret vaccinations in the dark of night – we trace, in this three-part series, the path of an unlikely alliance with a man who calls himself the Elephant King.

On the day he fell, Little Mandela woke up in perfect health. The 8-year-old went to the village school. He played football with the other kids. But, on this day, Little Mandela’s legs – the legs of a boy named after a great African hero – stopped working.

When told that Little Mandela’s sickness was polio, and that it was incurable, his parents took him to see a local mystic. The mystic said he would cure the boy. He dug a hole in the ground. He buried Little Mandela up to his hips, in an upright position, with the trunk of his small body in the open air. He left Little Mandela like that, half-buried, for a month.

High rate of refusal

The southeastern province of Katanga, Democratic Republic of the Congo – where a grown-up Mandela now tells his story, hoping it will encourage parents to immunize their children – has a high refusal rate for polio vaccination. A staggering 50 per cent of unvaccinated children here actually have access to the vaccine but are exposed to polio because their parents refuse to let them take it. This decision is heavily influenced by local religious leaders who misunderstand, and, therefore, fear, the vaccine.

It is in pockets of resistance like this one that polio often attacks today. In 1988, 350,000 cases of paralysis resulting from polio were reported worldwide. In 2012, only 222 cases were registered. Of 39 genotypes of the virus, there are now only four. Fantastic progress has been made possible by an effective vaccine and coordinated international efforts.

Yet, a few countries are still considered high risk. So-called ‘sanctuaries’ for the virus have been created by large pockets of unvaccinated children in the tribal areas of Pakistan, southern Afghanistan, rural Chad, northern Nigeria and southeastern Democratic Republic of the Congo. These pockets threaten to bring the virus back into circulation, even as the world is closer than ever before to wiping it out. Polio has disappeared by 99.9 per cent. But it is the remaining 0.1 per cent of the work that is the most difficult, the most expensive – and the most important.

Direct strike at fears

Today, in Katanga’s Tanganyika District, Little Mandela has grown into Papa Mandela. He is now 30 years old, yet his body still seems split in two. His trunk is massive, the result of years of pulling himself on crutches to all the places his legs cannot take him. His legs are like ghosts. One imagines them, rather than sees them, in jeans that seem to float, empty, on his body.

Megaphone held tightly in his callused hand, Papa Mandela speaks before a crowd. His voice is warm and sad at the same time. His words aim at the greatest fears of his audience: the fear of whites, of outsiders, and of their intentions.

“In any case, my dear brothers and sisters, do not hide your children by saying this vaccine kills. If the white man wants to kill us, he’ll kill us anyway. Does anyone eat food without salt here? Whoever eats porridge without sugar? If whites want to kill you, they will poison you, because there is nobody who can eat food without salt. Is it not so?

“We gave you the mosquito nets. They were white, but the mosquito nets you accepted. Agree to vaccinate my little brothers and sisters – this is the only thing I ask!”

The Elephant King

Tanganyika District overflows with groups that oppose vaccination. To their detractors, they are cults. To their followers, they are churches. Either way, these spiritual groups are ubiquitous in local life. Some are the size of a village. Others group together several religious leaders, or pastors, and have many thousands of fervent followers. The Kitawalas are one such group.

Absent in the crowd listening to Papa Mandela on this day are the pastors themselves, whose teachings have a huge influence on the day-to-day decisions of their followers. Pastors, that is, like PP2, a colorful and influential leader of the Kitawala Filadelphie sect with whom UNICEF has forged an unlikely alliance in the fight against polio.

PP2, whose name is short for Pastor Paul 2, calls himself the Elephant King. At 54 years of age, he is the highest authority of the Kitawala Filadelphie movement, and everyone feels it. His every move is scrutinized, his word is respected, and his entourage is totally dedicated to the daily care of the elephant.

The Kitawalas follow a doctrine that rests on: a deep mistrust of Western civilization; a resistance of anything that comes from the Congolese State; and ‘life according to nature’, in which Jesus’ way of life in biblical times is seen as both a guide to daily life and a reason to protect against the intrusion of the modern world.

Kitawalas do not vote. They do not send their children to school. They do not use modern medicine, preferring the virtues of home brews and prayer. They reject technology. The most radical among them do not wear shoes or belts because the buckle signifies iron, which signifies the white man – which, in turn, signifies the suffering of the Congolese at the hands of the West.

Upon taking power, PP2 was opposed to vaccination in general, and to vaccinating against polio in particular.

“I refused the vaccine because of God. In the Bible, Matthew speaks of King Herod. He had learned that a baby king was born in the country, and he went into the hospital. He went there to kill all children aged 0 to 5 years. Book of Matthew, chapter 1, verse 1–50.

“At the time we saw polio occur in the hospital, we also saw the polio vaccine coming here for free. The vaccine is also for children from 0 to 5 years. How can we explain this?”

Making contact

PP2 was first approached by UNICEF in 2009; he had never before been in contact with health authorities. It took many months to gain PP2’s confidence, and to understand both his doctrine and its foundations. The Elephant King was fierce in his beliefs, but open to dialogue. Along the way, he shared more about why the group was refusing the vaccine.

“In 1880, when the Church came, they told us to stop our practices of natural medicine and bloodletting. The whites told us, ‘Stop using medicines to protect you. Stop protecting yourselves. The only great healer is God.’

“So we took our methods and we threw them out. After we’d thrown out everything, the white man came back to tell us: ‘Come, this time I will give you medicine to protect you.’”

The Kitawalas deeply mistrusted a vaccine that was both approved by the Congolese State and produced in Europe. Their fear was fed when mass immunization teams marked numbers on houses to show how many children had been vaccinated there. The Kitawalas cited the Apocalypse and the marking of homes. They called it ‘the mark of the beast’.

Armed with a stronger understanding of the Kitawalas’ fears, the local team – made up of a community mobilizer and the area’s chief doctor – shared their perspective with PP2. A long discussion began, one that revolved mainly around the role of divine will in the death of children. Did God want human beings to step aside while children died or were paralysed? Or might God approve of a little help from a vaccine?

A Swahili Bible was passed from hand to hand for hours at a time, over the course of months, as PP2 and the community organizers discussed the question. But even as PP2 himself became more open to the idea, he warned of the challenge: Changing the attitudes of thousands of people born into the Kitawala doctrine would never be easy.

Part 2 of this series will explore a ‘Trojan horse’ strategy.