DR Congo

In the Democratic Republic of the Congo, a powerful ally in the fight to end polio: Part 3 - The owl approach

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.

Southeastern Democratic Republic of the Congo, 2 April 2013 – We whisper like thieves as we enter the Kadima mission at night through the palms, their spiky shadows projected on the ground in the light of the moon. An Armed Kitawala named Kitobo leads the way, silent and barefoot. He guides the group away from the homes, and away from curious eyes.

Two plastic chairs are the scene of the field operation. The health centre nurse prepares vials of polio vaccine, some vitamin A and de-worming tablets. One by one, parents come out of the dark night. They carry children, sleeping babies, little ones still half asleep.

One by one, the children step into the light of a torch, open their small mouths and receive two bitter-tasting drops that have been the subject of much negotiation. A few murmurs are exchanged, and they disappear again into the night.

By this strange, secret routine – so hushed and cautious that you’d think it must be illegal – more than one hundred children are vaccinated.

PP2, short for Pastor Paul II, is the leader of the Filadelphie Kitawala sect – and the man behind the secret night vaccination. After years of awareness-raising and negotiation with UNICEF-supported social mobilizers, PP2 is now in favor of the polio vaccine, which he had previously advised his followers to refuse.

His one caveat: The vaccination must be carried out at night, so as not to attract attention of those among his followers who do not approve of the vaccine – or of anything that comes from the West.

PP2 is also conscious of his image, and does not want the village near his mission to think he has ‘yielded’. He and his followers are different, he says: “We are the ones they call the owls, nocturnal. Our business is made in parentheses. The owl is a bird that flies always at night. It eats at night. It escapes the sun.”

Vaccination in whispers, and in the dark of night: These are the terms of the ‘owl approach’.

PP2, who is venerated by his followers with the title of the Elephant King, is full of contradictions. Is he a leader with a real vision who places children’s well-being at the centre of development, or is he a leader with an eye to his own power? Whatever the case, PP2 is indispensable. Without him, there will be no vaccination.

“Let me alone go into the missions, I say. If you enter, they will not listen, not even to one thing, because the dog listens only to his master. If you are not the owner of the dog, it will bite you or it will bark and run. All these stories, those who accepted the vaccine and those who have not accepted are all my people. Patience. Or take us all and put us in a tank or a plane and throw us in the ocean. And all problems will be over.”

Some of PP2’s followers, and those of other faith groups nearby, still do not agree with PP2’s openness to the polio vaccine. Katanga Province, where the mission is located, has a high refusal rate for polio vaccine. A staggering 50 per cent of unvaccinated children here actually have access to the vaccine.

Here, a follower of another local religious group refuses the vaccine, despite a long talk with a social mobilizer. She claims her right to die, even as the mobilizer explains that her refusal of the vaccine can affect other people in the community, and that polio is often not lethal but could instead leave her paralysed.

Building dialogue with communities in pockets of resistance like this one is vitally important. These so-called ‘polio sanctuaries’ threaten to allow the virus to re-circulate, even as the world is closer than ever to ending polio for good.

A vaccination team discovered this boy with acute flaccid paralysis in a nearby village. They brought him to the Songa health centre to be tested for polio. Here he waits on his father’s lap.

Even in places where vaccine refusal rates seem low, small clusters of non-compliant households continue to spark outbreaks of polio among under-vaccinated children. In other pockets of resistance, like those in Nigeria’s Kano and Sokoto States and Pakistan’s Quetta block, more than 60 per cent of new polio cases in 2012 were among families who refused to vaccinate their children.

In high-risk areas such as these, as well as in Katanga, families are in need of intensified social mobilization efforts and increased resources.

Vaccination in this Filadelphie Kitawala mission may be carried out by night, for now, but awareness-raising efforts continue. During the launch of the vaccination campaign for the Kabalo health zone, a traditional dancer enacts the innocent surprise of a child who finds himself paralysed by polio.

The initiative to eradicate polio is the largest non-military enterprise in human history. Globally, it brings together dozens of international organizations, governments all over the world, tens of thousands of health workers and millions of volunteers.

But this gigantic undertaking is built on local successes, such as at Kadima mission. These successes are often the result of long, patient dialogues like the one carried out with PP2 – and through him, his followers – since 2009.

Step by step, dialogue with communities and influential leaders can help relegate polio to its rightful place, next to smallpox, on the list of diseases that were once devastating – but that humankind has finally overcome.