Polio in Burundi

The last couple of posts got a bit negative.   So, some good news.

Went out with the team for a drive today, along the lake to the nature preserve.  (Hippos, crocs, lots of birds.  More perhaps in a bit.)  Ended up at the Congo border, which is just over half an hour from town: hey look, there's the eastern Congo! 

Okay.  While going along the road, we passed hundreds of people on bicycles.  (Made in China.  Note that by Burundian standards, a bike is about as big an investment as a nice car would be for most readers here.)  And at least four times, we passed people in something different: hand-powered tricycles.  Three of these were being pulled along behind bikes (though they were providing auxiliary power with the hand cranks) while one was moving alone -- not very fast, but getting there.

The first time I saw one, I said, "Huh?"  Second time I looked more closely, and spotted the rider's withered legs.

By the fourth time, I was ready to ask our driver.

Yep: polio.

The driver said that polio had been a big problem in Burundi once, but that this was "vingt, treint ans devant".  Did people get polio now?  Non, non.  Tous les gens sont vaccinee?  Oui, oui, vaccinee.

(I wonder about the hand-crank-trikes.  Funded by donors?  Good chance.  Designed by donors, or by Burundians?  They did have that ramshackle-but-indestructible look I'm starting to associate with certain aspects of local manufacture.  Don't know.)

I know that polio has almost been eradicated worldwide.  (Not quite.  Soooo close.  It's really hard to finish the job, but they're still trying.)  But Burundi is the sort of place where it might still lurk.  So, when we got back to the hotel, I broke out the google...

...and, yes.  Last case in 1999.  There was a big wave of childhood inoculations that year (carried out despite the continuing civil war) and another one in 2002 (ditto).  They seem to have killed it off for good.

At least in Burundi.  Take a look at this map.  You can see how the virus keeps trying to reintroduce itself across Africa from its surviving stronghold in Nigeria.  There are only four countries left where polio is endemic, but because it can produce asymptomatic carriers, there are more than a dozen countries where introduced cases keep popping up.  There were several introduced cases this year in the Congo... just across that border we saw today.  So, the war isn't over.

But consider these figures: in 1980, Burundi had about 50,000 cases of measles.  In 2000, they still had 18,000.  Last year they had 43. 

Whooping cough, 10,000 in 1980, 72 in 2000.  Not one case since 2004.

Neonatal tetanus, bad records before 1990, but just 14 cases last year.

(All figures taken from this table,  which is one of the more cheerful things I've looked at since arriving here.)

I can't imagine how these campaigns were conducted in the middle of a decade-long civil war, but somehow they were, and they worked.  Donors may have provided the vaccines and the funding, but at the end of the day, this work was done by Burundians putting needles into the arms of other Burundians.  It boggles the mind a bit to think of it... even without the civil war, the difficulties ranged from nonexistent infrastructure -- no electricity!  no roads! -- to simply convincing millions of illiterate farmers to allow needles to be stuck in their kids. 

So, let's hear it for the vaccine people.   

I don't know what to say beyond that, so I'm going back to writing my report now.

[Update: Noel Maurer adds more details, with graphs and links.]

Comments

[Natalie]

And if there is any reason to despise Jenny McCarthy and the rest of the anti-vaccination crowd, this would be one.... (Sorry about the dip into rabid bug-eyed spewing, but that's a hot button for me.)

Love to hear more, thanks for the posts. You realize that you are making me want to go to Africa even more...

[Random African]

And it's not Nigeria, it's Northern Nigeria.
They have their own religious issues with vaccination.