Mother of polio-affected girl opens doors to vaccination – and helps rid Nigeria of polio for good
Hafsat may not be able to read, but she never forgets a name, or a child. Her own tragedy was too great.
"Where are Hassan, Hassana and the other kids?" Hafsat asks the woman of the house from the doorway.
"Hassana is in, but Hassan is outside,” says their mother.
"Please call him, and also call Adnan, Walesa, Rahinatu and Hussaina.” Hafsat wears a UNICEF-blue hijab to cover her hair, and to make her easily recognizable as a Volunteer Community Mobilizer (VCM) in Kano where she lives with her ten children.
Hafsat knows every child below the age of five by name, in each of the 220 households in her settlement. She knows every newborn baby. She knows the vaccination status of every pregnant woman. And, most of all, she knows whether each and every one of the children in the settlement has been vaccinated against polio.
Hafsat is in the northern Nigerian State of Kano. Many children do not receive the polio vaccine here: an average of 5% of children in the State were missed in the last four campaigns. Sometimes children are missed because parents misunderstand and therefore fear the vaccine, and refuse to allow their to children take it. Sometimes they are missed because vaccinators don’t know the exact number of eligible children in each household.
Whatever the reason, irreversible paralysis surfaces in one child out of every 200 children that are infected with the virus.
In this case, it does not matter that Hafsat cannot read. She understands this statistic – “one child out of every 200” – better than anyone. She understands it in the way only a mother can, because Hafsat’s own daughter was that “one child.”
Hafsat believes that her daughter now six years old, went unvaccinated because the vaccinators did not know how many children in her household were eligible to receive the vaccine. She believes that her small daughter has polio today because the vaccinator did not know to ask for her by name.
And that is why Hafsat now walks along the hot, dusty tracks between the houses in her settlement, knocking on door after door and calling each child by name.
“You know why I am here?" Hafsat asks at another doorstep.
"Yes, it’s about the polio eradication campaign," says a young mother with a baby at her hip.
"You still don’t accept the vaccine?" Hafsat’s smile fades.
"No, he doesn’t allow us to." The woman’s face is regretful, but her husband’s wishes are clear.
Hafsat doesn’t give up. She speaks about some of the misunderstandings that the family may have about the vaccine. Then she says:
“Do you know that, to go to the Holy city of Mecca from Nigeria, you have to be take polio drops, since Nigeria is a reservoir of the virus?”
Mecca is the holiest site in Islam, the place toward which devout Muslims unroll their prayer mats to pray five times a day. It’s unlikely that most of the children in this poor, remote part of Kano will be able to make the Hajj, the pilgrimage that is seen as a pinnacle in the life of a Muslim. Still, to argue with what is required to go to Mecca would be unthinkable.
The woman is silent. Maybe she will tell her husband what Hafsat has said, but it is clear that the decision about vaccination is not hers to make.
It’s a strange balance. Hafsat herself must rely on the endorsement and approval of her work by religious and other local authorities – most of whom, in the hierarchy of this part of Nigeria, are men. And yet, without women like Hafsat who can literally “get a foot in the door” – in a place where many women would never open the door to a man – the effort to end polio in Nigeria wouldn’t have a chance.
Hafsat can’t take back what happened to her daughter. But since she began her work, Hafsat has reached 56 more households than the vaccination team used to reach. Thanks to her, 159 additional children now receive the polio vaccine in this high-risk settlement.
Earlier this year, a deteriorating security situation and the tragic deaths of vaccination workers made it necessary to suspend vaccination activities in Kano State. For two months, whole communities went unvaccinated. Fortunately, activities have now been reinstated in Kano, with a vaccination campaign carried out in April 2013.
Now, across Kano State, 557 VCMs like Hafsat again knock on doors, as part of the on-going polio communication campaign. There are nearly 2200 VCMs working in eight high-risk States in Nigeria, with plans to scale up the project this year.
In the meantime, Hafsat continues through her day. She walks down the hot, dusty street. She knocks on doors. Sometimes, when the doors are opened, she will hear words like “He won’t let me.”
But always – always – she will persist.
by Priyanka Khanna and Jasmine Pittenger UNICEF
(Some names have been changed.)