Par Natacha Ikoli
KAGANGA, Democratic Republic of the Congo, 21 June 2012 – Since 2010, the Democratic Republic of the Congo (DRC) has had 193 polio cases.
The disease, which affects the nervous system, can lead to paralysis and lifelong disability. All this can be prevented with only two drops of the oral polio vaccine. Yet DRC has high rates of vaccine refusal.
|UNICEF reports on efforts to reduce vaccine refusal and increase vaccination coverage in the Democratic Republic of the Congo. Watch in RealPlayer|
Vaccine refusal contributes to polio’s spread
DRC almost achieved polio-free status in 2005, but the virus re-entered across the Angolan border in 2006.
“When the virus re-emerged, people’s immunity was extremely fragile,” said Dr. Granga Daouya, a UNICEF immunization specialist. “The disease was able to spread fast throughout the country. Despite the many campaigns to immunize the population, the virus continued to claim victims.”
Vaccination refusal contributed to this fragile immunity. Refusal often occurs because people don’t understand the value of immunization or because they have heard rumors of harmful side effects. In some regions, resistance is largely based on cultural and religious beliefs.
“One of the biggest obstacles to eradication is the difficulty of reaching people from a geographical and a religious standpoint,” Dr. Daouya said.
Marco Kiabuta is a religious leader in Mukwaka, a remote village in northern Katanga. He has an unswerving belief that the polio vaccine is unnecessary for his followers. “We have our faith as a protection… We are not refusing the vaccination because we think it’s a poison but we don’t need it because we have only one doctor within us and it’s God,” he said.
Mr. Kiabuta is a charismatic man and his message against the polio vaccine is widely followed.
|© UNICEF DR Congo/2012|
|Polio resurfaced in the Democratic Republic of the Congo in 2006. In an effort to eradicate the disease by 2015, UNICEF and its partners have placed a particular on focus on engaging communities to increase immunization coverage.|
Distrust of healthcare services
Distrust of healthcare services and conspiracy theories have also contributed to skepticism about vaccination.
In Kimvula, Etienne Makiadi Mafuta is a civil servant who enjoys taking computer classes at the Kimvula vocational training center. He also has eight children, two of whom still live at home with him. The other six have gone to study in Kinshasa.
Mr. Mafuta used to refuse polio vaccination for his children. Quinine, a malaria medication, is given based on the weight of the child, he would say, so why isn’t the vaccine administered the same way? For a while, he wondered if vaccines given without consideration for a person’s weight could be fatal, perhaps contributing to Kimvula’s mortality rate.
Engaging the community
Engaging the community is key to putting an end to vaccine resistance and misinformation. Traditional leaders are being engaged to promote vaccination in their communities. Health workers are also mapping refusal, which enables targeted advocacy.
Outreach workers are learning active listening techniques, which enables them to address the concerns of resistant leaders. Other outreach activities include public debates with the participation of whole villages, street theater, door-to-door counseling, and radio and television public service announcements.
|© UNICEF DR Congo/2012|
|A young man receives a polio vaccine in the Democratic Republic of the Congo. Since 2010, the country has had 193 polio cases.|
These efforts are having an effect
UNICEF Communication for Development Officer Astrid Nsunka Muzita said that community mobilizers have raised awareness among leaders. Sustained advocacy, partnering and community participation have helped change attitudes about vaccination in many previously resistant communities.
Kimvula’s traditional chief regularly brings together parents in his compound to have an educational chat. During these sessions, parents can ask questions and express their concerns. Once they are at ease with polio vaccination, parents often start raising awareness about the importance of immunization in their communities.
After Mr. Mafuta spoke with a community mobilizer and engaged in debates with his community leaders, he came to understand the effectiveness and importance of immunization.
“It’s only after the counseling that I accepted to give the vaccination to my children…In fact I was the first one to take the vaccine,” he recalled.