World Polio Day, Oct 24: ‘Any number more than zero is too much’

A slightly revised version of my article in The News on Sunday on Oct. 23, 2016, posted here with additional links and photos. The world watches as the last three polio endemic countries strive to relegate the crippling virus to history

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Polio survivors Ramesh Ferris and Minda Dentler share their experiences – and dreams about a polio-free world. Photos: Beena Sarwar

“In 1955 Dr Jonas Salk invented the preventive vaccine. It is outrageous that 25 years later I contracted polio,” says author and global health advocate Ramesh Ferris.

Standing on his good leg, a crutch compensating for the paralysed one in braces, eyes gleaming behind black-rimmed glasses, Ferris passionately addresses the audience of about a hundred physicians, scientists and international diplomats. They include representatives from the world’s three remaining polio endemic countries — Pakistan, Afghanistan, and Nigeria.

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I am at an event titled “Polio Past & Present: Global Progress since the 1916 New York City Polio Outbreak”, at the historic New York Public Library on September 20, 2016, hosted by the World Health Organization, Center for Disease Control, the Bill & Melinda Gates Foundation, UNICEF, Rotary International, Global Citizen, and United Nations Foundation.

A hundred years ago, “polio season” paralysed and killed children every summer in America, I learn. A third of the deaths occurred in New York City.

“Children were not allowed to check books out from this very library die to fear of polio being contagious,” says Dr Richard Besser, Chief Health and Medical Officer, ABC News.

With the cause of polio unknown and no effective preventive measures, there was “fear and irrational actions,” comments Dr Tom Frieden, Chair, Polio Oversight Board and Director, US CDC. Aggressive vaccination and “a web of humanity” – technicians, health workers, and others working in tandem — enabled the West to end the disease.

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President Roosevelt: one of the most prominent polio survivors of the USA, where parents lived in fear for their children until the polio vaccine began being administered.

But “things may be happening at local levels we don’t know about,” he says. Referring to the huge setback in Nigeria this summer, when the detection of three children with polio dashed the country’s hopes of being declared polio-free, he notes that those children “have a strain of polio we didn’t know about, that has been around for five years”.

Over in India in 1980, Ferris’ impoverished mother, unable to care for her year-old crippled baby, left him at an orphanage in Coimbatore. A Canadian family adopted him soon afterwards.

Abandoned “on the street in Bombay” at three-years old, Minda Dentler similarly gained a new life after an American family adopted her. Polio had paralysed both her legs. Her adoptive family, all athletes, encouraged her to participate in sports. Dentler went on to become an award-winning wheelchair para-triathlete and the first female hand-cyclist to complete the Ironman World Championship in Kona, Hawaii.

“In 2015, my daughter Maya was born,” she says, muscular arms resting on two crutches. “…I want to see a polio free world.”

Like Ferris, she has “endured” (her word) multiple corrective surgeries. Thanks to medical facilities in their adoptive homes they can lead fulfilling lives despite the difficulties. They know that polio survivors in their country of birth are not as fortunate.

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Ramesh Ferris and Minda Dentler present a placard to DG WHO Dr Margaret Chan.

Ferris has met many on his travels to Pakistan, India, and Afghanistan as part of his awareness raising work. He also met his birth mother. Had she not left him at the orphanage, he says, he would have been like the polio cripples he met in Coimbatore. With no recourse to corrective surgery or prosthetic limbs, they can’t do “anything other than crawl and beg”.

“It’s not just about funds,” says the shaggy-haired, broad-shouldered Ferris. “I’m calling on all global citizens to tweet, post, hold their governments accountable.”

At the New York event, the mood is celebratory. The world has never been, as Director General WHO Dr. Margaret Chan says, “so close to eradicating a disease since smallpox in 1988”.

A panaflex-covered wall provides a pictorial chronology of the history of polio. A live jazz band belts out swinging ambient sound as attentive wait staff go around with trays of canapes.

“Fifteen million children have escaped polio due to being vaccinated,” says Dr Chan. “But we are not over the finish line yet.”

The world waits for three countries to cross that line. Their representatives sit together on the low stage, taking turns to speak — Dr. Isaac Adewole, Nigeria’s Minister of Health; Hamdullah Mohib, Afghanistan Ambassdor to USA; and Raja Ali Ejaz, Consul General of Pakistan.

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Dr Richard Besser introducing Dr Chan and representatives of the world’s remaining polio endemic countries

Dr. Adewole shares his devastation on July 4, 2016 when Nigeria discovered three new cases of polio while preparing to celebrate two years of being polio-free. Learning about the past and the “support from the international community”, he says, “has re-energized me for the future”.

He hopes that Nigeria will apply the lessons learnt from its successful eradication of Ebola. Foremost is the need for “political commitment”. There is a need to “build bridges with tradition and religion and to use all available resources as Nigeria is doing – “soldiers, nurses, regional network, neighbours” – to fight polio.

“We are dreaming of a day we can teach our colleagues in Pakistan how to do it,” he says.

Afghanistan has less than 10 cases of polio, but as Ambassador Mohib notes, “any number more than zero is too much”. His country will, he says,  “continue to cooperate with Pakistan to eradicate polio”.

Raja Ali Ejaz reaffirms Pakistan’s “unequivocal commitment” towards this goal. He talks about the “national consensus in Pakistan to uproot this disease” and lists those complementing government efforts — civil society, religious leaders, media, health community and “people from all walks of life”.

As a result, Pakistan has drastically reduced polio –14 polio cases detected this year, down from 34 in 2015, a 59 percent decline. The number of districts reporting polio has dropped by almost half, from 44 to 23.

“The last mile is often the most difficult,” to quote Dr Chan. But if this rate of progress continues, the hope that in our lifetimes we’ll be able to say we live in a polio-free world, may well become reality.

As the evening draws to a close, I run into a young woman in shalwar kurta and start talking to her. She is a 25-year old youth leader named Sufi Mujhgan Nazish, from Peshawar. She works with frontline vaccinators, monitoring and reporting on polio vaccinations with a monitoring group called Icon. The non-profit Global Citizens that works to achieve sustainable development goals (SDGs) on health, education, hunger, water, sanitation has invited her to a summit in New York.

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Pakistani youth activist Sufi Mujhgan Nazish from Peshawar with Ramesh Ferris.

She tells me she did her Bachelors in International Relations at Peshawar University, and is now planning to enroll in journalism. When she draws attention to children who haven’t been vaccinated, she says, the local agencies don’t feel too happy. But we have to keep pushing, she says. “Why 2030 to end polio? Let’s aim for earlier.” she adds with conviction.

It is young people like her in Pakistan, bolstering government efforts to eradicate the crippling disease, that give me hope.

 

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