The cost of arms, legs or life itself

Polio is one of the nastiest diseases humans have known. It’s a highly infectious and devastating disease caused by a virus, poliovirus, and most severely affects children. A number of infected patients develop severe, irreversible paralysis, and a few of them even die due to the paralysis. But many of those who survive live extremely traumatic lives under severe physical paralysis. The virus enters the body through the mouth, and multiplies in the intestine, and is constantly emitted through feces, from where it spreads across communities.

It used to be endemic to most of the world, but years of worldwide efforts have eradicated this disease from most of the world. But only most of the world.

It remains a major problem in 9 countries. What’s common between them all? Extremely high populations living in relatively squalid conditions, in extreme poverty. And the sub-continent, especially India and Bangladesh, remain at the very heart of the disease.

The New York Times has a rather extensive article on the disease.

……Nearly 18 years ago, in what they described as a "gift from the 20th century to the 21st," public health officials and volunteers around the world committed themselves to eliminating polio from the planet by the year 2000. Since then, some two billion children have been vaccinated, cutting incidence of the disease more than 99 percent and saving some five million from paralysis or death, the World Health Organization estimates.
But six years past the deadline, even optimists warn that total eradication is far from assured. The drive against polio threatens to become a costly display of all that can conspire against even the most ambitious efforts to eliminate a disease: cultural suspicions, logistical nightmares, competition for resources from many other afflictions, and simple exhaustion. So monumental is the challenge, in fact, that only one disease has ever been eradicated — smallpox. As the polio campaign has shown, even the miracle of discovering a vaccine is not enough…….
…………….Teams like the one that faced scorn in squalid warrens of Bareilly have made repeated sweeps in the state of Uttar Pradesh, home to 180 million people, which Dr. Cochi of the Centers for Disease Control describes as "historically the center of the universe for the polio virus." (bold fonts, my own).

In case someone reading this thinks it’s the NYTs usual case of India-paranoia, hold your horses. It’s all true, and it remains a great shame that India (like all other affected countries. From what I’ve seen (and heard about, from health-care workers), there’s little journalistic hype in this article.
Dig through the mountain of data a little deeper, and you notice that the countries on the list of most affected countries are Nigeria (by far the worst), Yemen, Indonesia, Somalia, India, Pakistan (here’s the full list), all Islamic countries. And in India, almost all the polio cases have come from Uttar Pradesh and Bihar’s slums, in Muslim dominated areas.

I’ve known a few health-care workers in India who worked (and still work) incredibly hard over the years fighting polio. Their job is thankless, and relentless, walking from house to house in slums, banging on doors and begging, pleading, cajoling or scolding parents to inoculate their kids against polio. Often, they feel they are talking to impregnable walls, that respond only by hurling abuse, or with stony silence. The minds of too many people (especially Muslims) in these slums have been brainwashed completely, often by religious "leaders".

".........."Please open up," pleaded one polio volunteer, Firoza Rafiq, outside the locked door in Bareilly during a drive last year. "We won't force you." The woman inside first shouted through a crack that she had no children, though a little girl had just scampered in....."

It's impossible to understate how well problems in these slums have been captured by that one line above. Years ago, I was part of a group taking a census in a slum (this one's in Bangalore, near Wilson Gardens), for a DPT/Measles/Polio vaccine drive. We'd knock on the door of a house, show our credentials, and ask how many kids were in the house, and if any one was pregnant (and if so, was receiving proper medical attention). It's amazing how often we heard answers that were blatantly false. There would be three kids clutching to a women who's obviously their mother, and who's obviously pregnant as well, while their father would, with a perfect poker face, say that they had just one kid, and that no one was pregnant in the house. Exaspereated, we'd ask about the other kids, and the father would say they were the neighbors, and just at that time, one of the (smaller) kids would rush up to him calling him "appa/abbu"! These are the kinds of odds faced by health workers in Indian slums.

It’s surprising how many people believe that the polio drops are not vaccines, but drops given (especially) to girls to make them sterile and incapable of having children. Other equally powerful rumors float around that these pills make boys impotent, and meek, and will make them servile. Yet other rumors insist that this is a western ploy to destroy Islam. And a lot of these rumors come from local religious leaders, who insist that this is a targeted government campaign to wipe out muslims. And why can’t these people learn from other muslim countries like Egypt or even the extremely poor Bangladesh, where very promising strides have been taken towards polio eradication?

What do they get out of it? Why were there riots in Nigeria during polio campaigns, where some health-workers were even hurt? HTF do people actually believe these rumors? Isn’t it reassuring enough when Amitabh Bachchan or Mohammad Kaif come on ads urging people to take this vaccine?
What will it take to eradicate this disease, when it’s not resources or availability of health-care workers or vaccines that is limiting?

(link to the Polio eradication website)