Can the world beat polio?

ABUJA, Nigeria — In the United States, polio mostly lives in the memories of grandparents. In Nigeria it is everywhere.

A Nigerian word for “crippled person,” in fact, is synonymous with polio.

And while the rest of the world celebrates the near-extinction of the disease, health officials warn the rise of polio in Nigeria this year could lead to a surge in other countries. 

“If we don’t complete the job, polio will come back and there will be many, many cases," said Frank Mahoney, chief health officer for polio response at the Center for Disease Control.

At a market in Abuja, Nigeria’s capital, 20-year-old polio victim Umar Mahmoud pushed himself around on a makeshift skateboard, calling for spare change to pay for food and, maybe one day, school fees.

“If somebody helped me, I would continue with my schooling,” he told GlobalPost. “I would forget this begging.”

Mahmoud said he would settle for enough money to buy lunch. 

That same day in late October, a world away in New York, billionaire philanthropist Bill Gates had a more hopeful message. He called on world leaders at the United Nations to renew their commitment to polio eradication. With another $2 billion, he said, the disease could be a thing of the past in just a few years. 

“We think we're only maybe two or three years away from no child being hurt by this disease,” he said at the time. “Then you watch and make absolutely sure, and then by 2018 we'd have the certification that this, like small pox, is the now the second disease to ever be eradicated." 

Donations for polio eradication have increased since Gates’ call and Nigerian President Goodluck Jonathan has vowed that his administration “will not sleep” until the disease is wiped out. But Rotary International, an aid group, says the funding gap remains in the hundreds of millions of dollars.

Ninety-nine new cases of polio have been reported in Nigeria in 2012 so far — more than in the rest of the world combined, according to The Global Polio Eradication Initiative. In the first 10 months of 2011, Nigeria had less than half as many polio cases. Afghanistan, Pakistan and Chad have also reported cases this year, but far fewer than in 2011. The disease can kill or cripple but can be prevented with a vaccine. There is no known cure.

John Campbell, a senior fellow at the Council on Foreign Relations and a former US ambassador to Nigeria, told GlobalPost that the vaccine is available in northern Nigeria, a primarily Muslim region where most of the victims are found. But families often refuse to vaccinate their children, he said, because they’ve been told the process was dangerous, a possible plot to kill Muslims by Christians and the West.

"A team administering the polio vaccine might work a street,” he said. “When the local residents hear the team is coming, they start handing particularly their male babies out over the back fence so they are not there when the polio workers arrive."

Campbell said that vaccinations are also hindered by the presence of Boko Haram, a local militant group.

“Boko Haram” roughly translates to “Western education is a sin,” a nickname given to the group because it was founded by a man who preached against the excesses of the West. Campbell said this ideology intensifies distrust in vaccine programs.

Insecurity in the areas where Boko Haram operates also prevents vaccination teams from reaching out, he said. In the past three years, Boko Haram has attacked churches, schools, security forces, media houses, government buildings, communications infrastructure and the local UN headquarters.

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Mahoney, from the Center of Disease Control, said that while threats against health workers have contributed to the rise in polio, the difficulty of reaching remote, transient communities is also a factor. Nomadic communities, he added, are likely to cross international borders and spread the disease.

“It moves with the people that are infected with the virus,” he said. “Somebody within that group of people would be infected with the virus and they carry that virus to the area where they are moving to.”

The few nomadic groups the Nigerian government has reached have been receptive, Mahoney said. 

Tashikalmah Hallah, a spokesperson for the minister of health, said the government is also working with local leaders to convince other communities that vaccinations will not harm the children.

“There are some that still reject it,” he told GlobalPost. “But on this issue, with the help of traditional rulers as well as religious leaders within the communities, that case of rejection has gone down."

At the market, two of Mahmoud’s friends spoke about their own struggles with polio. Mohammad Shehu said he was diagnosed with the disease when he was 4 years old. Since then, he has pushed himself around on a wheeled wooden plank with plastic flip-flops on his hands. Bilani Shehu stood nearby on one good leg, propped up with a crutch. He said he goes to school when he is not begging.

A few feet away, Mohammad Aliyu sold prepaid mobile-phone cards from a metal tricycle he built himself. When a nearby mosque rang with the call to prayer, Aliyu lowered himself onto another slab of wood with wheels and rolled off to pray.

“I had 10 years in this world before becoming sick,” he said. “I’ve had maybe 30 years like this.”