Lagos — About 600 Nigerian children have been crippled by poliomyelitis and Bauchi State presents the highest polio cases in the North eastern part of the country leaving 313 children crippled in a single community of Azare, a local government identified to have the highest concentration of the virus in the world. This is no doubt the reason Bauchi State government is stepping up the fight against the debilitating disease.

The growing trend of polio cases in Nigeria which currently rank the country first in the world and with over 80 per cent of the global cases is worrisome. Nigeria is ahead of Afghanistan, India and Pakistan. And it is equally more disturbing that the North accounts for over 80 per cent of the debilitating disease in Nigeria.

However, the recent visit to Nigeria by Mr. Bill Gates, co-founder of Bill and Melinda Gates foundation, where he visited the Sultan of Sokoto and met with State Governors in Abuja is said to be yielding a positive result. The meeting resolved that state governors and local government chairmen in the country should take ownership of the project which means that the programme will no longer be a ceremonial event where wives of Governors flag-off the Immunization Plus Days (IPD) rounds.

The fact is obvious that today polio is still in Nigeria and can paralyse a child, so obvious that even by the end of 2008; Nigeria is identified as the highest producer of The Wild Polio Virus (WPV) in the world. 600 Nigerian children have been crippled by poliomyelitis and Bauchi State presents the highest polio cases in the North eastern part of the country leaving 313 children crippled in a single community of Azare, a local government identified to have the highest concentration of the virus in the world.

This statistics portend danger not only for Bauchi State and Nigeria, but the global effort to eradicate the virus. In May 2007, a new government emerged in Bauchi State whose leadership believed that a greater tomorrow cannot be guaranteed if children are not protected against preventable diseases especially polio. So, in the race against time to demonstrate its commitment to end the wild polio virus (WPV), the Governor Isa Yuguda administration re-launched wider campaign that would ensure immunization coverage of all children across the state.

Realising that the challenge of overcoming the obstacles towards eradicating the virus and other preventable diseases requires local solution, it decided to set up the State Primary Healthcare Development Agency (BSPHCDA) to create the bridge and an enabling platform for it and the global partners to evolve integrated strategies that would arrest the spread of the polio virus and other child killer diseases across the state.

Chairman of the agency, Dr. Musa Mohammed Dambam in an interview with THISDAY said the organ was established to provide sound development on primary health care structures and services in the state, adding that the law establishing the agency came into being in January, 2008 "but started its operations sometimes in April, 2008."

He explained that prior to the establishment of BSPHCDA, the primary health care system had almost collapsed and characterised "by dilapidated infrastructures, lack of skilled personnel, inadequate basic equipment, drugs, water supply and electricity." He said the facilities were mostly deserted and the few skilled personnel lost interest and morale in the services.

According to him, "there were 1,100 primary health care facilities in the state in 2006 out of which only 875 were functional, 40 per cent of the facilities were dispensaries, 19 per cent maternities and 13.5 per cent were primary health centres (PHC) and the services provided in the facilities were mainly on consultative services as the patients were sent out to buy drugs and consumables."

"Routine immunisation services were available in only 40 per cent of the functional facilities, while the services were not provided daily, mostly once a week, and routine immunisation coverage was less than nine per cent in 2006 as much attention was paid to supplemental oral polio vaccination which has a higher coverage between 91-103 per cent in 2007. Unfortunately, wild polio virus continued appearing in some local government areas in the state," Dambam said.

He also lamented that the situation was so bad that maternal and child health services were only provided in maternities with less than 20 per cent of the clients attending the antenatal care delivering under the supervision of skilled personnel, while health education and other components of primary health care services such as environmental sanitation and global issues like polio eradication campaign were monetised "even with development partners and their contributions not properly coordinated, all partners were operating parallel services such that staff were confused as to whom they were responsible to.

"In fact, when this administration came on board, they looked at the health indices, did a situation analysis and found out that a lot of the health problems that were affecting the state can be tackled at the primary health care level. In the past, a lot of attention was paid much on the secondary and tertiary level leaving the primary level where 70-80 per cent of the populace attended, so the Government felt it is no longer wise to allow every disease that can be prevented to degenerate to the level of requiring so many resources. So this is one reason that informed the establishment of the agency," Dambam further explained.

Another reason for the setting up of BSPHCDA, according to the chairman was when government realised that the responsibility of providing primary healthcare was so enormous for the local government councils to handle. Thirdly, government also wanted to be proactive because it has been discussed and suggested that every state of the federation needs to have state primary health care development agency that would support the primary healthcare as provided by the National Health Act, which was about to be signed into law. "So we decided to even start before the enactment of the law."

In 2008, the state had a resurgence of the Wild Polio Virus (WPV) whereby the state became fourth in the country in terms of the number of WPV cases. In the beginning of the year, THISDAY investigation revealed that the state maintained very high profile in terms of the WPV coming second to Kano State, which necessitated the agency to re-strategise for what is described as "the total onslaught to eradicate polio from the nooks and crannies of Bauchi State," in line with the 2009 national targets for polio eradication.

So through the agency, a statistic of the endemic areas were marked out, immunization coverage and impact indicators were monitored and development were drawn and harmonised to successfully re-launch an aggressive campaign that would rapidly respond to outbreaks in an affected area in line with national target of making Bauchi State a polio free unit of Nigeria.

According to Dambam, the present administration believes the task of eradicating polio in the state by the end of 2009 is feasible and achievable, which must be carried out to its logical conclusion. To begin with, the government instituted a high powered committee to enlighten the public on the danger of the wild polio virus as well as the mobilisation committee to generate response to immunization exercises. This is beside the directives issued to all political office holders, local government chairmen as well as traditional, religious and community leaders to spearhead the fight against the spread of polio virus in their respective areas.

Dambam also told THISDAY that "initially, the agency faced some fresh challenges including the activities of some anti-polio vaccines campaigners, but after our sustained campaigns and advocacy visits to these leaders and town hall meetings with the people, I can tell you that we are now receiving 100 per cent support and cooperation from the people, particularly the parents and this has really helped us in this war against the polio virus.

"We have made some tremendous impact and in the past six months, we have remained consistently immunized over 1.5 million children. Whatever gain we make at the campaign level if our routine immunization remained low, we are not going to achieve anything, so we felt that we had to put up a sustained structure that will improve the routine immunization". He added that "we found out that only 200 health personnel were manning the over 1000 health facilities in the state. So we embarked on training more health personnel in this area and we were able to train thousands of this category of staff as well as raise the number of facilities provided for routine immunization from 200 - 500 units, and we also established outreach services whereby prompt attention are given to enhance the exercise.

"About 100 motorcycles were therefore procured and distributed to facilitate the movement of health personnel to these outreach centres in order to improve immunization coverage in remote parts of the state. And as of coverage we rose from less than 10 per cent in 2007 to now over 60 per cent as of today as per coverage. We are yet not there but I can assure you that we will surely be there and meet the 2009 national target for polio eradication in Bauchi state," Dambam emphasised.