What’s Behind India’s Outbreak of Polio Paranoia

It’s hard to imagine that anyone could object to a campaign to eliminate polio — a disease that maims, paralyzes, and even kills its victims, who are mostly children. Yet, in one of the more bizarre confrontations between Islamic fundamentalists and the modern world, a tiny group of clerics in India is doing just that — and giving new life to a deadly disease.

Poliomyelitis, a contagious viral disease that once crippled and killed thousands of children annually, has been eliminated in most of the Western world thanks to a vaccine invented by Jonas Salk in the 1950s, but it still survives in some of the world’s poorest countries. India seemed to be on the verge of eliminating polio last year, when it reported just 66 cases of the disease, down from 1600 in 2002. This year, however, things have gone horribly wrong with India’s polio elimination campaign; 325 cases have been reported already, and at least 23 of them have been fatal. What’s caught people’s attention is that 70% of those infected with polio this year are Muslim, even though Muslims account for only 13% of India’s population. What’s even stranger, and frightening, is the reason: some Muslims believe that the polio drops are part of a conspiracy to sterilize their children, and are refusing to let them be vaccinated.

This year’s polio outbreak has been concentrated in India’s largest state, Uttar Pradesh, home to over 170 million people. It is here, say health workers, that a few ultraconservative Muslim clerics have spread a myth that the polio vaccine is part of an underhanded campaign to sterilize Muslim children and lower the Muslim birth rate. Dr Hamid Jafari, the regional advisor for the World Health Organization (WHO) on polio eradication, says that the majority of Uttar Pradesh’s Muslims have got their children vaccinated, but, “in certain places, fatwas have been issued against the vaccine.” In those places, Muslims have stopped state health workers from entering their houses and administering the polio vaccine, which is administered orally, to their children.

Dr. Jafari adds that paranoia is not the only reason for the hostility to the polio drops. Uttar Pradesh is notorious for being one of the worst-administered regions of India, and most of the state has appallingly bad hospitals and health services. Muslims, who are among the poorest of Indians, bear the brunt of this collapse in the state’s health infrastructure. Dr Jafari says: “There’s a sense of frustration among many Muslims: they tell the health workers, we’ve never seen anyone coming to take care of us, why are you coming just to give us polio drops?” The result: India’s health officials estimated recently that up to 15% of households with children in the western part of Uttar Pradesh state may have been skipped in recent vaccination drives. In a state with a very high population density and poor sanitation, that figure is large enough to ensure that polio — which spreads through contaminated water and contact with excrement — has made a comeback, just when it looked like the net was closing on it in India. Although 90% of India’s districts are polio-free, the disease has spread out this year from its epicenter in western Uttar Pradesh to other parts. In March, sewage samples in three slum areas of Bombay, India’s financial capital, found polio virus strains in the water. Earlier this week, a nine-year old Bombay girl was found to have got the polio virus, the first case in two years in the city.

Even more disturbing are the global implications of such paranoia. Dr. Jafari says that genetic analysis shows that the strain of polio from Uttar Pradesh, in the past couple of years, has left India, and spread to at least three African countries that had made great strides against polio — Angola, Namibia, and the Democratic Republic of the Congo. This year, he says, the Uttar Pradesh strain of the polio virus has leapt out of India and reinfected two polio-free neighboring countries: Bangladesh and Nepal. “This shows that the continuation of polio in one country is a threat to all the world,” he says.

Some countries are taking the renewed threat of polio very seriously. Last year, Saudi Arabia announced that all travelers from countries with polio, under the age of 15, would have to show valid proofs of vaccination before they got a visa to enter the country. India’s health minister, Anbumani Ramadoss, stung by criticism, announced recently that that he will step up his government’s efforts to eliminate polio in the country — and make a special effort to reach out to India’s Muslims. “We are going to have a special program to enlighten them,” he told the press recently, adding he would be meeting Islamic leaders in Uttar Pradesh to figure out how he could dispel Muslim anxieties about the polio vaccine. Unless he can, many more parents in India, and throughout the world, will start grappling with their own worries about a disease they thought had been conquered.