Local health officials in Burkina Faso recently threatened to use force against households refusing the yellow fever vaccine, according to a district medical director.
More than seven million people were immunised during a December yellow fever vaccination campaign in the country’s high-risk zones, according to the government. But some 30 Muslims in a remote region near the border with Mali told health officials they feared the vaccine would cause infertility, said the district medical director of Orodara.
Director Clement Meda told IRIN his efforts to persuade the community had failed. “When we realised their reticence and refusal [to the vaccine], we sent in administrative and health officials to talk to them, but it did not work.”
On 31 December at 4am, Meda said military police accompanied local doctors to households in the villages of Sokouraba and Samogohiri where children had not been immunised. “We knew at that hour, they could not tell their children to run away from us and that the family would be home,” Meda told IRIN. “The men were the ones who had steadfastly refused access to their children. [Eventually], we were able to vaccinate all 30 [non-immunised persons].”
Meda said with the police present, the men no longer protested.
The district medical director said the doctors were also able to immunise children for polio and gave vitamin A to women and children who had been found “very weak.”
Meda said another group of Muslims living in the same district had refused to immunise their children against polio during a 2005 campaign, based on fears the vaccine would make girls infertile. Health officials similarly used the threat of force in 2005, he told IRIN.
Private right vs. public good
Dan Wikler, an ethics professor in Harvard University’s Department of Global Health and a former ethicist with the World Health Organization (WHO), said police-accompanied vaccinations may create long-term damage. “The consequences may not be felt locally but this use of force could undermine vaccination efforts in other parts of the world if people come to associate public health with violence.”
Health director Meda dismissed concerns that the use of force would sow fear in the population against future public health campaigns. “Refusals are rare during these campaigns. There is no risk of negative consequences, in principle, based on our experience with [those who have refused]. They have since joined our other health initiatives.”
Wikler raised the case of the 2003 ban on polio vaccinations by Muslim clerics in northern Nigeria, who claimed the vaccine was a Western ploy to spread HIV and sterilise Muslim girls. The boycott was responsible for the spread of polio to about a dozen countries, according to WHO.
Wikler told IRIN this polio vaccination campaign in Nigeria was a rare case that would have justified the threat of force to enforce compliance. But apart from exceptions like Nigeria’s battle against polio, he said health officials need to prepare other options to ensure compliance.
Positive force
He recommended establishing “positive force” – linking immunisations to rewards – to overcome resistance. “These resisters must depend on authorities for services, like schooling. Make the immunisations required for students, or link them to other benefits the population may count on from government.”
But Orodara medical director Meda said the families who originally refused the yellow fever vaccine do not register for birth certificates or allow their children to attend school. “They are completely cut off from government and society,” he told IRIN.
Meda said the community is reclusive and eludes the government census. IRIN was unable to reach members who protested the yellow fever vaccinations.
Ethicist Wikler told IRIN engaging religious leaders opposed to life-saving health campaigns is a more sound policy than force. “That takes time. It is not something authorities can achieve in a weekend during the course of immunisations. It takes years. It is the government’s fault for letting dissension fester.”
Lack of religious training on social and health issues has sown confusion among certain clerics when it comes to vaccinations, according to one researcher. “[According to Islam’s religious text] for Muslims, disease is a trial,” said Ismaël Tiendrébéogo, a member of the Circle for Studies and Research in Islamic Training in the Burkina Faso capital Ouagadougou. “But God has never said that one should not seek remedy for his illness.”
Despite the fact that a yellow fever vaccine has been available for 60 years, the number of people infected and dying from the viral disease has increased in the last two decades, according to WHO.
Burkina Faso had a yellow fever outbreak in 1983 with more than 70 percent of 380 infected persons dying, according to the government.
bo/pt/np
More than seven million people were immunised during a December yellow fever vaccination campaign in the country’s high-risk zones, according to the government. But some 30 Muslims in a remote region near the border with Mali told health officials they feared the vaccine would cause infertility, said the district medical director of Orodara.
Director Clement Meda told IRIN his efforts to persuade the community had failed. “When we realised their reticence and refusal [to the vaccine], we sent in administrative and health officials to talk to them, but it did not work.”
On 31 December at 4am, Meda said military police accompanied local doctors to households in the villages of Sokouraba and Samogohiri where children had not been immunised. “We knew at that hour, they could not tell their children to run away from us and that the family would be home,” Meda told IRIN. “The men were the ones who had steadfastly refused access to their children. [Eventually], we were able to vaccinate all 30 [non-immunised persons].”
Meda said with the police present, the men no longer protested.
The district medical director said the doctors were also able to immunise children for polio and gave vitamin A to women and children who had been found “very weak.”
Meda said another group of Muslims living in the same district had refused to immunise their children against polio during a 2005 campaign, based on fears the vaccine would make girls infertile. Health officials similarly used the threat of force in 2005, he told IRIN.
Private right vs. public good
Dan Wikler, an ethics professor in Harvard University’s Department of Global Health and a former ethicist with the World Health Organization (WHO), said police-accompanied vaccinations may create long-term damage. “The consequences may not be felt locally but this use of force could undermine vaccination efforts in other parts of the world if people come to associate public health with violence.”
Health director Meda dismissed concerns that the use of force would sow fear in the population against future public health campaigns. “Refusals are rare during these campaigns. There is no risk of negative consequences, in principle, based on our experience with [those who have refused]. They have since joined our other health initiatives.”
Wikler raised the case of the 2003 ban on polio vaccinations by Muslim clerics in northern Nigeria, who claimed the vaccine was a Western ploy to spread HIV and sterilise Muslim girls. The boycott was responsible for the spread of polio to about a dozen countries, according to WHO.
Wikler told IRIN this polio vaccination campaign in Nigeria was a rare case that would have justified the threat of force to enforce compliance. But apart from exceptions like Nigeria’s battle against polio, he said health officials need to prepare other options to ensure compliance.
Positive force
He recommended establishing “positive force” – linking immunisations to rewards – to overcome resistance. “These resisters must depend on authorities for services, like schooling. Make the immunisations required for students, or link them to other benefits the population may count on from government.”
But Orodara medical director Meda said the families who originally refused the yellow fever vaccine do not register for birth certificates or allow their children to attend school. “They are completely cut off from government and society,” he told IRIN.
Meda said the community is reclusive and eludes the government census. IRIN was unable to reach members who protested the yellow fever vaccinations.
 ...They are completely cut off from government and society... |
Lack of religious training on social and health issues has sown confusion among certain clerics when it comes to vaccinations, according to one researcher. “[According to Islam’s religious text] for Muslims, disease is a trial,” said Ismaël Tiendrébéogo, a member of the Circle for Studies and Research in Islamic Training in the Burkina Faso capital Ouagadougou. “But God has never said that one should not seek remedy for his illness.”
Despite the fact that a yellow fever vaccine has been available for 60 years, the number of people infected and dying from the viral disease has increased in the last two decades, according to WHO.
Burkina Faso had a yellow fever outbreak in 1983 with more than 70 percent of 380 infected persons dying, according to the government.
bo/pt/np
This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions
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