Kano State’s Measles Battle: Gaps and Challenges Amid Diphtheria’s Toll

By Shahida Salihu, Kano – Nigeria

In the heart of Nigeria’s Kano State, Muhammad Inuwa Musa, a dedicated public health practitioner at the Dutse General Hospital’s Department of Children Immunizations, stands as a beacon of hope in the battle against measles and other epidemics.

Musa along with many others like him, tirelessly educates the populace, especially in rural communities, about the importance of immunizing their children within the first year of life.

But the complexities of epidemic preparedness for measles and most recently Diphtheria outbreak in this region, where the challenges faced by healthcare professionals mirror a deeply human narrative of hardship and resilience

“We enlighten people, especially those living in rural communities, to bring their children for the first dose of measles vaccine within the first year of their lives,” says Musa.

Measles, Diphtheria; an intersection

Kano is one of the most populous states in the country with an annual growth range of more than 3%.

Earlier in the year, measles outbreak – an annual epidemic – in the State reached alarming levels, with 800 confirmed cases reported across 11 local government areas of Kabo, Gwale, Dala, Kumbotso, Madobi, Ungoggo, Tarauni, Karaye, Municipal, Fagge and Tsanyawa with Kano metropolis being the hardest hit, making it the epicenter of the outbreak.

Neighboring states have also been grappling with the highly contagious disease. Katsina state has reported approximately 1260 cases and 9 deaths, while Jigawa has recorded 250 cases and 3 deaths. Kebbi state in the northwest is also witnessing a surge in measles cases.

Not long after, the state is currently grappling with a severe diphtheria outbreak – a serious bacterial infection caused by the bacterium called Corynebacterium species that affects the nose, throat and sometimes, skin of an individual, raising concerns among health officials and international organizations. The outbreak, which began in June 2023, has seen a significant increase in cases across several states in Nigeria. Kano, along with Katsina, Yobe, Bauchi, Kaduna, and Borno, has been particularly hard-hit, reporting the majority of cases

As of January 2023, the Kano State Ministry of Health confirmed that 25 persons, mostly children, had been killed following the outbreak.

As of March 15, Kano State alone had 377 cases out of the 389 confirmed cases across 21 states.

According to a situational report from the National Centre for Disease Control (NCDC), this translated to 44.7 percent and 56 deaths out of every 62 recorded nationwide.

Crossroads…

In response to the alarming outbreaks, health officials, led by the Nigeria Centre for Disease Control and Prevention (NCDC), are urging parents and caregivers to ensure that their children receive the Measles, Mumps, and Rubella (MMR) and Pentavalent vaccine vaccine, which includes protection against measles and diphtheria respectively.

However, the first challenge in Kano State’s epidemic preparedness is battling the prevailing misconceptions that these life-saving vaccines are harmful.

Most parents are torn between fears and misconceptions, an anguish they feel, worrying about their children’s safety when it comes to vaccination.

“We enlighten people, especially those living in rural communities, about the safety of the vaccines,” says Musa

Another gaping hole in Kano State’s epidemic preparedness is the lack of awareness and access to some remote communities. According to Mr. Musa, “The government doesn’t even know about many people living in some places.” This reveals an invisible crisis, where communities exist in the shadows without the resources and attention required to protect their children from measles.

In the immunizations department, healthcare professionals wage a relentless battle. Their commitment highlights the silver lining within the challenges, a testament to the potential for change and improvement in Kano State’s epidemic preparedness. “We have different types of vaccine injections for children. We thank Kano State government because they are really trying in providing immunization vaccines for us,” Musa acknowledges that the government’s role in prevention is the light that keeps hope alive in these communities.

Tragically, Mr. Musa shares stories of children brought to the hospital with measles at the age of five. “The reason why all this is happening is that the child was not administered the measles vaccine when they were born.” The human cost becomes painfully evident in these children’s suffering.

The stories of these children, their pain, and suffering, underscore the urgency of bridging these gaps in epidemic preparedness but not without surmounting the myths that brings about immunization hesitance.

Between Myths and Science

Amina Oluwatoyin, is a resident whose life has been shaped by a relentless struggle against measles. Her story offers a unique perspective into the challenges faced by locals and their traditional beliefs in the battle against this highly contagious disease.

Amina’s first encounter with measles came in her childhood, and she recounts, “I felt hot inside my body more than normal.” Despite enduring the hardship of this illness, at the age of 14, she found herself in the clutches of measles once again, pushing her to stay away from the sun, taking refuge in dark, cool, and well-ventilated spaces.

But what sets Amina’s story apart is the deep-rooted traditional beliefs within her tribe. In her community, measles is not merely a medical condition but a spiritual affliction. They believe that a charm placed at the entrance to their homes serves as a protective shield against the measles “spirit,” preventing its entry. Traditional medicine, deeply ingrained in their culture, is the go-to remedy, and Amina has seen her family rely on it for generations.

The vaccine, a common medical intervention, is met with skepticism, as many in her tribe believe it exacerbates the situation. Instead, they turn to unconventional yet traditional remedies like red oil and palm wine, which they believe to be effective. In this community, there is a marked absence of a scientific approach to remedy the ailment, and generations have thrived with their own healing traditions.

However, a glimmer of change is on the horizon. Amina Oluwatoyin is now beginning to seek a scientific understanding of the world around her. Her journey represents a bridge between traditional beliefs and modern medical science. Her story epitomizes the complexities and nuances of the battle against measles and diphtheria in Kano, where beliefs and traditions often intersect and clash with scientific approaches.

In the ongoing struggle against measles, her transition towards scientific reasoning signifies the gradual shift that is needed to ensure that Kano State’s epidemic preparedness aligns with both medical advancements and the deeply rooted beliefs of its residents.

A Critical Juncture…

Kano State’s epidemic preparedness for measles and other epidemics is at a critical juncture, deeply intertwined with human emotions and struggles. These challenges represent opportunities for change and progress.

While the battle against epidemics is both a medical and human endeavor, ramping up awareness campaigns remains a key instrument in bridging the gap.

But that’s not all, Musa believes that Government can do more by meeting those who will not come to the hospital in their enclaves.

“Government should provide camping groups that will go to different villages to give children vaccine injections because some people will not come to the hospital to collect the vaccine.”

His words carry the weight of the unvaccinated children’s futures, a call for proactive measures to ensure no child suffers the agony of epidemics.

As the situation unfolds, health officials remain vigilant and are closely monitoring the situation to implement necessary measures to control the spread of the disease

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