Thirty years ago, polio affected nearly 350,000 people per year across 125 countries. Today, the poliovirus is circulating in only two countries, Afghanistan and Pakistan, where five new cases have been reported so far in 2017. But progress to eliminate polio in the region has been difficult, particularly in North-West Pakistan, an area affected by deadly flooding, ongoing conflict, and attacks against vaccine health workers.
As our sturdy Land Cruiser inched its way down a precipitous dirt track, trying to descend from a high ridge into the Rift Valley, I wondered what might happen if we had an accident here in the heart of Kenya’s remote Samburu County. Mobile signals had faded soon after we left the town of Maralal several hours before. We could have tried to walk back, but would have been very unlikely to make it before nightfall. Luckily, after a few mishaps and some serious jolting, we arrived at our destination in the valley—lonely Suyan manyata, whose distant circular outline we had seen from the ridge.
Talking to some of the women in the manyata, I realized that the ground that we had covered to get to them was nothing. We had done it in good health in a vehicle built for difficult terrain. As they told us what life was like in their village, my heart quailed at the thought of enduring a bumpy ride in a run-down van if one were pregnant or in labor with complications—if at all transport could be obtained. Just a few days ago, a child had died here of malaria, the women said. How did they usually get help, I asked. “We send our fastest runner 18 kilometers to the nearest dispensary,” said Ma Toraeli, a grandmother in the village. “From there someone comes to help us”. Health workers also visited the village from time to time, she said, to immunize babies and perform other routine checks.
Immunization seemed high on people’s minds in Samburu. Later that day, we visited Barsaloi, a larger village with its own government dispensary and another run by Catholic nuns. The two stood side by side, with a well-worn path between them. There I met another grandmother, Agnes, who had brought an infant girl, Salini, to be immunized, although her record showed that she was early and didn’t need this service yet. But while Stephen, the clinical officer at the government dispensary, was examining the baby and we were on the subject of immunization, the district head nurse showed us how vaccines were stored at the required temperature in the two-room government dispensary without power supply.