Fear of Polio

What the poliosophobia entry says

The 2008 encyclopedia of phobias gives poliosophobia as the fear of contracting poliomyelitis and sends the reader on to its general entry for fear of disease. No case, no figure, no history.

The historical fear it names was real and enormous in its time. The experience of polio in the era of Franklin D. Roosevelt was examined in a study published in the Bulletin of the History of Medicine in 1998 under the title A Crippling Fear, which is the register the subject was discussed in.

How the eradication campaign worked

Because some national governments could not contain outbreaks on their own, the World Health Organization launched the Global Polio Eradication Initiative in 1988, with the goal of eradicating the disease by the year 2000. The World Health Assembly approved a global plan of action in 1989 and the organisation's regional committee for Africa adopted the resolution.

The African strategies were intensified in 1996, when Nelson Mandela launched the Kick Polio Out of Africa campaign, which aimed to vaccinate 50 million children in that year alone. Mass immunisation was supported by five things at once:

• national immunisation days
• surveillance for acute flaccid paralysis
• training of community health workers locally
• door-to-door campaigns
• functional cold chain systems to keep the vaccine viable

Why the campaign was halted

In 2003 the political and religious leaders of Kano, Zamfara and Kaduna states brought the immunisation campaign to a halt by calling on parents not to allow their children to be immunised. Their argument was that the vaccine could be contaminated with anti-fertility agents, specifically an oestrogen hormone, with HIV, and with cancer-causing material.

The reasoning offered was geopolitical as much as medical. A spokesman for the governor of Kano said that since the eleventh of September the Muslim world had begun to be suspicious of any move from the Western world, and that people had become genuinely concerned about the polio vaccine. Datti Ahmed, a Kano physician heading a prominent Muslim body, said the vaccines had been corrupted and tainted by evildoers from America and their Western allies, and that modern-day Hitlers had deliberately adulterated the oral vaccine with anti-fertility drugs and with viruses known to cause HIV and AIDS.

A World Health Organization doctor investigating polio cases in Kano told an American newspaper that events in the Middle East had aggravated the situation. The Islamic scholar Sheikh Yusuf Al-Qaradawi, president of the International Fiqh Council, said he was completely astonished by the attitude of his fellow scholars in Kano towards the vaccine.

What the case shows about fear

The account of the boycott makes a general point: where public trust is eroded, rumours spread, and the spread of rumour leads to the rejection of health interventions. That is a description of a mechanism rather than of an emotion, and it is the reason the episode matters more than any single belief held in it.

It also inverts the phobia framing completely. A fear of catching polio, which is what the Greek compound names, would have produced queues at the vaccination points. What actually stopped the campaign was a fear of the thing that prevents polio, held by people whose children were the ones at risk, and grounded in a distrust of where the vaccine had come from rather than in anything about the disease.

Vaccination has been plagued by controversies worldwide, and the polio programme was neither the first nor the last to meet one. What distinguishes this instance is that the fear was specific, publicly argued by named people, and measurable in its consequences for a campaign that had set out in 1988 to finish the disease within twelve years.