In an attempt to eradicate an outbreak of polio, Health officials in Indonesia will vaccinate millions of children this week. The vaccination programme is a massive response by the government to try to stamp Indonesia's first outbreak of polio in a decade.
Backed by the World Health Organization (WHO), Indonesian teams aim to vaccinate 6.4 million children under age 5 in three provinces on West Java this week, where polio has paralyzed 14 children since it was detected there last month.
The government moved quickly to try to contain the outbreak when it first appeared by immunizing about 6,000 children in a handful of affected villages, but there still are some stray families with children who have not taken the oral vaccination. They are at risk of becoming paralyzed themselves or could spread the virus to others even if they stay healthy, only about one in 200 children infected ever develop symptoms.
Dr. Immanuel Tarigan, who is helping coordinate vaccinations in some of the affected villages, says the villagers do not understand the usefulness of the vaccine, and rumors are rife that when children are vaccinated, they get a fever. He is working 100 kilometers south of Jakarta.
He also says apart from fears the vaccine will make children sick, a small number of families also balk at immunizations because they claim giving children any type of drug goes against their Muslim beliefs, a belief not shared by most Muslims.
Fortunately those cases are rare and more than 80 percent of Indonesia's 210 million people have already been vaccinated against polio, but enough exist to keep the virus a threat in Indonesia.
Polio is spread when sewage-contaminated water comes into contact with unvaccinated children. It usually attacks the nervous system, causing paralysis, muscular atrophy, deformation and sometimes death.
It is suspected by Health officials that the latest outbreak was brought into Indonesia by a migrant worker or a Muslim pilgrim returning from the hajj in Saudi Arabia. Polio remains native in only six countries worldwide, Nigeria, India, Pakistan, Niger, Afghanistan and Egypt.
In the WHO view this re-emergence in Indonesia of polio is a setback to its plan to eradicate the disease from the world by year's end because it is forced to take valuable resources away from countries where polio is entrenched.
Health officials say the Indonesian outbreak can possibly be traced back to Nigeria, where polio vaccinations were suspended for several months in 2003 after radical Islamic preachers told parents the vaccinations were part of a U.S. plot against Muslims and warned them against having their children immunized.
The outbreak in Indonesia is the first there since 1995, and in an effort to make sure it does not spread beyond West Java, the free immunization will be repeated in the three provinces again next month to provide additional coverage.
Capt. Margono, an army official supervising the Cidahu subdistrict where the outbreak occurred says if they find that families are reluctant to come to the post then the paramedics will go door-to-door.
Dr.Tarigan, the area's doctor, said a mark will be left on houses where unvaccinated children live and local health workers will keep returning until each child has been immunized. He says they have a commitment to control it, and in his view it is equivalent to AIDS, a person may look healthy, but if they are infected they can pass it on to others.