Kenyan Volunteers Track Polio’s Elusive Spread

Samburu County, Kenya – A motorbike engine erupts, sending up a plume of fine dust across the northern Kenyan landscape in the June heat.

Eroi Lemarkat speeds down a dirt track after hearing reports of a child who has suddenly lost the use of one or both limbs. The cause might be polio, or it could be another condition; either way, delay is not an option.

Each report pushes him farther into isolated settlements, frequently several hours away from the closest health centre.

While wild poliovirus has been eradicated across Africa and Kenya has not reported a case since 2013, a vaccine‑derived strain can still persist in areas with low immunisation coverage. There, the attenuated virus from the oral polio vaccine may spread and mutate, posing a threat chiefly to under‑immunised, remote and nomadic communities.

Quiet surveillance

In Nairobi, health officials routinely analyse wastewater for poliovirus traces, often detecting the virus before any clinical symptoms appear.

“The data collected by community health volunteers in high‑risk counties like Turkana and Samburu enables the ministry to launch swift, targeted interventions,” said Dr Galm Glelo, the Ministry of Health’s national lead for polio surveillance, in an interview with Al Jazeera.

Nevertheless, wastewater surveillance is limited to areas with functional sewer systems.

In Kenya’s sparsely populated north, lacking any wastewater‑sampling sites, the effort hinges on community health volunteers.

Rather than waiting for symptomatic children to arrive at clinics, volunteers pursue reports of acute flaccid paralysis (AFP), gathering stool samples to ascertain whether poliovirus is circulating in communities seldom reached by formal health services.

Against the Clock

For Lemarkat, each investigation starts with a rumor.

Reports of a child who has suddenly stopped walking or lost the use of an arm or leg travel swiftly through villages and nomadic settlements, moving from neighbours to elders and local leaders long before health workers are notified.

Lemarkat pursues every lead, frequently riding for hours to reach isolated households. Before speaking with parents, he enlists the backing of village elders, administrative chiefs, or religious leaders to reassure the community and earn their trust.

Time is critical; health workers must obtain two stool samples within 14 days of paralysis onset to maximise the likelihood of detecting the virus.

“It is a race against time. If we arrive too late, we may lose the chance to confirm whether polio is the cause,” Lemarkat told Al Jazeera.

An overlooked case can let transmission persist unnoticed, especially in communities where children seldom access health facilities.

Building Trust

Surveillance becomes even more challenging along Kenya’s border with Somalia, where pastoralist families routinely cross in search of water and pasture.

“Nomadic pastoralist communities constantly move back and forth across these invisible international borders in search of water and pasture,” said Dr Emmanuel Okunga, who leads disease surveillance at Kenya’s Ministry of Health, speaking to Al Jazeera. “They are largely unaware of regional healthcare jurisdictions.”

Earning the trust of these communities is often just as vital as reaching them.

Parents may be wary of outsiders or unfamiliar medical procedures, which can make it challenging to convince them to permit stool sampling of their children.

Lemarkat has spent over five years cultivating relationships with families across the region and understands how quickly that trust can evaporate.

“If a volunteer does not handle these conversations with absolute respect and care, a family may simply pack up their shelter and disappear into the bush before a sample can be taken,” he said.

“That could leave a potential outbreak unmapped and uncontained.”

Containing the virus also relies on cooperation that extends beyond Kenya’s borders.

“Teams on both sides of the international border must operate in perfect tandem to ensure that no migratory child slips through the cracks undetected,” said Dr Pius Mutuku of the Ministry of Health’s Public Health Emergency Operations Centre, speaking to Al Jazeera.

The Final Mile

Each report Lemarkat investigates enables health officials to ascertain whether poliovirus remains in circulation and to act before it can spread further.

Despite laboratory testing, wastewater monitoring, and cross‑border coordination, Kenya’s final push against polio still hinges on individuals willing to trace rumours across great distances, often to locations where roads cease and phone signals vanish.

For Lemarkat, there is continually another report to follow, another family to visit, and another community to reach.

“It’s a lot of work, but it’s worth the effort,” Lemarkat said. “We must protect every child; children represent our future.”

Source link