Armed with juggling batons and acrobatic tricks, a troupe of young circus performers is touring towns throughout Kabul, Afghanistan to encourage families to vaccinate their children against polio.
Their variety shows are part of a global effort to finally eradicate polio, a highly contagious waterborne virus that typically infects children under 5. According to the World Health Organization, polio has been reduced globally by 99% but cases still persist, and the best defense against polio’s re-emergence is vaccines.
During one circus act, a performer dressed as a giant snake — representing polio — leaps on stage and threatens to attack every child in the community until Hamid, the circus ringleader, defeats the venomous villain with a box of vaccines.
The circus helps children and their families better understand the deadly consequences of polio, which attacks the nervous system and can cause lifelong paralysis in unimmunized people.
“We pass on these important messages in a fun way, which people listen to and they understand,” Hamid told the Global Polio Eradication Initiative (GPEI). “Giving a message without fun means people will not take that message away.”
That message is especially important in Afghanistan, one of only three countries that has yet to eradicate wild poliovirus. Of the 13 new cases of wild polio identified in 2017, eight were diagnosed in Afghanistan and five in neighboring Pakistan. In 2016, the Global Polio Eradication Initiative identified 37 cases of wild polio, 13 of which occurred in Afghanistan.
Children and teenagers from around Kabul perform in the roving circus, which frequently visits areas at risk of polio outbreaks. Young children are especially vulnerable to polio in communities of people displaced by conflict because their neighborhoods often lack running water and safe sanitation systems.
Throughout August and September, health workers across Afghanistan administered nearly 10 million repeat doses of oral polio vaccine to children under five as part of National Immunization Days, an initiative led by GPEI. Since 2000, more than 10 billion doses of the oral polio vaccine have been delivered to nearly 3 billion children around the world, the World Health Organization reported.
Continuous vaccination is important for preventing the development of another strain of the polio virus — Circulating Vaccine-Derived Poliovirus (cVDPV) — which can evolve when the weak virus that’s contained in vaccines mutates over a long period of time. The cVDPV strains can spread through communities where vaccination rates have decreased.
So far, the GPEI has identified 53 cases of cVDPV in Syria where a long civil war has prevented the consistent administration of polio vaccines. Ten more cVDPV cases have been reported in the Democratic Republic of the Congo.
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