HealthScapades Episode #15 | “Old Stubborn Woman, Ma Pa Mi Nau” | 03.10.2024
by Tayo Fasuan
It was a hot afternoon during Day 2 or 3 of the polio outbreak response, usually carried out by engaging in intensive, house-to-house vaccination of every eligible child in an entire geopolitical zone of the state where the outbreak was observed.
As a vaccination supervisor, I had already done my supportive supervision for the vaccination teams under my watch when the Ward Focal Person, who was the coordinator of teams at the ward level, called me to help resolve a case of non-compliance.
A case of non-compliance, also called a rejection case, is a case of anyone who refused vaccination for his/her eligible child(ren) or ward(s). Most times, their rejection is based on fear and rumour-mongering that the vaccine is dangerous, which are quickly resolved with a patient explanation.
However, there was no easy resolution that day, so they had to call me, the so-called ‘senior supervisor from Abuja’, to help. I walked there in the hot sun because we don’t usually use vehicles for supervision. When I got there, I knew there was trouble when I saw the old woman they were battling with.
She sat at the entrance of her house like a Rock of Gibraltar, looking like a fierce lioness. When she stood up, she was so tall and intimidating too, and I wondered why the teams were persistent in the face of that obvious and overwhelming ‘imminent danger’. With the woman looking at me like she would pounce on me, too, I quickly faced the team to ask what happened. What I was told was serious enough for me to face the giant old woman.
During polio OBR, we usually carry out surveillance too for other diseases of public health importance, among which are measles, cholera, diphtheria, monkeypox and others. The team had seen a serious case of measles in a child, and the woman, who was the grandmother, refused to allow them to properly examine her to recommend her for further testing and treatment.
I looked at the woman again, knowing fully that appeasing or explaining to her wouldn’t work. So I went the whole nine yards and told her without hesitation that when we came back with security men, and we realised the child was really sick, dying, or dead, she would go to jail irrespective of her age or being a grandma.
We briefly went into a staring contest, which I won because she went in immediately after to bring the child. We were shocked. The child was having terrible rashes on her body, with other symptoms such as cough and runny nose, typical of measles infection. When the grandma tried to explain it away as heat rashes, the child and I gave her a bombastic, criminally offensive side-eye.
As we were planning to have the girl moved to the healthcare centre, she whispered to me that there were other children with similar symptoms inside. The grandma overheard and shouted at the child to keep quiet. That seemed to prompt the other children hidden inside to shout in unison, as kids do, and run outside. Their bodies weren’t pretty sights at all – they were filled with rashes and sores.
Measles is highly infectious, and its complications are way too dangerous to be kept hidden as that old woman did. As the ambulance came to pick up the children, the old woman was still insisting it was heat rashes. All of us gave the woman exasperated looks like the comedian Shank Comics, as if to tell her, “Old stubborn woman, ma pa wa nau…”