Polio's profound impact on Malawi’s children
The story of one girl who was paralyzed by the disease.
It started one summer evening late in 2021 in Ngwenya, an area on the outskirts of Lilongwe, Malawi’s capital. A then 3-year-old little girl complained to her grandmother, who is her caregiver, that her right hand and arm were feeling hot and making her feel uncomfortable. Her grandmother did her best to comfort the child overnight and took her to the hospital the next day. The doctors were initially confused about her condition but after months of treatment and testing a clearer and disturbing picture emerged. Wild Polio Virus Type 1 (WPV1), which was last detected in Malawi in 1992, and which the continent had been declared free of in 2020, was back in Africa.
The detection of the Acute Flaccid Paralysis (AFP) caused by wild poliovirus type 1 in Matilda* set off a chain of events which has led to a massive immunization campaign in the region. With the support of UNICEF, the governments of Malawi, Mozambique, Tanzania, Zambia and Zimbabwe have embarked on a 4-month campaign aiming to vaccinate over 20 million children against the virus.
*Real names were not used in order to protect the identity of the family in this story.
The strain of virus which has infected Matilda and triggered this urgent and epic vaccination campaign, was traced back to Sindh Province in Pakistan which, along with its neighbor Afghanistan, are the only countries in the world where Wild Polio Virus is still considered endemic. That this strain has appeared so far away in Malawi, in southern Africa, is testament to the fact that, especially in a globalized world, vaccine preventable diseases (VPD’s) are constantly circulating and that vaccines remain the most powerful defense we have against diseases which can permanently harm and even kill children.
“At first I was heartbroken but now I have accepted the situation. I was instructed to go with her to the hospital on a daily basis for physiotherapy. This is difficult because I have to leave everything else to just concentrate on her.”
Matilda’s suffering is, however, not limited to the physical effects of the wild polio virus. “Her friends used to come to play with her but after the news went out that she has polio all her friends stopped coming by,” says Mariam. "After I asked the parents, they told me that it was because they heard that she had a deadly disease.”
The poliomyelitis virus, though very infectious, is spread primarily through contact with contaminated fecal matter and, less frequently, through contaminated food or water. After being ingested through the mouth it travels to the intestine where it multiplies and can invade the nervous system and cause paralysis.
![4-year-old [NAME CHANGED*] Matilda exercises with a walker at her home in Ngwenya in Area 24 of Lilongwe. Matilda is the child who first displayed symptoms of Acute Flaccid Paralysis (AFP) as a result of polio.](/sites/default/files/styles/media_large_image/public/UN0641205.jpg.webp?itok=aKPL4et9)
Good sanitation and regular handwashing can help prevent the spread of the virus, but only strong healthcare systems and regular routine vaccinations provide a lasting safeguard against the disease.
Misinformation about Vaccine Preventable Diseases is a big problem not only in Matilda’s community, but across the world. During the second leg of the polio eradication campaign in Malawi in April 2022, health workers found parents who refused to allow their children to receive the Oral Polio Vaccine (OPV) out of fear that it was actually the COVID-19 vaccine, which is deeply mistrusted in part due to disinformation spread via social media and word of mouth.
Type 2 and Type 3 Wild Polio Virus have already been eradicated and, at the turn of the millennium, the world was on the brink of eliminating Type 1 and thus polio entirely. In Malawi, the effort to eliminate polio and protect all children continues.
Only through consistent childhood vaccinations in tandem with education-focused community outreach, can we hope to reach every child and put a permanent end to polio.
