Polio Report

7/21/2019 Polio Report

http://slidepdf.com/reader/full/polio-report 1/37

1

BARRIERS TO ERADICATING POLIO IN THE MUSLIM WORLD

AND THE ROLE OF THE UK DIASPORA COMMUNITIES



MADE IN EUROPE 2

ACKNOWLEDGEMENTS 1

EXECUTIVE SUMMARY 4

PART 1: BACKGROUND 6

1.1 INTRODUCTION 7

1.2 ABOUT THE PARTNERS 7

1.3 POLIO 8

1.4 WHY DIASPORA? 9

PART 2: POLIO AND THE DIASPORA IN THE UK

2.1 NIGERIA 13

2.2 PAKISTAN 16

2.3 AFGHANISTAN 19

2.4 THE SOMALI AND SYRIAN DIASPORA IN THE UK 222.5 RELIGIOUS LEADERS IN THE UK 22

PART 3: FINDINGS 25

PART 4: RECOMMENDATIONS FOR FUTURE WORK 29



3

ACKNOWLEDGEMENTS

MADE IN EUROPE WOULD LIKE TO THANK THE FOLLOWING

FOR THEIR CONTRIBUTION TO THE PROJECT

CHARITIES AID FOUNDATION

BILL AND MELINDA GATES FOUNDATION

PUBLIC HEALTH ENGLAND

MUSLIM COUNCIL OF BRITAIN

MUSLIM DOCTORS ASSOCIATION

ROTARY INTERNATIONAL

NIGERIAN MUSLIM FORUM UK

SHAYKH IBRAHIM MOGRA

SHAYKH UWAIS NAMAZI NADWI

LIVERPOOL NIGERIAN COMMUNITY ASSOCIATION

KENT AFGHAN MUSLIM COMMUNITY

WOLVERHAMPTON MUSLIM COMMUNITY

WALTHAMSTOW WOMEN’S GROUP

MAYA SUKKARI, MADE IN EUROPE

SHANZA ALI, MADE IN EUROPE

MAAZ KHAN, MADE IN EUROPE



MADE IN EUROPE 4

EXECUTIVE SUMMARY

Polio is one of the few diseases we are able to prevent but unable to

cure. It poses a great risk of paralysis in vulnerable children who are

not immunised against the virus. In 1988 multiple high-profile entities

led by the World Health Organization agreed to work towards the

eradication of polio at a time when there were 388,000 cases in 125

countries worldwide. As a result of this emphasis, worldwide incidence

of the disease began to steadily decrease. By 2001, cases of Polio had

decreased by 99% and by 2012, Polio was endemic in only three

countries; Pakistan, Nigeria and Afghanistan. 1

Notably, prevalence of Polio in these countries has predominantly been

in Muslim-majority regions. Consequently, barriers to the eradication

efforts have been associated with the religious and cultural influences

of the people in these areas. The campaigns have been further marred

with violence and controversy making it difficult to achieve success.

MADE in Europe has undertaken a scoping exercise on the potential

role of UK diaspora communities in supporting the endemic countries

of Pakistan, Nigeria and Afghanistan to overcome the religious and

cultural barriers to eradicating the Polio disease. This project is

intended to raise awareness and form partnerships among the Muslim

and diaspora communities in the UK in order to identify future work that

can be done.

The ethnographic research was undertaken among the Pakistani,

Nigerian and Afghan communities in the UK through focus groups with

community members and interviews with community leaders. Overall,

1 Action to Stop Polio Now, 2012. Global Emergency Action Plan. [ONLINE] Available at:

http://www.polioeradication.org/portals/0/document/resources/strategywork/eap_201205.pdf



MADE IN EUROPE 5

the three communities expressed similar perceived barriers to Polio

eradication, including:

a) Anti-Western sentiment due to the current global political climate and

the role of the ‘West’ in the country’s domestic affairs - which was

being used by religious key players to create opposition towards the

vaccination campaign

b) Lack of awareness and understanding of the disease and vaccines

on a general level, and whether vaccine uptake contradicts Islamic

practices

c) Corruption on a political level that is impacting any effective progress

and failing to stop the violence towards vaccinators

Based on the research findings, a number of recommendations are put

forward to enhance the current Polio eradication efforts in the endemic

countries, and engage the diaspora in this work:

a) To address the lack of awareness and mistrust among the diaspora

communities, an educational campaign is required in the UK to

raise the profile of the Polio disease and more broadly of health

promotion within the Islamic tradition.

b) Train and engage religious leaders in the UK and North America on

the issue to then disseminate the knowledge through fatwas 2,

khutbahs 3, and seminars to achieve depoliticizing of eradication

efforts

c) Create a coalition of Muslim stakeholders in the UK to lead a

concerted effort

d) Mainstream bodies are recommended to reduce tension by

supporting Muslim and diaspora organizations to take the lead on

working with government and local NGOs in-country

2 Fatwa(s): a ruling on a point of Islamic law given by a recognized authority.

3 Khutbah(s): the primary formal occasion for public preaching in the Islamic tradition



6

PART 1/BACKGROUND



MADE IN EUROPE 7

1.1 INTRODUCTION

MADE in Europe has undertaken a scoping exercise with the support of Charities Aid

Foundation on the potential role of UK diaspora communities in supporting the

endemic countries of Pakistan, Nigeria and Afghanistan to overcome the religious

and cultural barriers to eradicating the Polio disease. This project is intended to raise

awareness and form partnerships among the Muslim and diaspora communities in

the UK in order to identify future work that can be done. This is with the aim of

addressing the opposition to polio immunization in these Muslim-majority regions and

the low priority the UK community has given this issue.

Research was undertaken among the Pakistani, Nigerian and Afghan communities in

the UK to further understand the opposition towards Polio immunization in their

respective countries of origin/heritage. Focus groups with these diaspora

communities were held UK-wide. Leaders from various backgrounds, including

political and religious, were also interviewed on a one-to one basis to gain from their

insight. Media outlets such as Muslim magazines and Friday prayer sermons were

used as a platform to begin the process of raising awareness in the UK. The

outcomes were to understand the diaspora’s views surrounding vaccination and to

identify potential areas where diaspora and the NGO sector can contribute to this

work globally.

Finally, a culminating roundtable event was held on the 29th of January 2014 to bring

potential stakeholders from the Muslim diaspora together with existing partners to

discuss the findings of this research and actions for the future. The final thoughts and

actions discussed at the event have been incorporated into the recommendations

section of the report.

1.2 ABOUT THE PARTNERS

MADE IN EUROPE

MADE in Europe is a UK-based NGO working to mobilize Muslim communities to be

at the forefront of the fight against global poverty and injustice. Its work focuses on

creating opportunities for Muslim communities such as volunteering and campaigningand capacity building Muslim development-sector organizations.

Its aim is to identify the barriers on global issues where there are low levels of

engagement by Muslim communities and to build knowledge and understanding of

these issues resulting in greater numbers of Muslims actively supporting these

causes through individual actions, and through the work of Muslim and non-Muslim

development NGOs.4

CHARITIES AID FOUNDATION

Charities Aid Foundation (CAF) is a charity dedicated to getting the best for othercharities and their donors. For over 80 years, they have found the most effective and

4 MADE in Europe www.madeineurope.org.uk



MADE IN EUROPE 8

efficient ways to connect donors to the causes that matter to them and for money to

get where it’s needed. CAF’s mission to support the charitable sector and build a

stronger culture of giving is more important than ever. CAF continues to be a powerful

advocate for giving, and helps the voluntary sector build on Britain’s proud history of

generosity towards charitable causes.5

1.3 POLIO

Poliomyelitis (polio) is an infectious virus, which enters through the mouth and

multiplies rapidly in the intestines. Initial symptoms of Polio include fever, fatigue,

headache, vomiting, and stiffness and pain of one’s muscles. 90% of those infected

have no signs of illness but can continue to infect others. One out of every 200 cases

results in complete or partial paralysis of the body’s muscles, commonly affecting the

leg muscles, also known as acute flaccid paralysis (AFP). AFP is irreversible and

results when the virus enters the bloodstream, infects the central nervous system and

impairs one’s muscles. Death occurs in 5-10% of such polio cases when the

individual’s breathing muscles become immobilized. 6

Polio often occurs in children under five and there is no cure for the disease. 6 Health

professionals have employed prevention strategies by immunizing against Polio

during infancy. Some individuals are unable to be vaccinated for various reasons, but

if the majority of a community are immunized against the disease, this reduces the

number of potential hosts and the virus can be eradicated.

Polio eradication efforts began in the 1980s after the advent of the vaccine a fewdecades earlier. In 1988 the World Health Organization along with multiple high-

profile entities agreed to work towards the eradication of polio at a time when there

were 388,000 cases in 125 countries worldwide. As a result of the emphasis on a

global eradication program, worldwide incidence of the disease began to steadily

decrease. By 2001, cases of Polio had decreased by 99% and by 2012; Polio was

endemic in only three countries- Pakistan, Nigeria and Afghanistan. 7

Notably, prevalence of Polio in the endemic countries has predominantly been in

Muslim majority regions. Consequently, barriers to the eradication efforts have been

associated with the religious and cultural influences of the people in these areas. The

campaigns have been further marred with violence and controversy making it difficultto achieve success. Due to the inability to control the disease in these three

countries, strains of Polio have recently been discovered in East Africa and the

Middle East as of late 2013. These new cases have threatened the re-emergence of

Polio on a global level.8 Cases of Polio in 2013, as adapted from the Council of

Foreign Relations, are shown in Figure 1 below.9

5 Charities Aid Foundation www.cafonline.org

6 WHO | Poliomyelitis. 2013. WHO | Poliomyelitis. [ONLINE] Available at:http://www.who.int/mediacentre/factsheets/fs114/en/

7 Action to Stop Polio Now, 2012. Global Emergency Action Plan. [ONLINE] Available at:http://www.polioeradication.org/portals/0/document/resources/strategywork/eap_201205.pdf

8 Polio Emergence in Syria and Israel endangers Europe. The Lancet, Volume 382, Issue 9907, Page1777, 30 November 2013

9 http://www.cfr.org/interactives/GH_Vaccine_Map/index.html



MADE IN EUROPE 9

In April 2013, at the Global Vaccine Summit in Abu Dhabi, leaders and philanthropists

pledged their commitment to eradicating Polio by 2018 in the remaining locations.

The result was the Polio Eradication and Endgame Strategic Plan 2013-2018.

10

Thiswill take alternative approaches to ensure efficiency of vaccination uptake including

flexible teams of vaccinators, door-to-door care in conflict areas, improved area

mapping using technology and closer monitoring of vaccination uptake. This hopes to

address the underperformance in best practice quality standards of the vaccination

program worldwide.2

1.4 WHY DIASPORA?

NGO engagement with diaspora communities is not a new phenomenon but therehas been a recent increase in the international community’s attention towards its

potential in achieving global development goals. When examining the positive

linkages between diaspora and development proposals, Mohan (2002) concluded

that “…development by the diaspora via diasporic flows and connections back 'home'

facilitate the development - and, sometimes, creation - of these 'homelands'”.11

With regards to the Pakistani and Nigerian diaspora in particular, there is research to

indicate their potential for enacting change at both the grassroots and policy levels

informally and formally in their countries of origin.12

Beyond the financial implications

10 Polio Eradication and Endgame Strategic Plan 2013 -2018

www.polioeradication.org/resourcelibrary/strategyandwork.aspx 11

Mohan, Giles and Zack-Williams, A.B., 2002. Globalization from below: conceptualizing the role of the African diasporas in Africa's development. Review of African Political Economy , 29(92) pp. 211–236.

12 Erdal, Marta Bivand; & Horst, Cindy, 2010. Engaging Diasporas in Development. A Review of PilotProject Pakistan, PRIO Paper PRIO



MADE IN EUROPE 10

of remittances, their spheres of influence and cultural awareness are proving just as

valuable.13

Thus, when faced with difficult and context-specific issues in what

appear to be cultural and religious barriers such as those seen with the Polio

campaigns, drawing on the diverse knowledge of the diaspora, along with the

potential of financial support, can be of great benefit.

13 UK Pakistani diaspora, 2013. Pakistan – International Development Committee. [ONILNE] Available at:http://www.publications.parliament.uk/pa/cm201213/cmselect/cmintdev/725/72510



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PART 2/POLIO AND THE

DIASPORA IN THE UK



MADE IN EUROPE 12

MADE in Europe sought to explore the potential of engaging diaspora communities in

the UK to further understand the religious and cultural barriers hindering the

eradication efforts of Polio. The subsequent ethnographic research took a qualitative

approach with the aim of recommending ways in which the communities, their leaders

and affiliated charities could engage in creating change. All focus group participants

and certain community leaders requested anonymity and for this reason, names and

positions are not disclosed.

Focus groups were primarily utilized to collect data and information from the various

communities but they were also structured to educate the participants on the disease

itself and the existing opposition to Polio in their respective country. The overall aims

of the workshops were to:

a) Explore the knowledge, attitude and behaviour of the diaspora community with

regards to Polio and immunisation

b) Raise awareness of the disease and gain support for future work and collaboration

in assisting the eradication efforts.

The sessions included a preliminary questionnaire, a short PowerPoint presentation

and video, and printed material relating to the eradication effort and the controversy

surrounding it. Participants generally felt confident in immediately addressing the

issues and were eager to participate so the sessions were semi-structured with key

questions posed by the facilitators to direct conversation.

Sampling of the populations was achieved via gatekeepers and a ‘snowball’

recruitment technique. The gatekeeper was chosen as someone who had strong links

throughout their community and could bring participants together in a trustedenvironment. As the topic of Polio and vaccines proved to be controversial and

sensitive, this was important for recruitment. The samples represented the

heterogeneity of the Muslim community including Sunni and Shia Muslims as well as

participants from a variety of careers and backgrounds. This ensured a full range of

socioeconomic backgrounds and perspectives were represented. Where appropriate,

native-speaking facilitators were used to lead the focus group such as those with the

Pakistani community.

Preliminary questionnaires and evaluation forms were distributed to compile

anonymous data.14

By quantifying certain information, the aim was to gauge if the

focus group methodology was an effective way of increasing understanding of thedisease and encouraging participants to take future action on the issue.

Although each of the communities may have discussed similar issues plaguing the

Polio campaign in their countries of origin, their perspectives shed light on solutions

that are culturally specific. Presented by country of origin, the following data reflects

the results of the 8 community focus groups and community leader interviews held

across the UK, as well as insights gained from the roundtable event.

14 See Appendices 1 and 2



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2.1 NIGERIA

2.1.1 MethodologyEngaging with the Nigerian community resulted in several interviews with community

leaders and three focus groups in different cities in the UK. Two of the interviews

were with doctors living in the Leeds community and actively involved with medical

relief efforts in Nigeria, one was the imam of a large Nigerian community mosque in

South London, and another with a leading member of the Nigeria Muslim Forum - a

UK-based Islamic organisation and affiliate of the Muslim Council of Britain.

Three focus groups were held with the Nigerian communities of Liverpool, Coventry

and Leeds. All three workshops were held in English and in locations that were

familiar to those attending.

The first focus group was held in Liverpool on August 24th 2013 with the support of

the Liverpool Nigerian Community Association. Although initially the focus groups

were advertised as gender-segregated, the women and men showed up at the same

time and suggested that such a setup was not necessarily culturally-relevant. At this

session, there were 3 female participants and one male participant with one

facilitator. These numbers were smaller than expected but allowed for in depth

discussions.

The second focus group was held in Coventry on December 7th, 2013 with the

support of the Nigerian Muslim Forum UK (NMFUK). This was a mixed female and

male group with two facilitators. There were 10 participants, 3 of whom were female

and 7 were male.

The third focus group was held in Leeds on December 8th, 2013 with the support of

NMFUK. This was also a mixed gender group with two facilitators. There were 12

participants, 11 of which were male and one female.

The participants ranged from newly arrived students to well-established

professionals, over 90% of who originated from the Muslim northern states of Nigeria.

The participant ages ranged from 26 to the mid 50s and as a reflection of the Nigerian

community itself, the focus groups consisted of female and male Muslims with a

minority number of Christians.

Information gathered from the participants is summarised below:

Liverpool Coventry Leeds

No. of maleparticipants

1 7 11

No. of femaleparticipants

3 3 1



MADE IN EUROPE 14

Age2 x didn’t answer1 x 30-35 yrs1 x 50-55 yrs

1 x didn’t answer1 x 20 -25 yrs3 x 26- 30 yrs3 x 31 – 35 yrs2 x 36 – 40 yrs

5 x didn’tanswer1 x 26 – 30 yrs4 x 31 – 35 yrs

1 x 36 – 40 yrs1 x 46 – 50 yrs

Length of time inthe UK

2 x didn’t answer1 x 7 yrs1 x 30 yrs

2 x didn’t answer7 x 1yr2 x 9-10 yrs

5 x didn’tanswer4 x 1 -2 yrs3 x 4-5 yrs

Marital Status2 x didn’t answer2 x Married

1 x didn’t answer6 x Single2 x Married1 x Divorced

5 x didn’tanswer2 x Single5 x Married

Would you

vaccinate yourchildren?

4 x yes 10 x yes 12 x yes

Aware of Polio 4 x yes 10 x yes 12 x yes

Believe Vaccinesare Permissiblein Islam

3 x yes1 x didn’t answer


12 x yes

Of a total sample of 26 participants, 96% felt comfortable vaccinating their own

children. All had heard of Polio due to either a general awareness or having

witnessed the campaign in Nigeria but only 54% knew someone who had beendisabled by the disease. 88% of the participants believed vaccines were permissible

in Islam; the remaining 12% declined to comment or were unaware. The focus groups

proved effective as 85% expressed an increase in understanding after the session

and also pledged to communicate what they had learned to others. This included

calling family members or using their own spheres of influence in the UK or Nigeria to

raise awareness of the seriousness of the disease.

2.1.2 Discussion

The Nigerian participants and interviewees had a strong awareness of the Polio

disease and the issues facing the campaign in their country. Of those who did not,

they were still able to express their thoughts based on a cultural awareness.

Nigeria itself has a history of colonization that is still present in the social memory of

the large and heterogeneous population.15

This has translated into a strong anti-

Western sentiment that was mentioned as a barrier to disease eradication by every

single participant in all three focus groups. 20% of the total participants believed that

Nigerians were not vaccinating their children out of a fear of sterilization by the

Western vaccines. Many also believed that there was a general lack of awareness of

the Polio disease. One community leader claimed that Nigerians are statistically

suffering more from the threat of many other diseases, which have higher mortality

15 Coventry Focus Group, December 2013



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rates such as Malaria and Measles.16

This begged the question, much like that

discussed with the Afghan community, as to why the focus on Polio by the

international community. The often invasive pursuit of vaccinating children in Northern

Nigeria has led communities to believe there is a hidden agenda by Western

organisations.17

Furthermore the impact of the “Pfizer case” on the psychology of Nigerians was

mentioned in every focus group and all participants were aware of it. This case arose

from a drug trial in 1996 targeting meningitis in which the pharmaceutical company

misused Nigerian children as participants. Several children died and a long court

case ensued between Kano state and Pfizer.18

This resulted in an exacerbation of

the mistrust towards Western organisations that is still felt by local and expatriate

Nigerians alike.16

From a religious standpoint, extremist groups or religious leaders who are banning

the community from vaccinating their children are thought to do so on the basis ofopposing Western influence as well as out of ignorance.

19 Several rumours have

been circulated regarding porcine products in the vaccine and this has also had an

impact. Any type of pig product in the vaccine would seemingly classify it as

impermissible to the layman and little has been done to counteract this notion on a

community level. One doctor explained that since Islam is very important to Northern

Nigerians, it must be part of the solution as much as it is part of the perceived

problem. One example she explained could be sourcing the vaccine from Saudi

Arabia, a country highly regarded by northern Nigerians as being the home of the

holy city of Mecca. This could potentially quell any mistrust by rural Nigerians and

religious leaders alike and “assure people they are doing the right thing Islamically by

offering a ‘halal’ vaccine”.20 By sourcing vaccines from trusted Muslim countries, anti-

Western sentiment towards the vaccines could be mitigated. Religious opposition

from leaders can further be targeted with a general education campaign on the

permissibility of vaccines in Islam and the disease itself. One Christian participant

suggested that education of Polio should be spread countrywide and not only

regarded as a Northern issue. She carried on to say that if the disease was so

dangerous it should be as familiar in the people’s minds as Malaria or HIV.21

Participants also discussed the corruption within the political structure of the country

as contributing to the hindrance of the Polio campaign14

. One participant stated,

“Corruption allows our leaders to capitalize on the lack of awareness”. Doctors

attending the sessions claimed that not only was there a disregard from ministers but

the poor infrastructure of the northern Nigerian healthcare system was simply not

conducive to administering viable vaccines. Lack of electricity and cold fridges are not

ensuring the proper storage of the vaccines. Among the focus group participants, the

healthcare professionals with experience in Nigeria all agreed the importance of

capacity building the country’s existing healthcare system to ensure clean and

accessible facilities, which people can feel comfortable attending.14, 16

Furthermore

16 Interview with Nigerian Doctor 1, November 2013

17 Leeds Focus Group, December 2013

18 Business and Human Rights, 2014. Pfizer Lawsuit re: Nigeria 1996. [Online]

http://www.businesshumanrights.org/Categories/Lawlawsuits/Lawsuitsregulatoryaction/LawsuitsSelectedcases/PfizerlawsuitreNigeria

19 Interview with Religious Leader, South London, November 2013

20 Interview with Nigerian Doctor 2, November 2013

21 Liverpool Focus Group, August 2013



MADE IN EUROPE 16

incentivising the vaccinators’ work is also causing an abuse of the system and some

children are known to forcefully receive the vaccines on multiple occasions. Another

participant claimed she had witnessed vaccinators pouring the vaccines in the street

but reporting the children had been inoculated, just to receive the promised monetary

incentive.14

Proper training and regulation, she believed, could potentially solve this

issue. Another solution suggested was to offer an infant the full immunisation

schedule rather than targeting children solely for Polio by going door-to-door.15

This

could help strengthen general public health and uptake of all vaccines.

Overall, the political and social circumstances such as the lack of awareness and

corruption of the country play an equally strong role as do the religious

misconceptions.

2.2 PAKISTAN

2.2.1 Methodology

Engaging with the Pakistani community resulted in several interviews with community

leaders and three focus groups in different cities in the UK. Six interviews were

conducted with community leaders in the Pakistani diaspora; a doctor and committee

member of the Muslim Doctors Association, a prominent Politician and member of the

House of Lords, a counter-extremism specialist and public figure, an academic at a

Muslim college in the Cambridge community, a public health researcher and

community activist and a philanthropist.

Three focus groups were held with the Pakistani community; one in London and two

in Wolverhampton. All participants were Muslim and originated from major cities in

Pakistan. Although the first workshop was held in both English and Urdu, the last two

were held only in Urdu to accommodate the participants. The focus groups were

gender segregated as is more appropriate for the cultural context and were held in a

local mosque and community centre.

The first focus group was held in Walthamstow, London on September 29th 2013 with

the support of an active member of the Walthamstow Muslim community. This was an

all female group with a total of 8 participants and two facilitators.

The second focus group was held in Wolverhampton on November 10th, 2013 with

the support of an active member of the Wolverhampton Muslim community. This was

an all female group with 9 women and one facilitator. The third focus group was held

on the same day in Wolverhampton and was an all-male group with 9 participants

and was led by a male Urdu-speaking facilitator.



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London Wolverhampton


0 9


8 9

Age

3 x didn’t

answer

2 x 30 – 35 yrs

1 x 46 – 50 yrs1 x 51 – 55 yrs

1 x 56 – 60 yrs

6 x didn’t answer

3 x 20 – 25 yrs

1 x 26 – 30 yrs

2 x 31 – 35 yrs

1 x 36 – 40 yrs3 x 41 – 50 yrs2 x 51 – 60 yrs

Length of time inthe UK

3 x didn’t

answer

3 x 30 –35 yrs

2 x 40 – 45 yrs

6 x didn’t answer

1 x 2yrs

1x 9 yrs5 x 10 – 20yrs

3 x 21 – 30 yrs2 x 31 – 40 yrs

Marital Status

3 x didn’t

answer

2 x Married

1 x Separated2 x Divorced

6 x didn’t answer

2 x Single

10 x Married

Would youvaccinate yourchildren?

8 x yes 17 x yes

Aware of Polio 8 x yes 18 x yes

Believe Vaccinesare Permissiblein Islam

7 x yes

1 x didn’t

answer

16 x yes

2 x didn’t answer

Of the 26 participants who were aged 26 to mid 50s, 96% vaccinated their own

children. All participants had heard of Polio and only 19% knew someone who had

been affected by the disease. 23 of the 26 believed vaccines were permissible in

Islam and the remaining 3 declined to comment or were unsure. The focus groups

generated lively discussions and after the session, 92% expressed a strong increase

in understanding of the disease and its impact. 17 of the participants pledged to raise

awareness of the disease amongst their families and friends.

2.2.2 Discussion

Pakistan has an on-going eradication programme that is spearheaded by several

NGOs with governmental support. The campaign however has seen some of the

worst violence including the murder of vaccinators and the detonation of bombs



MADE IN EUROPE 18

targeting health clinics. This has instilled a sense of fear and discomfort among the

general public towards the eradication efforts.23

Volunteers and health workers risk

their lives on a daily basis to carry out the campaign. On an initial superficial analysis

of the issue by the media, it appears that there are extremist religious forces that are

unhappy with the eradication efforts and are thus spurring on the violence. After much

discussion however, it became clear that the situation is much more complex.

The participants attested that many of the Pakistani communities in which the disease

continues to exist have low literacy levels and therefore awareness of the disease is

low and unfounded rumours are able to spread.24,25,26

Of the focus group participants

who stated their own reasoning for resistance to the vaccine, all believed a lack of

understanding of the disease and the vaccine played an important role. Examples

included a misunderstanding of what a live oral vaccine is and whether it is itself

capable of debilitating the infant.24

Furthermore a prominent British Pakistani

politician who remains a public figure in Pakistan and maintains strong ties with its

political and business elite reported in his interview “a lack of education and

awareness about the disease and the vaccine” as a cause for the resistance in the

rural areas of the Khyber Pakhtunkhwa (KPK) and Federally Administered Tribal

Areas (FATA)27

.

The popular myth of the vaccine causing sterilization was mentioned often in the

focus groups, as was the confusion over whether the vaccine consisted of non-halal

animal product such as porcine. These misunderstandings, two participants claimed,

could easily lead rural Pakistanis to believe they were averting the will of Allah

(God)25,26

. Religious leaders are therefore failing to make their followers aware of the

reconciliation between the Muslim faith and medical science. Some stated this was

due to the power dynamics at play in which leaders use the lack of awareness as a

tool to maintain power25

and others felt that it was a general misunderstanding

among the religious scholars of whether the vaccine is permissible or not.26

However

in an interview with a British Pakistani academic, who brings a background in social

psychology to the discussion, the question of “how ideas and beliefs around health

are absorbed in different ethnic and religious communities” was raised. He went on

to further suggest, “that once a misconception or myth surrounding a health matter is

introduced into a community, it becomes very difficult to remove or contest it”.28

Thus,

if religious institutions are perceived as a credible source of information on health

issues in these communities, it becomes important to understand the necessary role

that these institutions and individuals must then play in educating the public andcreating awareness.

What proved more concerning than the religious misunderstandings, however, were

the socio-political factors discussed in depth by all the participants. Current events

including power dynamics, western spying, conflict and extremism were cited as key

factors behind the country’s inability to move the eradication programme forward. The

sham vaccination programme used by the CIA to capture Osama Bin Laden for

example was mentioned by many of the focus group participants as well as all of the

23 Shackle, S., 2013.The Struggle for a Polio-free Pakistan. New Statesman. [Online]

http://www.newstatesman.com/politics/2013/06/struggle-polio-free-pakistan 24

London Focus Group, September 2013 25 Wolverhampton Focus Group Female, November 2013

26 Wolverhampton Focus Group Male, November 2013

27 Interview with British Pakistani Politician, October 2013

28 Interview, British Pakistani Academic, November 2013



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individual interviewees who argued that such events, which are instilled in the social

memory of the population, have led to a high level of mistrust. One interviewee went

as far as saying that “the CIA operation to gather information about Osama Bin Laden

using a vaccination programme although not related to Polio caused traumatic

damage to the credibility of international health programmes in Pakistan, and in

particular the northern areas where the militants are. They now believe that health

workers are CIA spies collecting DNA and information on militants”.29

Conflict in

various parts of the country has also contributed to this mistrust, leading to

conspiracy theories that the West is attempting to sterilize Muslim children through

vaccines to reduce the Muslim population. This misconception was just as commonly

cited as that of the CIA spies in both focus groups and interviews.

Participants also outlined how the current political climate is of notable importance as

the rates of corruption among the government and its departments has led to a failure

to clampdown on the violence targeting vaccination workers.26

The eradication

programme therefore finds itself in a politically charged environment in which certain

political players including the Taliban have used the campaign to leverage power. By

determining solutions to bypass the political corruption and work with religious and

societal leaders to educate communities without the felt threat of Western infiltration,

the participants believed true progress could be made in Pakistan. They believed

their contribution could come in the form of alerting family members in Pakistan of the

threat of Polio24,25, 26

and financially supporting trustworthy Muslim NGOs willing to

become a part of the eradication efforts abroad25

. Finally, participants also felt that

pressure could be created on Pakistani stakeholders through ethnic and religious

media outlets in the UK, which according to one high-profile interviewee “is watched

and monitored closely by everyone in Pakistan, and has real potential to impactthem”.

30

2.3 AFGHANISTAN

2.3.1 Methodology

Engaging with the Afghan community resulted in several interviews with community

leaders and two focus groups in different cities in the UK. Four interviews were

conducted with community leaders in the Afghan diaspora. Two of which were Imams

at large community mosques and two were prominent community leaders. The two

focus groups were held in the cities of London and Rochester, Kent comprising a total

sample of 12 Afghan participants.

The first focus group was held in London on October 26th, 2013 with the support of an

active member of the Afghan Muslim community. This was an all female group with a

total of 3 participants and one facilitator. The session was conducted in English.

The second focus group was held in Rochester on November 17th, 2013 with the

support of a member of the Kent Afghan Muslim community. This was an all male

29 Interview, a prominent Pakistani speaker and specialist in counter-extremism, September 2013

30 Interview, a prominent Pakistani politician and public figure, October 2013



MADE IN EUROPE 20

group with 9 men and one male facilitator. Although the session was conducted in

English, there was some facilitation in Farsi.


London Rochester


0 9


3 0

Age

2 x didn’t answer

1 x 30 – 35 yrs

3 x didn’t answer

2 x 15 – 20 yrs

1 x 26 – 30 yrs

1 x 36 – 40 yrs

1 x 41 – 45 yrs

1 x 46 – 50

Length of timein the UK

2 x didn’t answer

1 x 30 years

3 x didn’t answer

1 x 4yrs

4 x 10 – 15yrs

1 x 16 - 20 yrs

Marital Status 2 x didn’t answer1 x Married

4 x didn’t answer

1 x Single

4 x Married

Would you vaccinateyour children?


5 x yes

Aware of Polio 3 x yes2 x didn’t answer

7 x yes

Believe Vaccines arePermissible in Islam

3 x yes 2 x didn’t answer

7 x yes

Of the total sample, 70% had some previous knowledge of Polio and only 15% knew

someone who had been affected by the disease. 8 out of 12 would vaccinate their

children but 10 believed vaccines were permissible in Islam while the remaining 2

participants declined to comment or were unaware. 69% expressed an increase in

understanding of the Polio disease after the focus group and 63% of them pledged to

raise awareness of the disease amongst their families and friends.



MADE IN EUROPE 21

2.3.2 Discussion

Afghanistan is a country that has been riddled with conflict for decades.31

The spread

of Polio has been just one of many issues that the government has faced. It should

be noted that most recently, the Taliban who have been the Polio campaign’s biggestopponent, lifted the ban and have shown support of the inoculation of children in the

northwest regions.32

In 2013, only 14 cases were reported in Afghanistan and the

Global Polio Eradication campaign has stated that the country is on the verge of

becoming Polio-free in the very near future.33

Afghans who participated in this

research project were unaware of the recent developments but still offered their

insight.

A lack of awareness of the disease was cited by over 60% of the participants as a

driving force behind why Afghans were not vaccinating their children. Several

reported seeing television promotion of the vaccine on Afghan channels in the UK but

explained that the advertisements fell short of explaining the urgency of eradication orthe impact of the disease itself

28. One well-known Afghan community leader in the

UK strongly questioned the relevance of the eradication campaign in light of the

country’s current political and social climate.34

He believed there were other ways to

come to the aid of the Afghan people including bolstering education, capacity building

and tackling other more threatening diseases.

When asked whether there was any capital in involving the Afghan diaspora in the

issue at hand, focus group participants believed that there could be an impact if they

were convinced of the urgency and importance of eradicating Polio. They described

their UK community as well connected and well established and would be willing to

take steps to communicate the information back to their families in Afghanistan.

35

Theparticipants explained that it was actually the tribal elders and village heads that held

the key to disseminating knowledge and tackling this problem.36

They argued that it is

these individuals who hold more power and influence than political or religious

leaders in Afghanistan. Many agreed that while religious arguments were of

importance they would not necessarily lead to change as a community’s decisions

are driven by a variety of other factors such as fear of militant attacks and well-

being.35

The most important factor raised by the groups was that of the Taliban, a political and

religious extremist group found on the border of Pakistan. Participants outlined how

Taliban militants have hindered Afghans from vaccinating their children in the past.Such groups and their religious leaders regard the vaccine as impermissible in Islam

primarily due to anti-Western sentiment. The participants explained that although

different Afghan communities hold differing opinions on the permissibility of the

vaccine, the fear of violence keeps people away. These fears, the participants

reiterated, can be mitigated by engaging local tribal leaders and educating them on

the importance of vaccination.35

Some suggested that Afghan leaders in the UK, both

31 Nasimi, S., 2013. Afghanistan: beyond ethnicity. Open Security. [ONLINE]http://www.opendemocracy.net/opensecurity/shabnam-nasimi/afghanistan-beyond-ethnicity

32 Yusufzai, A., 2013. TTP unlikely to follow Afghan Taliban on anti-polio help. Dawn. [Online]http://www.dawn.com/news/1012291/ttp-unlikely-to-follow-afghan-taliban-on-anti-polio-help

33 Global Polio Eradication Initiative, 2014. Polio this week. [ONLINE]http://www.polioeradication.org/Dataandmonitoring/Poliothisweek.aspx

34 Interview, Afghan Community Leader, November 2013

35 London Focus Group, October 2013

36 Rochester Focus Group, November 2013



MADE IN EUROPE 22

social and religious, could be a medium for transferring knowledge that is non-

threatening.35

Whether this can still play a role in light of the Taliban recently

changing their stance and assisting the eradication efforts is unclear.

2.4 THE SOMALI AND SYRIAN DIASPORAIN THE UK

Although Polio remains endemic in only three countries, in the year 2013 the total

number of Polio cases recorded in non-endemic countries (240 cases) surpassed

those recorded in the endemic countries (160 cases). Somalia accounted for 190

cases and Syria, which had not seen Polio since 1999 accounted for 23 cases, and

significant measures have been taken by the Global Polio Eradication Initiative to

control the spread of the disease in and around these countries.37

However, withexisting connections to Somali and Syrian diaspora communities living in the UK,

MADE carried out additional interviews with community leaders from this group to

gauge their level of awareness and attitudes towards eradication efforts in these

countries. Furthermore, major UK Muslim umbrella bodies and organisations were

also interviewed on this issue.

Interviews were conducted with leadership from the Somali Relief and Development

Forum (SRDF), the Muslim Charities Forum (MCF), the Muslim Council of Britain

(MCB), the Muslim Doctors Association (MDA), and a Syrian medical student from

the Muslim Health Students Network (MHSN).

Given the high level of awareness regarding the Syrian conflict, awareness about the

Polio outbreak was also found to be quite high among the individuals interviewed

from the Syrian diaspora and Muslim organisations.38

Barriers to eradication were

considered to be related to infrastructure, conflict and inaccessibility rather than due

to religious, cultural or socio-political attitudes.

The Somali diaspora however mentioned strong cultural taboos and a lack of

education towards the Polio disease especially in rural areas, highlighting significant

religious misconceptions and socio-political mistrust towards vaccines in general,

which they felt stemmed from religious extremism, conflict and perceived institutional

corruption. Although limited and anecdotal, based on the data gathered in these

interactions, a case can be made for potential overlaps and similarities in barriers to

eradication in Somalia and the endemic countries; however this report does not

explore this relationship further due to the comparatively minimal engagement with

the Somali and Syrian diaspora communities.

2.5 RELIGIOUS LEADERS IN THE UK

The research also included the opportunity to hold a focus group of religious leaders

who could provide some expert knowledge on the issues that may be playing a role in

37 Global Polio Eradication Initiative, 2014. Polio this week. [ONLINE]http://www.polioeradication.org/Dataandmonitoring/Poliothisweek.aspx

38 Interview, a Syrian medical student and member of the MHSN, October 2013



MADE IN EUROPE 23

the endemic countries. The eight scholars who participated are all men aged 26 – 40

and the faculty of a prominent religious institution in East London. Half of the group

had received training abroad in Bangladesh or Pakistan, while the other half was

educated in the UK. The result of the session was a strong desire to contribute to

future campaigns regarding promotion of health in Islam.


East London


8

Age1 x didn’t answer

6 x 25 – 29 yrs

1 x 40 yrs

Length of timein the UK

1 x didn’t answer

6 x 25 – 30 yrs

1 x 35 – 40 yrs

Marital Status1 x didn’t answer

7 x Married

Aware of Polio 4 x no

4 x yes

Believe Vaccines

are Permissible in

Islam

8 x yes

Received training

in health

5 x yes

3 x no

The religious leaders were supportive of vaccinations and explained that although

there were no specialized courses on health, the subject matter was well integratedthroughout their training. The training includes understanding the messages of the

Holy Quran and the traditions (Sunnah) of the Prophet Muhammad and it is these

teachings from which they extrapolate and make decisions on issues that matter to

Muslims today. Islamic civilizations of the past, one scholar explained, are known to

have pioneered the concepts of sanitation and hygiene for health purposes and this

should be strong support for promoting good health today. Furthermore, the group

was able to come up with several examples in Islamic history that could be compared

to the issues facing Muslims today with regards to prevention of disease including:

• The story of Umar – Umar ibn Al-Khattab said to Abu Ubaidah, another

companion of the Prophet, when the latter questioned him about his orderpreventing entry to and departure from an area where the plague was

widespread. Abu Ubaidah asked him: "Are we trying to escape from God's

will?" Umar answered: "Yes, we try to escape from God's will with God's will."



MADE IN EUROPE 24

• The story of Khalid – Muad (first military general) did not move away from a

contagious area and as a result died but Khalid had the wisdom to do so

based on precedent thus allowing his community to survive and thrive

• Further hadith including one that permits the drinking of urine as medicaltreatment in certain situations

One leading Sheikh in the group stated that the underlying issue of religious leaders

who are creating opposition abroad was perhaps their inability to align the present

situation with what is found in religious texts when faced with a contradiction. With

regards to vaccines he explained, as there is no alternative to preventing a child from

contracting the Polio disease, the vaccine is permissible even if it contains

impermissible ingredients. Such a statement has been supported by a fatwa issued

by Al-Azhar University scholars in 2003.39,40

It was apparent from their discussion, that the community of Islamic scholars in the

UK have very strong ties with their own religious leaders and teachers abroad. These

ties, one Sheikh said, were strong enough to disseminate knowledge in a non-

threatening way, countering anti-West sentiments and bolstering the on-going

grassroots efforts without compromising vaccinators’ safety. He went on to say that

this was not only true of their institution but of the plethora of Muslim institutions that

follow varying sects found in the UK.

In support of these thoughts, modern history is scattered with examples of

contemporary religious belief impacting societies’ relationship with globalisation and

modernity. It has been reiterated that an important element of the associational life of

diaspora with their countries of origin is that of religious belonging and organisation

and “such networks permit the exchange of ideas, commodities and people.”41

To integrate Public Health into the global Muslim religious dialogue it is vital to further

draw on the synergy between the Western Muslim communities. North American

counterparts to UK religious leaders hold their own extensive influence, and this is

strongly exemplified by the prominent Western scholar Sheikh Hamza Yusuf, who

was recently ranked as “the Western world’s most influential Islamic scholar”.42

Methods in which the UK Muslim community can work closely with those in North

America are further outlined in the recommendations presented by this report.

39 Fatwa Released from Al Azhar Scholars, 2003www.who.int/immunization_standards/vaccine_quality/englishtranslation.pdf

40 Al Azhar University is considered to be one of the foremost Islamic academic institutions for SunniMuslims and its scholars are influential globally.

41 Mohan, Giles and Zack-Williams, A.B. (2002). Globalization from below: conceptualizing the role of the African diasporas in Africa's development. Review of African Political Economy , 29(92) pp. 211–236.

42 Esposito, J., and Kalin, I., 2009. The Muslim 500. [Online]. http://themuslim500.com/



25

PART 3/FINDINGS



MADE IN EUROPE 26

This scoping exercise has demonstrated the potential of the diaspora community

having a role in the eradication efforts of the endemic countries. In general, the data

showed an achieved increase in understanding and more than half of all participants

felt empowered to take action against the disease. As Figure 2 shows below,

Muslims from the three communities showed an overwhelming support for the

vaccination of their own children and believed that their faith did not keep them from

doing so. Participants were further given an opportunity to understand and discuss

the issue in a confidential and comfortable environment. This resulted in a sense of

ownership and a desire to go away and inform families and friends in their countries

of origin.

Overall, the three communities expressed similar barriers to Polio eradication,

including:

• Anti-Western sentiment due to the current global political climate and the role

of the ‘West’ in the country’s domestic affairs - which was being used by

religious key players to create opposition towards the vaccination campaign

•

Lack of awareness and understanding of the disease and vaccines on ageneral level, and whether vaccine uptake contradicts Islamic practices

• Corruption on a political level that is impacting any effective progress and

failing to stop the violence towards vaccinators

Figure 3 below is a schematic representation of the range of reasons for resistance

mentioned or ‘buzz words’ in our research, and the arrows are used to indicate the

wider context or themes under which they were brought up.



MADE IN EUROPE 27

It is of note that CIA spies, sterilisation/HIV contraction, resistance/suspicion due to

the Osama Bin Laden, Dr. Afridi and Pfizer cases were all associated with anti-

western sentiments. The idea of vaccine-induced diseases was associated with anti-

western sentiments as well as a lack of awareness. A miscalculation of risks was

associated with just a lack of awareness, and finally no credibility and deep mistrust

were associated with both corruption and anti-western sentiments.

It thus becomes clear that although a lack of awareness and concerns about

corruption are perceived as important barriers to eradication, the majority of the

connections are being made with the anti-western sentiment, which was cited three

times as much as any other barrier and therefore is a concern to be addressed.

Participants and community leaders alike posed various solutions. To tackle religious

opposition, transfer of knowledge from trusted sources would need to occur with the

hope of depoliticising the disease. This would be complemented by a nation-wide

awareness campaign on Polio and health promotion in the UK. Collaboration between

Muslim stakeholders is also vital as a means to monitoring the concerted efforts.

Ultimately there will need to be a multifaceted approach.

As we move forward however it is important to note some of the challenges faced

throughout the course of the project. Although many religious scholars showed

interest in getting involved, there were certain instances of opposition from mosques

and community leaders in the UK. They cited an unwillingness to tackle such a

controversial topic and a fear of speaking up as it involved political parties abroad.

One mosque leader said they were opposed to such ‘reformist views’ and would not

agree to be interviewed. Several others failed to be convinced of the importance of

the disease and its relevance to UK Muslims or found it too controversial and as such

did not agree to deliver a Friday prayer sermon on the topic. To tackle such

sensitivities and move forward effectively it is important to engage influential

individuals from the relevant communities at the earliest stage of any campaign in

order to sufficiently address common fears, raise awareness and build trust.



MADE IN EUROPE 28

Furthermore, although our research brings to the fore the potential of new actors from

the diaspora in global polio eradication initiatives, and emphasises the power to enact

socio-cultural change and development ‘from below’, we are cautious of romanticising

or overstating the role and impact of this group by treating them as a homogenous

unit. It is therefore why we have diversified our recommendations to target different

players in the diaspora taking into account the varying degrees of influence and

connectedness they possess.

Moreover some participants noted an antagonistic relationship between diaspora and

the non-migrating peoples of their origin states.43

The notion that members of the

diaspora living in Western countries or more developed countries are better suited to

address the problems of that nation can be received in an antagonistic manner.

However other participants equally noted the trust and neutral value associated with

diaspora, therefore a closer inspection of this complex relationship is suggested and it

was our intention to consider any such underlying tension when producing the

following recommendations.

43 Interview, British Pakistani Academic, November 2013



29

PART 4/RECOMMENDATIONS

FOR FUTURE WORK



MADE IN EUROPE 30

4.1 RECOMMENDATIONS

The following recommendations are a result of the preceding research into the

perspectives of the diaspora communities on the eradication of Polio. Although the

research incorporated the perspectives of all three diaspora communities, the

developments made in Afghanistan during the course of this project including the

engagement of the Taliban on the Polio eradication campaign44

have significantly resolved

the resistance seen in that country and led to a professional and dedicated eradication

programme. Thus, the recommendations offered here will focus mainly on the Pakistani

and Nigerian cases – where the situation unfortunately has either deteriorated or not

improved enough.

Further research is encouraged to determine the viability of any of these approaches as

they have stemmed from anecdotal and qualitative research. Nevertheless there is a

potential for a diaspora-led effort in eradicating Polio that could work alongside current

international efforts.

4.2 THE DIASPORA

“AWARENESS CAMPAIGN”

To address the uncertainty among the diaspora communities towards politicized issues

such as the Polio vaccine, an educational campaign is required in the UK. This will raise

the profile of the Polio disease and more broadly that of health promotion within theIslamic tradition. This campaign would aim to address the questions surrounding the

emphasis placed on the Polio disease globally and ensure Muslims view the issue as a

religious duty. This could include the following:

• Identify and engage connected and influential cross-sector individuals from the

diaspora to pledge to prioritise polio and to place it higher up on the diaspora

agenda in the UK.

• Extend the education and awareness campaign to workshops and sessions

around the country, in particular with religious institutions to build on the work of

the focus groups of this project.

• Facilitate the transfer of knowledge and ideas about Polio and its eradication as

well as Islam’s emphasis on public health between the diaspora and their

countries of origin

• Utilize media outlets including ethnic media press, television talk shows, social

media and advertisements (that are culturally and religiously targeted) to build

pressure on key influential Pakistani and Nigerian stakeholders who maintain

close relationships with their British counterparts.

44 Babakarkhail, Z. and Nelson, D. 2013. Taliban renounces war on anti-polio workers. The Telegraph, [Online]http://www.telegraph.co.uk/news/worldnews/asia/afghanistan/10053981/Taliban-renounces-war-on-anti-polio-workers.html



MADE IN EUROPE 31

4.3 RELIGIOUS LEADERS

“TRANSFER OF KNOWLEDGE”To initiate the exchange of information, workshops and seminars in the UK can bring

leaders together to raise the profile of health promotion within the Muslim community with

an emphasis on the importance of Polio and the vaccine abroad.

Mapping spheres of influence among the Muslim leadership will ensure influential figures

from varied schools of thought are involved to achieve maximum impact. The strong links

between religious leaders in the UK and their teachers or affiliated institutions in endemic

countries can then be utilized to transfer knowledge on the issue. The aim is the

instigation of trusted dialogue between the religious faculty in the UK and their close

counterparts abroad that will create a ripple effect without jeopardizing the grassroots

campaigns. This is geared towards Pakistan and Nigeria where the most work can bedone.

The religious leaders must also play their role in depoliticizing the issue and clarifying the

Muslim legal perspective on the permissibility of vaccines by engaging with the European

Council of Fiqh and Fatwa, for example.

4.4 MUSLIM ORGANIZATIONS

“COMMITMENT TO PROJECT PARTNERSHIP RELATING TO POLIOERADICATION”

As discussed, there is a strong emphasis on health promotion and disease prevention in

the Islamic tradition. This means the continued existence of Polio in Nigeria, Pakistan and

Afghanistan must be seen as a responsibility and duty of Muslims in aiding their brethren.

As the disease begins to spread to Syria and other war torn areas, this is an opportunity

for prominent Muslim charities to divert some attention to the efforts. Recommendations to

taking action include:

• Muslim partners including umbrella global organisations, funding bodies, religious

leaders, and representatives from the endemic countries are brought together in ahigh level conference held in the UK to explore ways in which Muslim efforts can

align themselves with those of the Global Polio Eradication Initiative partners. The

outcome could be a structured coalition dedicated to becoming representative of

the Muslim efforts on this issue and a knowledge incubator for the promotion of

research on improving public health in MMC countries and investment in the

health sector.

• Form a religious committee within the above coalition focused on providing timely

and effective responses to any religious opposition to public health initiatives in

high conflict or tension situations.

• The coalition could partner with local organizations in Pakistan and Nigeria that

are involved in the Polio campaign to amplify and support their work, and increase

uptake of vaccines from a religiously and politically-sensitive point of view. It can



MADE IN EUROPE 32

also provide strategic advice and consultation on integrating immunisation drives

into long-term public health strategies. This has the potential to strengthen

national health information and monitoring systems and capacity building of more

robust healthcare systems within the endemic countries.

4.5 MAINSTREAM ORGANIZATIONS

The following are recommendations set forth for the enhancement of global eradication

efforts undertaken by major stakeholder partners.

• Capitalize on the existing potential of Muslim NGOs in the UK to provide extensive

networks and capabilities that are culturally and religiously sensitive. This is based

on the Muslim NGOs’ experience and current international programmes.

• Reduce in-country tension surrounding the Polio campaign by supporting Muslim

and diaspora organisations to take the lead on working with government and local

NGOs in-country

• Work with diaspora across sectors to invest in improving current public health

systems in their countries of ethnic origin, where the skills, experience and

connection of the diaspora can be utilised by both these countries and the

international donor agencies.

4.6 OPPORTUNITIES FOR SUSTAINABILITY:POLIO IS A GATEWAY DISEASE

Research on the Polio issue in Muslim-majority countries has acted as an unexpected

gateway into exploring the untapped potential of the UK-based Muslim communities and

potentially the North American - to become significant stakeholders in championing global

public health initiatives in those countries. Currently, Muslim-majority countries present the

lowest quality of public health,45

not because of religious belief but rather other factors

such as gross national income, literacy rate, access to clean water and level of corruption.

Although religion does not seem to be responsible for harmful attitudes towards public

health in these countries, it certainly has the potential to foster positive attitudes andpractice. The importance of hygiene, preventative measures and sanitation is paramount

in the Islamic tradition as discussed in this report, and there is sufficient religious

precedent and text to support a faith-based educational campaign or to lobby and mobilise

Muslim NGOs to dedicate programmes specific to developing more robust public health

systems. Thus, a concluding recommendation resonating from our work is that the

emergency and issue of Polio be used to motivate and engage Muslim sector

stakeholders in what could lead the way for more long-term sustainable partnerships in

improving global public health in Muslim majority countries.

45 Razzak, J.A. et al., 2011. Health Disparities between Muslim and non-Muslim Countries. EasternMediterranean Health Journal. [ONLINE].http://applications.emro.who.int/emhj/V17/09/17_9_2011_0654_0664.pdf



33

APPENDICES



MADE IN EUROPE 34

APPENDIX 1

Polio Preliminary Questionnaire

Age:

Nationality:

Years in the UK:

Marital Status:

No. Of Children:

1. Have you heard of Polio?

□ Yes □ No

2. Do you know of a cure for Polio?

_______________________________________________________________________________

3. Do you know anyone who has been affected by Polio?

□ Yes □ No

How are you related to this person? __________________________________________________

4. Do you believe vaccination is permissible in Islam?

□ Yes □ No

5. Would you or have you vaccinated your children?

□ Yes □ No

Why or why not?

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

______________________________

6. Why do you think some Muslims in Nigeria are against vaccinating their children?

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

______________________________________________________



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APPENDIX 2

Evaluation Form

Thank you for attending today’s Focus Group on Polio.

Please take a few minutes to provide us with some feedback on today’s session.

1. To what extent has your understanding about Polio increased?

(1 = Not at all to 5= Significantly increased)

□ 1 □ 2 □ 3 □ 4 □ 5

2. How has your understanding of Polio changed?

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

3. How could this focus group be improved?

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

__________________________________________

4. Is there anything else that you would like to say that you didn’t get the chance to during the focus

group?

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

__________________________________________

5. Make a pledge to take action against Polio!

I pledge to___________________________________________________________________

If you would like us to stay in touch please provide us with your contact information

Email:



MADE IN EUROPE 36

APPENDIX 3

Roundtable Delegate List – January 29, 2014

Afghan Community

Bond

British Pakistan Foundation

Charities Aid Foundation

Department for International Development

Global One 2015

Human Appeal International

Islamic Help

Muslim Council of Britain, Health and Medical Committee

Muslim Doctors Association

Nigerian Muslim Forum UK

Public Health England

Rotary International

Somali Relief & Development Forum

Zahra Trust

Polio Report

Documents

Transcript of Polio Report