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Particle Agglutination Method for Poliovirus Identification
Published on: April 20, 2011
Partition and poliomyelitis: an investigation of the polio disparity affecting Muslims during India's eradication
Rashid S Hussain1, Stephen T McGarvey2, Lina M Fruzzetti3
1Warren Alpert Medical School of Brown University, Providence, RI, United States of America.
Background:
Significant disparities in the incidence of polio existed during its eradication campaign in India. In 2006, Muslims, who comprise 16% of the population in affected states, comprised 70% of paralytic polio cases. This disparity was initially blamed on the Muslims and a rumor that the vaccination program was a plot to sterilize their children. Using the framework of structural violence, this paper describes how the socio-political and historical context of Muslim populations in India shaped the polio disparity.
Methods And Findings:
A qualitative study utilizing methods of rapid ethnography was conducted from May-August 2009 in Aligarh, Uttar Pradesh, India. Field methods included participant observation of vaccination teams, historical document research, and 107 interviews with both Global Polio Eradication Initiative (GPEI) stakeholders and families with vaccine-eligible children. Almost all respondents agreed that Aligarh was a highly segregated city, mostly due to riots after Partition and during the 1990s. Since the formation of segregated neighborhoods, most respondents described that "Muslim areas" had been underdeveloped compared to "Hindu areas," facilitating the physical transmission of poliovirus. Distrust of the government and resistance to vaccination were linked to this disparate development and fears of sterilization influenced by the "Family Planning Program" from 1976-1977.
Conclusions:
Ethnic violence and social marginalization since the Partition and during the rise of Hindu nationalism led to distrust of the government, the formation of segregated slums, and has made Muslims victims of structural violence. This led to the creation of disease-spreading physical environments, lowered vaccine efficacy, and disproportionately higher levels of resistance to vaccination. The causes of the polio disparity found in this study elucidate the nature of possible other health disparities affecting minorities in India.
Limitations:
This study is limited by the manual coding of the transcribed data, size, and some dialectal difficulties in translation.
Insights
Structural violence and social marginalization in India created segregated Muslim communities, leading to significant polio disparities. Historical distrust and fears of sterilization fueled vaccine resistance, impacting public health outcomes.
Area of Science:
- Public Health
- Sociology
- Epidemiology
Background:
- Significant polio incidence disparities existed in India during the eradication campaign, with Muslims disproportionately affected.
- In 2006, Muslims, 16% of the population in affected states, constituted 70% of paralytic polio cases.
- Initial explanations for this disparity blamed the Muslim community and spread rumors of sterilization plots.
Purpose of the Study:
- To analyze the socio-political and historical context of Muslim populations in India.
- To understand how structural violence shaped polio disparities within this community.
- To examine the role of distrust and historical events in vaccine resistance.
Main Methods:
- Qualitative study using rapid ethnography in Aligarh, Uttar Pradesh, India (May-August 2009).
- Methods included participant observation of vaccination teams, historical document research, and 107 interviews.
- Interviewees included Global Polio Eradication Initiative (GPEI) stakeholders and families with vaccine-eligible children.
Main Results:
- Aligarh was found to be a highly segregated city due to historical riots.
- Segregated "Muslim areas" were underdeveloped compared to "Hindu areas," facilitating poliovirus transmission.
- Distrust of government and vaccine resistance were linked to disparate development and fears stemming from a past "Family Planning Program" (1976-1977).
Conclusions:
- Ethnic violence and social marginalization since Partition and during rising Hindu nationalism fostered distrust and segregation.
- This structural violence created environments conducive to disease spread, reduced vaccine efficacy, and increased resistance.
- Findings illuminate potential causes of other health disparities affecting minority populations in India.
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