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Polio must be eradicated. It's a crippling disease but it can be beaten, as I should know

World View: Bill Gates's campaign against the virus prompts our columnist to recall his own battle with it almost 60 years ago

Patrick Cockburn
Sunday 24 February 2013 01:00 GMT
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A child receives polio vaccine in Kano, Nigeria
A child receives polio vaccine in Kano, Nigeria (Getty Images)

I always have an emotional jolt when I hear of people administering polio vaccine being murdered in Pakistan or Nigeria. The latest killings were in Kano, in northern Nigeria, earlier this month, when at least nine women health workers were shot dead by gunmen as they prepared to give the oral-drop vaccine to children. The motive is a belief among Islamic extremists that the polio immunisation campaign is a Western plot against Muslims, possibly aimed at making the men infertile.

I have a personal interest in this, as I caught polio in one of the last epidemics in Western Europe, in Cork, in 1956. It affected both my legs and, initially, my back, so, for a time, I was confined to a wheelchair and used crutches until about the age of 10.

I thought about the Cork epidemic again earlier this month when Bill Gates used the annual Dimbleby lecture to speak about his campaign to eradicate polio, now confined to Pakistan, Afghanistan and Nigeria, by 2018. Standing beside an "iron lung", a terrifying apparatus used to keep alive polio victims who could no longer breathe on their own, he quoted from my account, in a book called The Broken Boy, of the beginning of the Cork epidemic and what had happened to me.

I had not read in recent years the passage cited by Mr Gates, which describes the start of the epidemic in June (polio was called "the summer plague"). Ostensibly to prevent panic, and more practically to avoid commercial damage to Cork businesses, the main local newspaper, The Cork Examiner, played down the outbreak, reported new polio cases below the fold with comforting headlines such as "no occasion for undue alarm" and "outbreak a mild one". Victims were not named and heavy coverage was given to polio epidemics elsewhere in the world. These repeated understatements and the generally evasive tone had the quite contrary impact of persuading people in Cork that the illness was far worse than was being reported. It was widely believed locally that the authorities were secretly moving dead bodies out of the back door of the fever hospital, St Finbarr's, and burying them in the dead of night.

By the time I caught polio at the end of September, The Cork Examiner had stopped reporting the epidemic, under pressure, so my father told me, from its main advertisers, who found that news of the outbreak was deterring customers from visiting Cork and was having a depressing effect on their businesses.

Polio as a disease always had a charge of fear to it which has now, mysteriously and horribly, been transferred to the vaccine being used to eradicate it. It is an old illness – there are pictures of ancient Egyptians with withered limbs – but it has produced epidemics only in modern times. Previously, most people were self-immunised by being affected by the virus at an early age. But the growth of modern cities with sanitation and clean water in the 19th century for the first time left great numbers of people vulnerable, and it is a very easy disease to contract.

The first big epidemics took place in cities such as Melbourne, Copenhagen, New York and Chicago. It created such terror because it primarily affected young children and there seemed no way of remaining safe from it. Everybody was affected by the polio virus, usually without knowing it, though only a small minority suffered long-term physical damage. It was largely a middle-class disease because their living conditions were better, but, in New York, where there was a serious outbreak in 1916, it was blamed on newly arrived Italian immigrants. Townspeople in Long Island and New Jersey patrolled the roads with shotguns to keep out visitors. Cats were suspected of spreading the virus and 72,000 of them were hunted down and killed. Blondes were believed to be more vulnerable than brunettes.

I caught polio because my parents believed that their children would be safe from the illness because we lived deep in the countryside outside the town of Youghal in eastern Cork. In fact, I would have been safer in the slums of the city because it was people living in isolation such as ourselves, who had not been self-immunised, who were most at risk.

I have vivid but episodic memories of being ill. I had woken up in my bedroom in our house, Brook Lodge, with a headache, sore throat, nausea and sweating. The symptoms were not much different from flu, but because there was an epidemic the local doctor recognised them for what they were. He called an ambulance. I remember it was a cream-coloured vehicle that stopped beside the tall dark-green yew trees outside the house. The rear doors of the ambulance were open and two men in white coats carried me into it on a stretcher as my distraught mother waited in tears beside the vehicle.

Searching to say something comforting to cheer me up, my mother said: "The driver will turn on the siren and all the other cars will get out of the way." I must have sensed the panic in my mother's voice and I screamed, "I don't want them to sound the horn! I don't want it!"

I was three weeks in St Finbarr's, where the treatment was good, and several months in an orthopaedic hospital in the city, where care was dreadful. After a time, I refused to eat the disgusting food or speak to anybody, and my parents believed I was dying, though the doctors attributed my decline to the effect of polio rather than mistreatment.

Against the doctors' advice, my parents took me home where I rapidly recovered my spirits. At first, I was in a wheelchair, but, with physiotherapy, I learned to walk again using callipers and crutches. After a few years, my parents felt I was becoming too dependent and sent me to a boarding school in Dublin called St Stephens, which was good for me, and where I threw away my crutches. I have never been able to run and do not drive, but otherwise my physical injuries have had only a limited impact on my life.

An effective vaccine against polio had been discovered by Dr Jonas Salk in the US in 1954. Tested there successfully the following year, it was not being widely used in Europe at the time of the Cork epidemic. Polio is close to being eliminated worldwide but, as Mr Gates pointed out, its elimination must be total or it will rebound because of the ease with which it is transmitted, and soon there will again be tens of thousands of cases in dozens of countries.

In one sense, I was lucky that my parents were well enough off to look after me. When I meet people who, like me, were crippled or partially disabled by polio, I usually find it encouraging because so many have done well in life despite injuries far worse than mine. A farmer from Blarney, near Cork, whose family had adapted all the farm machinery so that he could operate it despite severe disabilities, once said to me that he and I met only the survivors, not the people whose families were too poor to look after them properly.

I thought of his words again when I read about children in northern Nigeria, their legs crippled in a polio epidemic in 2003 because they had not been vaccinated. Unable to stand on their withered limbs, they propel themselves on wooden skateboards, dodging cars and vehicles, as they beg amid the roaring traffic.

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