Mohammed Abubakar's home is not on any map — at least not yet. To reach his settlement in a desolate part of northern Nigeria, four health workers creep over deep-rutted roads in an old Peugeot for an hour, then ride motorcycles over narrow dirt trails for another 30 minutes — stopping only for the odd herd of cattle. Finally, they spot a cluster of mud-brick huts, known to the Fulani nomads who live there as a ruga.
“As-salamu alaykum,” — peace be with you — says Ardo Babangida, a traditional leader accompanying the team. Children swarm around the visitors, and Daniel Santong, an easy-going veterinarian and leader of the group, asks to meet Abubakar, the head of the household. Meanwhile, a young colleague whips out a smart phone and uploads the settlement's Global Positioning System coordinates into a database.
Abubakar arrives, clad in a lavender tunic and white skull cap, and Santong tells him that they are trying to eliminate polio in nomadic people. Abubakar clasps his guest's hands in appreciation. He says that he cannot remember the last time that health workers came to vaccinate his children.
It is a story that Santong and his colleagues are now accustomed to hearing, even though door-to-door immunization campaigns happen on a near-monthly basis in the region.
These dusty paths are the front lines of polio eradication. A 25-year, US$10-billion global effort has taken the number of polio cases from hundreds of thousands per year to just hundreds, but it is now struggling to stamp the virus out of its final strongholds in Pakistan, Afghanistan and Nigeria, where transmission has never been interrupted.
Of these, Nigeria was the only one to see an increase in cases from 2011 to 2012, and public-health experts worry that the virus's recalcitrance here will prevent global eradication, and eventually lead to a wider resurgence of the disease.
The barriers to polio eradication in Nigeria are complex and numerous. The country does not have a working public health-care system, and some local government officials are less than committed to the cause. In urban centres in the north, widespread distrust of the government leads many parents to refuse vaccination for their children.
What is more, in February several polio workers were murdered — for unknown reasons — at health clinics in Kano, northern Nigeria's largest city.