Kenya - How Rumours Started - Combatting Antivaccination Rumours: Lessons Learned from Case Studies in East Africa

Rumours may be religious, political or ethnic in origin. In a meeting of KEPI staff, some suggested that the rumours may have been spread by health workers or others who did not understand the purpose of NIDs, or because of jealousy, or feeling left out. Some health workers were trained during social mobilisation activities while others were not. Whether it was priests, health workers, mothers, or chiefs, rumours continued to flourish in Central Province because no one could answer the questions raised by the mothers. All their sources of information didn't know the answers.

Rumours in Central Province have circulated from 1996 to the present. They vary in character, but the major ones are about OPV being laced with contraceptives or HIV. These rumours seem to have impacted the 1997 campaign most, but rumours themselves have not necessarily played a central role in low turnout for NIDs. It is rumours along with other factors which may account for the poor results in Central Province.

The first Kenya NIDs in 1996 took place in the context of a political atmosphere that bred fear and distrust. The current government and its ruling party, in the view of people in Nyeri, had neglected the Central Province because it is home to the political opposition. President Moi and his Kenya African National Union Party have governed Kenya since independence.

A study in 1997 reported that the involvement of the Office of the President (Provincial Administration) in mobilisation and use of the Chiefs' camps as immunisation centres reinforced negative publicity against NIDs, since the provincial administration was perceived to be a tool of the ruling party. [7] The report went on to say that the administration's involvement in NIDs may have sent the wrong signal and helped fuel negative allegations from sections of the Catholic Church and some opposition politicians.

People had not been adequately sensitised to the global eradication of polio. Some health workers, most of the mothers and caregivers, and all of the opinion and religious leaders did not understand the purpose of NIDs. After all, mothers in Central Province were doing a good job of getting routine immunisations for their children. Now why all of the free, extra doses? Kenya had not had a case of polio since 1984; as far as everyone was concerned, polio was not a problem in Kenya.

Health workers had told mothers for several years before the NIDs that their children needed only four OPV doses to be fully immunised. Based on that knowledge, questions came up. Wouldn't the extra doses be toxic to their children? Couldn't their children be overdosed? And if the government was going to spend all this money on polio, why wasn't another disease chosen since their children were already immunised against polio? Why should polio be a priority, given all the health problems they faced? Why this campaign when we are immunised already? Who has seen a case of polio?

In addition to a political situation fraught with suspicion, national elections were scheduled for 1997. Political divisions were entrenched and deepening. People questioned whether the ruling party was attempting to root out the opposition by the use of vaccines that are toxic, or laced with contraceptives or HIV/AIDS. People in Central Province were fearful of anything "free" from the government.

Once rumours and the growing fears got rolling, they were hard to stop. They continue to circulate on a limited scale today. No one could help the mothers. When mothers went to their religious leaders or some of the health workers, they could not get factual answers to dispel their fears or refute the rumours because of inadequate preparation against the rumour campaign. Social mobilisation and training were limited and late due to inadequacy of financial and human resources.

There has been a widespread belief that the Catholic Church actively campaigned against NIDs by dispensing erroneous information in 1996 and 1997. However, while some priests influenced people to boycott the NIDs, it was not for religious reasons. The priests felt that they had a moral obligation to speak out against issues that threatened the community. [8]

In this atmosphere of fear, several other things happened that may have consciously or subconsciously contributed to the uneasiness and the rumours of people in Central Province. NIDs were launched at the same time as the national HIV/AIDS campaign. Perhaps these two health issues became linked in some minds and may have accounted for the rumour that OPV was laced with HIV.

People also had a fear of devil worship. The Commission on Devil Worship, chaired by Bishop Nicodemus Kirima of the Roman Catholic Diocese of Nyeri, had just concluded its work. Some rumours were related to devil worship, including the color of OPV (red) and the snake on the WHO logo. Fears came up about the safety of children, especially opening their mouths, which caused caregivers to associate the move with the "removal of tongue," a practice said to be associated with devil worship. House marking during the 2000 NIDs was rejected in some areas because of its association in the popular mind with devil worship.

While official statistics confirm low turnout, might the figures be based on erroneous estimates of the number of children under five in Central Province? That is the suggestion of the former Provincial Medical Officer, Dr. Mwangi, in an interview in his medical offices.

The Stories

In 1996 Bishop Nicodemus Kirima spoke from the pulpit against polio vaccination NIDs. The Kenya Ministry of Health and Douglas Klaucke, WHO Regional Epidemiologist, met with Archbishop Ndingi Mwana'a Nzeki, Bishop Njue, Bishop Koris, and the communication officer for the Catholic Church, several other top church officials, and their medical doctor in a six hour discussion. This meeting was called in an attempt to stop Church opposition to NIDs.

The Catholic Church leaders and officials believed that OPV was laced with contraceptives. They cited TT and contraceptive studies. The meeting was further complicated when the WHO medical officer stated, contrary to fact, that WHO did not support contraceptive research.

During the discussion it became clear that the bishop was not against polio campaigns per se, but saw them as a prelude to other campaigns, especially ones that would involve injections that could then be laced. This anti-vaccination campaign was based in the Diocese of Nyeri, and without support from the national bishops' conference, much less the Vatican. The campaign, however, did have an international dimension as vaccination opponents got their misinformation from the Internet.

As a result of the meeting, the church officials agreed to be quiet about OPV but they would not agree to support OPV. However, they did not follow up by communicating this pledge in their pastoral letters to all parishes.

8 National Immunisation Days (NIDs) Consultancy Final Report. 1997. UNICEF. Nairobi.