Two years after Nigerian militant group Boko Haram attacked his hometown of Gwoza – killing men and burning down houses – Ali Bello feared the worst when he received a panicked message from his wife.

The rickshaw driver – who works in the nearby town of Mubi in northeast Nigeria – raced home to find that their five-year-old son had been rushed to hospital after falling severely ill.

“When they told me the boy had polio, I did not believe it,” Bello told the Thomson Reuters Foundation by phone.

“Some people in Gwoza are afraid,” he said. “They have been telling their children not to go to our house.”

Nigeria was stunned in August when two cases of children being struck by polio were reported in Borno state – Boko Haram’s former stronghold – after two years in which the country, and the continent, had appeared free of the disease.

Two more cases have since been recorded by the Nigerian government, but health officials fear many more could come to light. Experts estimate that for every case of polio that paralyses its victim, 200 silent infections go undetected.

The virus, which can cause irreversible paralysis within hours, spreads rapidly among children, especially in unsanitary conditions in war-torn regions, where healthcare is limited.

Boko Haram’s seven-year insurgency aimed at creating an Islamic state has disrupted health services across Nigeria’s northeast and hampered efforts to get vaccines to children at risk.

While Bello’s older children received polio vaccinations many years ago, he said the younger ones had missed out due to the instability caused by the Islamist group.

And as fighting between the militants and the Nigerian army forces continue causing people to flee their homes, aid agencies are concerned that the virus could spread to neighbouring Chad, Niger and Cameroon, and nearby Central African Republic.

FIGHTING FEAR

Nigeria and the World Health Organisation (WHO) are strengthening surveillance systems, while a drive was launched by the U.N. children’s agency (UNICEF) last month to vaccinate more than 41 million children in West Africa’s Lake Chad region.

But health workers in Nigeria must contend not only with fear of the virus itself, but also suspicion of the vaccine.

Some religious leaders in northern Nigeria openly oppose polio vaccination, saying it is a conspiracy against Muslim children and that the vaccines could cause infertility and AIDS.

In 2013, gunmen on motorbikes killed nine health workers delivering vaccines in two separate attacks in the city of Kano.

Yet Nigeria’s health minister, Isaac Adewole, said misconceptions about the vaccines were “a problem of the past”.

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