Tanzania - Rumours - Combatting Antivaccination Rumours: Lessons Learned from Case Studies in East Africa

Sr. Dr. Birgitta Schnell, O.S.B. has run the St. Benedict's Mission Hospital in Ndanda for thirty years. It is the largest hospital in the Mtwara Region. As documented in the hospital's annual report, the outpatient department alone saw nearly 66,000 persons yearly. In addition to being the largest regional hospital, St. Benedict's operates a number of dispensaries and clinics in other areas of the region. Its reputation and range of services brings patients from all over the region.

During several meetings and conversations with Sr. Dr. Birgitta, when queried, she could not always remember exact dates. She said that sometime in the early 1990's she received a number of reports and newspapers concerning anti-fertility research in the Philippines, Mexico, and India, as well as other countries. One of her documents is a summary from a WHO Progress report that highlights phase II of an anti-hCG vaccine trial report from the Philippines. [10] Sr. Dr. Birgitta said that she did not actually conduct research, or go looking for this information. All of her documents and articles were sent to her. She reads a great deal. (The Philippines rumour campaign, which formed the basis of the Tanzania backlash against TT, is detailed in Annex I).

What she was reading began to alarm her, especially when word was surfacing about the anti-fertility trials at a time when Tanzania EPI was promoting TT vaccinations. When Sr. Dr. Birgitta attended a zonal meeting in 1994, she shared with the Ruvuma, Lindi, and Mtwara Regions the information she was getting. She and others were suspicious about why only women were told to get TT in Dar-es-Salaam, where vaccinations had already begun in the schools.

After that zonal meeting, different areas of the country began to question the TT vaccinations. In the Moshi Region around Kilamanjaro, Pro-Life activity promoted rumours and questions. Pro-Life produced anti-vaccination materials and gave them out to people to keep them from getting vaccinated. But Sr. Dr. Birgitta said that these activities were not a result of the zonal meeting and what was discussed there. Those activities were the work of the Pro-Life organisation.

When asked what happened following the zonal meeting, she said that Ministry of Health was very angry that she raised questions and wrote her a letter. (An Ministry of Health official said that the Ministry of Health held a meeting with EPI and church officials, had the vaccine tested, and sent Sr. Dr. Birgitta a letter.)

When asked if mothers were now getting TT vaccinations at the hospital, she said that she supported the EPI programme and that vaccinations are given routinely. She told of having the TT vaccine tested by an independent laboratory, so that she could assure herself that the Tanzanian TT vaccine was safe. When she saw that it was not contaminated, vaccinations were given at the hospital.

She said in her interview that she believes that it is very important to vaccinate and that it is very bad that WHO is mixing vaccinations with anti-fertility. "The vaccinations," as they were intended, "are very good and people need to try to get them." She recalled that 30 years ago when she first came to the hospital in Ndanda, she saw many people die from tetanus. So when people (i.e., health officials) thought that she was against vaccinations, she was not. She made it very clear, too, that her opinions on this matter come from the medical side - not the church. (From a walk through the hospital and observation of posters and other posted materials, it is readily apparent that her views are Pro-Life.)

Rumours with Legs

The rumours now discounted in Ndanda have surfaced in other parts of the country. The Tanzania Daily News on Friday, August 17, 2001, reported in an article titled "Isles adopts new anti-polio strategy" that in a seminar organised for journalists in Zanzibar on polio and measles campaigns, participants were critical of tendencies that discouraged efforts to immunise children. They cited a Muslim leader in Pemba who went around convincing followers that immunisations are anti-Islamic. He said that Muslim parents are offered drops of water and dates, and that this religious rite is as good as medicine. They also decried the rumour that in the islands children exposed to vaccines will be rendered sterile.

Several people said that the rumours in the Kilamanjaro area were started by a Pro-Life[9] organisation. Most of the rumours in all areas of Tanzania alleged that the TT vaccine was laced with contraceptives, or that it was anti-fertility.

Nearly everyone interviewed for this report said that Sr. Dr. Birgitta was spreading rumours, but none of those making this claim had actually spoken with her. She says that she did not spread rumours. She took the information she had discovered about anti-fertility clinical trials associated with hCG and raised questions at a zonal meeting. After she was convinced that the vaccine was safe, it was given out at her hospital. She shared her findings that the local vaccine was safe with her counterparts in the region.

9 Pro-Life organisations or members of organisations have the religious belief that life begins at the moment a sperm fertilises a human egg and that it is tantamount to murder to do anything that harms it or the developing foetus. Abortion for any reason is prohibited. According to Human Life International: Abortion is defined by Williams' Obstetrics as "The interruption of pregnancy before viability at the request of the woman, but not for reasons of impaired maternal health or foetal disease. The great majority of abortions now being done belong in this category." HLI states that "This definition by an authoritative source confirms that most abortions are performed for reasons that are considerably less than compelling; i.e., basically convenience. There are many different terms applied to abortion, most of which overlap to some degree and are confusing to most members of the public unless explained clearly."

10 "Anti-hCG vaccine phase II clinical trial – status report." Progress, No. 30. Special Programmeme of Research, Development and Research Training in Human Reproduction. The World Health Organization. 1994. P.8.