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Photo Book Reviews

The End of Polio: Global Effort to End a Disease by Sebastião Salgado, essay by Siddharth Dube Brazilian photographer Sebastião Salgado was appointed a UNICEF Special Representative in 2001.  His work on polio eradication, including this book, is helping to spearhead the last push to end the disease. Article rating: 4.86

Since the early twentieth century, polio has severely disabled approximately twenty million adults and children around the world.  From 1988 to 2002 the number of people dropped from 1000 children per day contracting polio in 1988, to 2000 people (adults and children combined) worldwide in the entire year of 2002.  In May of 1988 at the World Health Assembly in Geneva, nearly all the countries in the world resolved to eradicate polio completely by the year 2005.

In The End of Polio, Sebastião Salgado divides the book by the five countries he focuses on: the Democratic Republic of Congo, Sudan, Pakistan, Somalia and India. Each section includes a different essay that touches on each country’s role in the eradication effort, and their own specific struggles to be truly free of polio.  Throughout the book Salgado examines the effects polio has had on children, and more specifically, the heroic efforts being made by the health workers to combat the disease.  His stunningly lush black and white photographs are complimented by a foreword by Kofi A. Annan, the Secretary-General of the United Nations, a deeply moving personal essay by UNICEF writer Siddharth Dube and an interview by Dr. Ciro A de Quadros, one of the creators of the polio eradication campaign. The book is a poignant tribute to these children living affected by the disease, as well to the millions of health workers worldwide, who have fought to surmount the dangers of their work to see that the perishable vaccine is properly cared for and dispensed. 

The vaccine for poliovirus was developed nearly a half-century ago by Dr. Jonas Salk and Dr. Albert Sabin, and is easily administered.  However, global immunization has been a difficult task due to the fact that in countries such as Somalia, India and the Democratic Republic of Congo, refrigeration is a luxury, sanitation is poor and there are no records of who has already been immunized.  Each child must receive four doses of the oral polio vaccine (OPV) before its fifth birthday, and without written records it is extremely difficult to keep track of what dosage the child is on, or if they have begun the process at all.

Salgado’s images range from photographs of people in wheelchairs and crutches who have been ravaged by the disease, to health workers holding children while administering the oral vaccine (the easier vaccine of the two, the other option being intravenous).  The choice of shooting in black and white makes his subjects stand out in the image, giving an honest yet brutal picture of the disease and the people involved.  Many of the images are close up, nearly portraits, while some step back and allow the viewer to see the larger picture, as it were, from the whole population of the Keny cattle camp in Sudan, to a street rally about the polio immunization campaign in India.

Siddharth Dube’s essay compliments the photographs as he tells the story of his brother who was paralyzed by polio when he was a child in India, giving the book a deeply intimate feel as he describes the hardships that many families around the world know all too well.  He also gives the history of poliovirus, the methods of combating it and the obstacles to be overcome to truly eradicate the di¬sease worldwide.  Complimenting his essay is an illustrated timeline of the disease, beginning in 1580-1350 BC and ending at the year 2005, as well as donor information,  how to help the campaign and selected resources.

INDIA, 2001 - The Rehabilitation Center for Children, in Kolkata, West Bengal, was founded in 1973 primarily to care for post-operative polio patients. © Sebastião Salgado

While eradicating polio has been no easy task, the sacrifices made have not been without rewards.  As of today the year-to-date count of polio cases in 2007 has so far been 187 globally, 155 in endemic countries and 28 in non-endemic countries (http://www.polioeradication.org/casecount.asp).  Considering that in 1988, 1000 children contracted polio every day, these new numbers have been cited as no less than a miracle.  With the support and dedication of nearly every country on the globe, the hope that polio will someday soon be eradicated completely is steadily glowing brighter.

While one of many tributes to this ongoing struggle, The End of Polio stands out in its eloquence, beauty and resolution.  It is books like this that truly inspire the reader to help with the global effort being made to eradicate not only polio, but other devastating diseases that also require our attention and support. 

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