Chasing Polio: Photojournalist Jean-Marc Giboux on Health Literacy, Healthcare Education and the Need for International Global Health Cooperation
New photography exhibition highlights the history of polio eradication efforts worldwide and the need for Health Literacy | By Kimberly J. Soenen
(Reconstructive polio surgery in Delhi. Photo by Jean-Marc Giboux.)
When I was young, I believed in Santa Claus even after my older brother told me he was not real. On one Christmas Eve night, we were told by my parents that Santa was going to visit our home before he took off on his sleigh to make global deliveries.
I believed, or, wanted to believe.
When Santa came to our front door carrying a large bag of gifts, he was jovial and joyous. He had a deep voice and a loud belly laugh just like the Santa I had been groomed to recognize in media, stories and book illustrations. But I noticed one thing as my brother sat on Santa’s lap making wishes in our foyer. Santa’s body sloped to the left side. At his shoulders, his left shoulder was much lower than his right and he held his head lower than most people, a little to the left of his core. There was strain.
It was then, as I sat crouched in my pajamas at the top of the stairs hugging my trusted co-believer—a terrier mutt we had named Pucci—that Santa was our next-door neighbor, the father of my then closest childhood friend. Denny had polio as a child and, although he was extremely active, the illness had impacted his body for life. His body was slightly contorted. I did not know when I was younger why his posture was compromised, but I was eventually told—and in that moment on Christmas Eve, I knew it was him. My friends and I did not know many people with polio when I was young, but as a young adult I did meet adults and elders who had been impacted irreversibly by the illness.
Photojournalist Jean-Marc Giboux considers himself to be in the school of concerned photographers. He has documented efforts to eradicate polio globally for 18 years. From 1997 until 2015 he traveled the world aiming to capture socially and politically-minded images related to polio that educate people and have the power to change legislation and Health Literacy practices globally.
Afghanistan and Pakistan have never stopped the transmission of endemic wild poliovirus. The African and Eastern Mediterranean regions of the World Health Organization (WHO) try to ensure that polio has truly ended and immunity against the virus improves. In many countries of the world, surveillance against polio is maintained through several Public Health program initiatives and vaccination activities continue, to make sure children remain protected as long as there is polio anywhere. Outbreak countries are those that have stopped indigenous wild poliovirus but are experiencing re-infection either through the importation of wild or vaccine-derived poliovirus from another country, or the emergence and circulation of vaccine-derived poliovirus.
All countries remain at risk of polio until the disease has been completely eradicated from the world. Until then, the best way for countries to minimize the risk and consequences of polio infection is to maintain strong population immunity levels through high vaccination coverage, and strong disease surveillance in order to rapidly detect and respond to polio.
(Schoolchildren, many of them polio victims, arrive in the morning at the Akshay Pratishtan School in New Delhi. February 19, 2004. Photo by Jean-Marc Giboux.)
I last bumped into Jean-Marc Giboux at a Museum of Contemporary Photography (MoCP) event in Chicago that was addressing the history and impact of BIPOC photographers. He is opening an exhibition in Chicago this month called Chasing Polio. I contacted him recently to talk about the polio exhibition, Covid, measles, the AntiVaxx movement and how Perpetual Warfare and political polarization impacts Global Health—most of all, children.
What have you witnessed in hospitals where children have had polio and have to be cared for despite modern day medicine and vaccinations?
Polio attacks the nervous system and leads to irreversible paralysis. The progress can be stopped but cannot be repaired. Polio victims don’t spend time in hospitals unless they can access reconstructive surgery, which is very rare. In countries with high poverty and marginalization rates, if a child has polio, it means having a child that cannot provide for the family and will be a burden for the family his whole life.
Reconstructive surgery is expensive and not easily available. In these countries it’s not rare to see children with polio begging in the streets. In the most severe cases, patients lose their ability to breathe on their own and end up surviving only with an iron lung machine. People in countries without access to that level of care do not survive.
In all of your time documenting polio patients and medical professionals making efforts to eradicate polio, what is most compelling to you about the international progress since the early 1990’s?
The fact that the campaign went on despite all the crisis that were tormenting the world and affected polio endemic countries. It was like a parallel universe. The wars inAfghanistan slowed the progress but didn’t stop it. Even the Taliban went along with immunization in the regions they controlled. Every world crisis had the potential to let polio explode again, but each time it was met with effective emergency responses by Global Health initiatives and Health Literacy programs. Unfortunately, the countries where the virus persisted are often among the poorest, with populations at risk unable to access basic health services due to isolation, neglect, civil strife, or war. Polio is definitely an illness of poverty.
What is the status now?
When all countries of the World Health Organization (WHO) voted unanimously to eradicate polio in 1988, there were more than 350,000 declared polio victims every year. Last year, in 2023, there were only twelve reported cases of the wild polio virus, including six in Pakistan and six in Afghanistan. These two countries are the two remaining polio endemic countries left in the world. There have been cases of polio derived from the vaccine, but the wild polio vaccine is on the verge of disappearing entirely.
(Photo by Jean-Marc Giboux)
What have you witnessed in the field that makes it challenging to educate people about Health Literacy and polio prevention—and, how, as a photojournalist to you earn the trust of parents and children, especially when a language barrier presents?
I witnessed two kinds of resistance to the vaccine. The first was immediately after the September 11, 2001 global warfare attack on the United States. During the wars in Afghanistan and Iraq, a brush fire rumor spread that the polio immunization campaign was a United States plot to sterilize young Muslim persons in Pakistan and Afghanistan, and also in Nigeria, Niger and Mali.
(Jalozai Refugee Camp for Afghans in Pakistan after September 11, 2001. Polio eradication education posters next to Osama bin Laden posters. Photo by Jean-Marc Giboux.)
In response, Global Health officials enlisted local and tribal leaders to authorize vaccinations. The fact that the United States Military and National Security apparatus used bogus vaccination programs to collect DNA from the children of Osama bin Laden to kill him didn’t help the Health Literacy or vaccination education cause.
The second notable resistance to vaccinations to polio was from mothers who could not access healthcare for their children in India because of corruption or neglect by people in power, but they kept being asked by WHO and other organizations to immunize their kids a few times a year. They tired of it and used that opportunity to express their revolt. 2021 started with a shooting incident on polio eradication health worker teams and with parents refusing to vaccinate their children in Karak City of KPK province of Pakistan. Karak is a hotspot of poliovirus. This hostile attitude toward polio vaccinators and misconceptions about religion and polio vaccine may turn out to be a major Public Health challenge because the rest of the world had been declared polio free and Pakistan may become a source of its transmission to other parts of the world.
How does the vaccination process work for parents?
Varioius organizations in the field globally conduct National Immunization Days once a year. These are days where kids are vaccinated twice one month apart. When there is an outbreak of polio, they will carry emergency polio vaccination to an area of the outbreak. To reach each and every child, some of them are immunized a few times in one year, but that is harmless. The drops are usually to be given twice a few weeks apart.
How did people respond to the polio vaccination tents and physicians administering care in some of the most remote areas of the world?
The immunization campaign has been overwhelmingly welcome almost everywhere I have traveled including places like India, Pakistan and Nigeria. People can see the destructive effects of polio there every day. Here, in the United States people have been protected from polio for so long, young people especially don’t know what the vaccination has prevented.
The impacts of polio on the body in the United States is not widely seen. What are the pitfalls of the successful vaccination campaign worldwide?
It is easy for younger generations especially to forget and dismiss the importance of vaccinations. If they witnessed what I’ve witnessed regarding the lack of access to vaccinations, Health Literacy challenges and Neglected Diseases worldwide, they may not be so enthusiastic about embracing and supporting the Antivaxx movement.
When you see how children are paralyzed or immobilized by polio repeatedly, that’s stays with you.
(Children line up and pray in the schoolyard before starting class at the Amar Jyoti Rehabilitation Center in Dehli, India. The Amar Jyoti Center is a charitable trust promoting integration for the orthopedically disabled by education, rehabilitation and job opportunities. The school is integrated, mixing physically handicaped children with healthy ones, so they learn to live together. Photo by Jean-Marc Giboux.)
The United States Centers for Disease Control and Prevention (CDC), Department of Health and Human Services (HHS) and the Office of the United States of America President struggle with maintaining the Public Trust in the context or healthcare. The Covid pandemic response was like building a plane in flight for the disjoint and competition-driven healthcare model. The lack of preparation and ineffective communication made Americans less trustful about vaccinations and Public Health data. We are still weathering through the byproducts and fall out of that mismanagement and lack of preparation today. How do you feel about where the Antivaxx movement is now?
The return of measles in the United States is terrible, It is happening and shouldn’t be. There is so much misinformation available that people make up their own opinion, thus, disregarding the Public Health and medical facts. Vaccines work and children are growing up safely and healthfully thanks in large part to vaccines. But vaccines only work globally when the citizens of every country are on the same page. Vaccinations and Health Literacy shouldn’t be politicized.
To what do you and others attribute the success of the polio eradication campaign?
The declaration to eradicate polio was made during the Cold War, and all the leaders of each country were on the same page when it came to vaccination efficacy. To this day, the polio eradication effort is the world’s largest Public Health initiative ever attempted by world leaders working together in the interest of Public Trust and Public Health.
I do understand the mistrust of the pharmaceutical industry because of their price gouging and every other tactic they use to extract profits. What is fascinating to me is Jonathan (Jonas) Salk never patented the polio vaccine. When Edward R. Murrow asked Jonas Salk about patenting to the polio vaccine, Salk famously replied “There is no patent. Could you patent the sun?”
He gave it away. Imagine this happening in our competition-driven society today. The notion of a pharmaceutical company innovating and developing a medicine today and donating it to society for the sake of Global Health and geopolitical stability is not even a consideration.
What other Global Health issues have you documented over the years and has photography made an impact on global health positively?
I have documented Cholera in Haiti, Human Immunodeficiency Virus (HIV) in Africa and India, and I worked with Doctors Without Borders on Tuberculosis (TB) in the former Soviet Union and Ethiopia. My work has been exhibited and published widely for Health Literacy and Public Health Education fundraising globally and I believe it is where it can make the most positive impact on Global Health with my lens.
Can one photograph, one frame, still make a difference in our media-saturated and Ai-hijacked world?
A picture of one child affected by polio will not change the world on its own, but it can evoke empathy, understanding, and compassion, and generate funding for Global Health campaigns.
What made you decide to exhibit your polio images in the SOME PEOPLE group exhibition in 2019 and at the Chicago Center for Photojournalism now? Is polio still a conversation? How do people respond to your work now vs. in the 1990’s?
Polio is not in the conversation any more and I want to continue pointing to it with my work. When I talk about it, only older generations remember the polio scare and iron lungs. Older people have friends who were paralyzed by polio. Even those older persons are surprised when I tell them polio is still not yet eradicated. I think it is vital to share history visually so people don’t forget. The past informs our Public Health decisions today.
(Cheshire Home for Handicapped Children in Sierra Leone, during the Civil War in 1998. Photo by Jean-Marc Giboux.)
The killing of polio eradication healthcare workers in Pakistan and Afghanistan is an issue of grave concern. More than 200 polio team workers have lost their lives while working on polio campaigns. There is a lack of awareness of the dangers of polio, and false religious beliefs are quite common in northern areas of Pakistan, especially in cities near the Pakistan-Afghan border. More than 200 polio team workers have lost their lives while working on polio campaigns. Do you have one memory of healthcare workers that has not left you over the years while working on polio eradication efforts? What’s at stake out there?
Sierra Leone was my first experience of an African civil war and the polio vaccinations were happening as the rebels from the Revolutionary United Front (RUF) were battling government forces on the outskirts of Freetown. The RUF was a rebel group that fought a failed eleven-year war in Sierra Leone, beginning in 1991 and ending in 2002. We could hear the artillery exchanges and I was following a team of vaccinators looking to immunize kids from refugees fleeing the fighting, on the road, in camps, and anywhere they were hiding. The healthcare workers were amazingly committed to the campaign even though they were about to become refugees themselves. The RUF took over Freetown a few weeks later and started a reign of terror hunting down ex-government workers in a wave of looting, rape and murders. I was airlifted out of Sierra Leone on a United Nations flight but the vaccinators had to stay behind.
It was heartbreaking.
( Polio vaccination campaign during the Sierra Leone civil war. A mother takes her child to a polio vaccination center while a government soldier guards the road that leads out of town, toward the frontline and the Revolutionary United Front (RUF). December 1998. Photo by Jean-Marc Giboux.)
You’ve documented Public Health issues, and the impact of trauma and vicarious trauma on children living in Chicago over the course of your entire career. What are you witnessing now and what would you like to see change in Chicago’s approach to, and model of, Public Health and Safety?
It is a work-in-progress because the lives of the kids I have been following are never settled…you know, kids are all a work-in-progress. So many neighborhoods and communities are damaged by poverty. Poverty is everywhere worldwide, and Chicago is no different. Poverty is the culprit and the consequences of that marginalization (most often intentionally) are a lack of access to basic health necessities, be it mental or physical healthcare.
For example: The City of Chicago municipal government and the private sector partnered in recent years and tried to improve access to healthy food in the neighborhood of Englewood by opening a Whole Foods store. It sounds good on paper and during the Public Relations campaign but people couldn’t afford it and the store closed after only two years. Dollar Stores—known for their toxic products— were the only ones to survive and now they are pulling out, too, so people have to turn to junk food in gas stations and liquor stories. The diabetes and obesity epidemic are the result.
Have you experienced positive change to Public Health and Safety in Chicago?
In ten years, I have not seen any meaningful change, but I learned that the best antidote to gangs and street life is a decent paying job and education. Lack of opportunity, instability and the lack of feeling safe is at the heart of the cyclical trauma and the cycle of poverty.
How do you see photography impacting people socially today? Do you believe one frame still move the dial on legislation and Global Health policy?
I wish it did, but in today’s world there is such a flood of images that people can pick and choose what will satisfy their point of view. Similar to health and vaccine information on the internet, people cherry pick what reinforces their opinions. Would "Napalm Girl” by photographer Nick Ut or Eddie Adams's photo of Brigadier General Nguyen Ngoc Loan shooting a Viet Cong prisoner have the same impact today as they did in 1968? I don’t think so.
Why do you continue working in photojournalism—what are the challenges, and what are the rewards?
I am still excited when I get a good one, and I still get fulfillment from it. The main challenge? Making a living, and staying healthy. The rewards? Freedom, learning every day, and being in control of my own life.
(Photo by Jean-Marc Giboux)
Let’s talk food, tunes and fun. Oui, oui.
Favorite thing to cook? Anything tandoori.
Three favorite Chicago bands now? Wilco, John Primer for the Blues, and Chris foreman every week at The Green Mill.
If you had an unlimited budget for a ten-page feature spread, what health or healthcare story would you like to photograph? Cancer Alley in Louisiana.
Dive diner or Three-Star restaurant? Dive.
Favorite restaurants in Chicago now? Oiistar in Wicker Park (Korean-Japanese fusion.)
Nikon, Canon, Sony, Leica, Hasselblad or…? And why?
All of them, with Hasselblad on top because it is large format. Whichever one is available. I don’t worship brands or the photographer cult of brands. They are all fine cameras and it’s all what you do with it.
Ai or Authorship? Authorship.
Place that you truly relax? Any swimming pool.
The story in Chicago that remains untold in reportage? Too many.
Chicago or Paris, and why? Paris, because I don’t live there!
Lake Michigan at sunrise, the Seine at dusk or the Ganges during Kumbh Mela?
All of them. I am lucky to enjoy all of them. Lake Michigan for the open space, the Seine for its history, and the Ganges to be on what feels like another planet.
You are exhibiting your polio images in Chicago later this month in a show called Chasing Polio. What will you be speaking about on Opening Night and who do you hope to reach with the story of polio eradication?
My life’s work on polio is about eradication efforts but it is also an important exploration into how other people live. The countries where the polio virus—and many other diseases—has persisted are among the poorest, with populations at risk in places where people are unable to access basic health services due to isolation, neglect, civil strife, and perpetual warfare. The story of polio eradication is a success story of universal cooperation for the betterment of humanity. A polio-free world is a gift to future generations. This type of long-term visionary Global Health collaboration seems more difficult to organize in today’s extremely polarized and violent world.
The economic and political forces in power in the United States and across the world are not working toward harmony and the wellbeing of citizens. Even wealthy countries won’t escape the consequences of climate change, for example. From Environmental Health to thoughtful immigration policy to healthcare policy and Health Literacy, we need new thinking.
Thank you Jean-Marc.
Merci.
Chasing Polio by Jean-Marc Giboux
Opening Night | April 12, 2024
6pm-9pm at the Chicago Center for Photojournalism
Exhibition Run | April 12 -May 29, 2024
Photographer Talk | April 18 7pm-9pm