On a road out of Kano, the largest city in Nigeria's Islamic north, Ayo Bello sits by two dozen brightly colored tricycles built by the Physical Handicap Association of Nigeria, of which he is a member. The vehicles have hand-controlled pedals for people with leg disabilities, such as Mr. Bello, who was paralyzed by polio at age 6.
Kano is the center of the world's worst outbreak of the disease, but its government refuses to participate in an international inoculation program, claiming that the vaccines are contaminated.
"We need the vaccine," Mr. Bello says. "But only if the vaccine is safe."
His ambivalence reflects a deeply damaging tension between international health agencies based in Western countries and the Kano authorities, who apply a strict form of sharia, or Islamic law. Both sides are keen to play down the political and religious aspects of the dispute, but some of the strongest opposition to the vaccination campaign has come from Islamic leaders who say the alleged contamination is part of a Western plot to make Muslims infertile. The resulting deadlock highlights an isolationist tendency in parts of the ruling northern elite.
"Anything where it would mean joining the international community, they don't want it at all," says a Kano-based imam from western Nigeria who asks not to be named. "This is not a new thing for them; they have been doing it a long time."
The Kano state government has boycotted two four-day inoculation campaigns held in Nigeria during February and March, even though the vaccines have been used in the country's other 35 states and have been certified safe by the World Health Organization. Sule Ya'u Sule, spokesman for the Kano government, denies any political motivations and says a test by a scientific panel showed the vaccines were contaminated with dangerously high levels of female hormones.
International health officials worry that the boycott will undermine attempts to eradicate polio worldwide by the end of this year. The World Health Organization says Nigeria accounted for nearly half of the 782 confirmed cases of polio last year, and that the disease has spread to eight other countries in the region.
The position of the Kano government is endorsed by a number of Muslim leaders who are highly critical of Western motives and behavior.
Inside a small schoolroom with Arabic writing on the blackboard and "Saudi Arabia" inscribed above the door, Imam Hashim Abdulla Mohammed Salis claims polio vaccines elsewhere in the world have been infected with the HIV virus, although he cannot name the country affected. He dismissed reassurances given by Olusegun Obasanjo, the country's born-again Christian president, who urged Nigerians to accept the vaccine after it was declared safe by a national panel including government representatives, traditional rulers, scientists, and Islamic leaders.
"I know that Obasanjo is not a Muslim," says the imam. "Anything that Obasanjo says will not appease me."
Opposition to the vaccine has been strengthened by a 1996 controversy in Kano involving Pfizer, the US drug company. A group of Nigerians has taken the company to court on behalf of more than 30 people who either died or were disabled after allegedly taking an experimental meningitis drug. Pfizer has denied wrongdoing. The case was reopened by a US appeal court last year.
The Pfizer case is cited by a number of people of Kano as a reason to be suspicious of the polio vaccine - and outside influence. Adamu Kachalla, a textiles trader, says northern Nigeria needs to be wary of attempts by Western countries to impose their values on Muslim societies. "They are not doing it without materialistic reason," he says.
Observers say northern Nigeria has always sought to preserve a strong identity in a country formed when the British colonialists fused the northern half with the predominantly Christian south in 1914. The northern region is poor and undeveloped even by the standards of a nation in which average incomes are estimated by the International Monetary Fund at a little more than a dollar a day.
Most of the military dictators who have dominated the country's postindependence politics came from the north, instituting a system in which wealth tended to trickle down to the northern region through the largess of influential men rather than through any coordinated attempts at development.
The result, analysts say, is that the region's leaders generally command great loyalty from people who have little hope of advancement through other means. Gen. Sani Abacha, the former dictator whose brutal rule turned Nigeria into an international pariah state, still has a prominent street named after him in Kano.
The vaccine dilemma is seen by some observers as the latest privation endured by northern Nigerians under a ruling elite that has long used a mixture of religion and politics to reinforce its power.
Men in and around the city's main market say they support the Kano government's position, and some say that strong, Islamic-based political leadership is critical in guiding their own decisions.
"We depend on our religion," says Mohammed Kabir, a Kano student. "Anything our leader says, we are going to agree with him."
Since the return of civilian rule in 1999, a dozen northern Nigerian states, including Kano, have imposed strict forms of Islamic law involving punishments such as amputation and stoning to death. Other northern states such as Zamfara, the first state to impose strict sharia, initially stayed out of the polio campaign but have since joined.
Back at the Physical Handicap Association of Nigeria workshop, Bello is torn between his respect for authority and his desire that others not suffer the hardships he has endured. He accepts the state government's conclusion that the polio vaccine is unsafe but adds that he thinks inoculation is a very good idea in principle.
"Things must not go on as they are now," he says. "There must be a way out."