Over a dozen Malappuram children are now under observation for suspected diphtheria.

"I have more trust in Allah than in doctors. When you trust doctors more than God, it is perfidy,” asserts Abdul Rahman, a madrasa teacher in Tirur, after a Malappuram child succumbed to diphtheria on Thursday.

This is no surprise in this district, where a worrying re-emergence of diphtheria is putting at risk considerable swathes of its population who still stubbornly shun immunisation and vaccination for supposedly religious reasons. On Thursday, 12-year-old Ameeruddin of Kondotty, who lived in a local orphanage died at the Government Medical College in Kozhikode. He was just one among the thousands of non-immunised children in the district. Over a dozen Malappuram children are now under observation for suspected diphtheria, and three more have been confirmed to have it.

By the latest official count, Malappuram has 23,912 out of 342,657 children below the age of five in the district, the highest in the State, kept out of all immunisation efforts.

That apart, official data also says more than one out of every three children aged between 5 and 10 – or a whopping 36 per cent – growing up in the district never had any immunisation. That leaves them vulnerable to everything from tuberculosis, diphtheria, whooping cough, tetanus, hepatitis-B, meningitis, measles, and polio myelitis. It is not that they had no access to immunisation. Too many of them were deliberately denied immunisation by their own parents or kin.

Two locally powerful and orthodox groups have been traditionally leading a stiff resistance to immunisation.

These include a large section of families owing allegiance to the Sunni faction led by Kanthapuram AP Aboobacker Musliar, and families of hard core Jama’at-e-Islami followers.

With the diphtheria debate now throwing up questions, Jama’at-e-Islami leader Shaikh Mohammed Karakunnu told The Hindu that to immunise the children or not was a question of “personal choice and freedom’’ of the people, and claimed that his organisation has not issued an official call to boycott all immunisation efforts. “We have not issued any such directive,” he said.

The Kanthapuram Sunni group too claimed a similar stance. Although no religious groups or leaders have officially opposed immunisation, none of them has made a call to the community to vaccinate their children, either.

“It is hard to convince the opposers, who claim themselves to be educated,” says the District Medical Officer, V. Ummer Farook.

Even the Indian Union Muslim League (IUML), the second largest constituent of the State’s ruling coalition with a near-complete political monopoly hold over Malappuram, has yet to do anything substantial, apart from its Late leader Syed Mohammedali Shihab Thangal and his younger brother Syed Sadiqali Shihab Thangal consenting to inaugurate a couple of oral polio vaccine drives earlier.

IUML district general secretary P. Abdul Hameed said that his party was now thinking of launching a campaign supporting immunisation. “It has now become the need of the hour,” he said.

There are also others who are not convinced, and for reasons apart from the religious. “We do not oppose immunisation per se. But we are against using children for experimental purposes,” says Mohammed Jaseel, spokesperson for the Institution for Homoeopaths Kerala (IHK).

Dr. Jaseel says a section of homoeopaths were opposing immunisation as vaccination was still being done for already eradicated diseases. “Naturally they suspect commercial interests to be behind mass immunisation,” he said.