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Beating Polio in India

 

"Your visit is long overdue... you need to see this program in action yourself."

After welcoming me to India, Rod Curtis, a communications specialist with UNICEF, draws my attention to a map of the country pinned to his office wall in Delhi.

Just a few years ago, he points out, India had more polio cases than anywhere else in the world. The northern states of Uttar Pradesh (UP) and Bihar, in particular, looked like they would never succeed in ridding themselves of this ancient disease. With poor sanitation, densely populated areas and large numbers of people living in extreme poverty, UP and Bihar were the ‘perfect storm’ when it came to the spread of polio. To make things even more difficult, some communities in these states had started to refuse vaccinations altogether.

In other words, the outlook was bleak.

Yet, fast-forward to today and India has gone 18 months without reporting a single case of polio. How did this complete turnabout happen in one of the world’s most populous countries?

This is what I am in India to find out – and to witness firsthand the mammoth effort that has successfully wiped out polio. Together with the Global Poverty Project’s Chairman, Peter Murphy, and CEO, Hugh Evans, I will get to experience one of India’s polio vaccination campaigns and see what it takes to vaccinate 75 million children in just a few days.

From our discussions with Rod, we discover that one of the reasons for this extraordinary turnaround against polio was the deployment of innovative new strategies for communicating the importance of immunisation to some of India’s most marginalised and socially excluded communities. Spearheaded by UNICEF - with assistance from the National Polio Surveillance Project (NPSP), The CORE Group and Rotary International - an extensive Social Mobilisation Network (SMNet) now sees thousands of community mobilisers, mostly women, working to persuade local communities to immunise their children.

To experience the SMNet in action, we leave the UNICEF offices in Delhi behind and head to the industrial city of Ghaziabad in UP – long the epicentre of polio outbreaks in the country. Here, one doesn’t have to look too hard to see the SMNet’s impact. As we walk through the streets on the way to the immunization booths, we are soon surrounded by the shouts and laughter of the Bulawa Tolis (“calling groups”). Armed with their Rotary flags and whistles, these brigades of children are deployed to fetch other children to immunization booths.

The SMNet’s impact is also glaringly apparent in the hundreds of posters we see adorning street walls and shop windows. Featuring Bollywood megastar Amitabh Bachchan, the posters appeal to families with the message “do boond zindagi ki” (“two drops of life”). And the message seems to have gotten through. Saying, “do boond” to the surrounding children, we receive a loud, excited cry of the same words back.

Before leaving Ghaziabad, we also witness the local partnerships community mobilisers have fostered with Muslim communities – often disproportionately at risk of contracting polio due to their marginalized status – in support of immunisation efforts. Local imams and mosque announcements now actively encourage congregations to immunise their children ahead of immunisation campaigns. So successful have such partnerships been, that resistance to polio vaccination has plummeted in recent years, with few pockets of resistance remaining across the country.

Our final stop before returning to Delhi is the railway station in Patna, Bihar’s capital city, where we witness vaccinators boarding trains and immunising children before they leave the station, making sure that no child misses out.

Despite what I’ve just personally witnessed, it’s not until I return to Delhi that I fully appreciate the significance of the communication and social mobilization infrastructure we’ve just seen. Sitting in the office of NPSP’s Deputy Project Manager, Dr Sunil Bahl, I’m told the polio surveillance and social mobilization initiative “is our gift to India.” He’s right.

In the process of eradicating a terrible and debilitating disease, the polio eradication effort in India has built the capacity of health workers to respond to future health emergencies. It has developed a blueprint for reaching every last child in even the most remote, socially excluded and marginalised communities with life-saving interventions. As Dr Bruce Aylward of the WHO once said, India’s polio program has reached “the populations that always get left behind for everything… [they’ve] put a face on the kids that nobody ever sees, the population nobody knows”. And it's the thousands of community mobilisers and vaccinators who have been at the very heart and soul of this extraordinary effort. They are the real heroes of polio eradication.

 The author wishes to thank Rod Curtis & UNICEF India, together with Rotary International and the NPSP for their hospitality during his recent trip to India. Thanks also to the Australian Institute of International Affairs (WA Branch) for providing the financial support that made this trip possible. 

You can view a longer version of this blog on the The End Of Polio website

Posted by Michael Sheldrick in Polio for column Action Stories on Jul 23rd 2012, 13:03

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