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Resource centre on India's rural distress
 
 

How polio ‘exporter’ won a mental battle by Tapas Chakraborty

Just over five years ago, a global study had labelled India the world’s “lone polio exporter”, prompting the United Nations secretary-general to write a letter of concern to Manmohan Singh.

Even three years ago, anti-polio workers in western Uttar Pradesh, then the disease’s epicentre in India, were often abused and driven away when they came to the villages for the vaccination programme.

Such memories today flooded into the minds of doctors and health workers as they celebrated the World Health Organisation’s move to take the “polio endemic” tag off India, which half a decade ago accounted for over a third of the planet’s new polio cases.

To Dr Amit Kamboj, a WHO doctor in Meerut, the last and most crucial leg of the battle had been for hearts and minds.

“When we look back, we feel the last barrier was psychological. It was a fight to overcome the doubts about our mission in the minds of an underserved community,” he said over the phone.

A polio activist who didn’t want to be quoted described the challenge she and her team faced in the districts of Meerut and Moradabad.

“Doors were shut in our face. We were subjected to abusive language. But that did not erode our determination,” she said.

The activist explained that many villagers in western Uttar Pradesh had age-old superstitions against vaccination.

“Also, they distrusted us as representatives of the administration. The only symbol of the government they were used to seeing were the dreaded police vans,” she said.

This meant seeking security for visiting the villages was a no-no. So, year after year, the activists kept coming by themselves, trying to win the residents’ trust.

“We organised drawing competitions for their children. We drafted in local politicians and panchayat members,” the activist said.

One masterstroke was the formation of the “bulawa tolis (calling groups)” — school-going volunteers in white T-shirts and blue and yellow caps who would travel from house to house on vaccination day and bring the children to the polio booths.

A multi-media campaign launched by the education, health and publicity departments and the unrelenting efforts of NGOs helped, said Govind Singh, Unicef’s sub-regional coordinator for Meerut.

“By end-2009, the members of this community were convinced about what we were doing and the result of 2010 proved this,” Dr Kamboj said.

By April 2010, Uttar Pradesh was free of new polio cases.

In Meerut alone, some 7,900 workers have been engaged in the immunisation programme since 2003. Public health experts say that more than 23 lakh health workers have been involved nationwide.

Since 2003, when Meerut alone reported over 300 new polio cases, the spread of the wild polio virus had largely been confined to Uttar Pradesh and Bihar’s Kosi river basin.

By 2006, outbreaks had been controlled in eastern and central Uttar Pradesh but the Meerut-Moradabad region kept reporting a sizable number of new cases.

In 2009, 741 Indian children, mostly from Bihar and Uttar Pradesh, contracted the disease, shaking the health workers’ confidence. But in 2010, the number fell more than 94 per cent to 42. The last case in India was reported on January 13, 2011, from Howrah in Bengal.