Sunday, 24 February 2013

National Immunisation Day Sunday 24th February 2013

Today is the day of the NID and we all assembled in our full working clothes to receive a briefing from Shyamji Sharma

Briefing as we leave the hotel

and then to leave the hotel by 8 am for what turned out for us, to be a long drive into the depths of Uttar Pradesh.

Bareilly is not the most developed of towns but

Horse and Cart

as we drove further into the countryside, we could see that is was becoming even less developed – it was a bit like

Food Stall

travelling back in time but coming across the occasional reminders of the 21st century such as people squatting by the side of the road making fuel bricks out of dung and mud at the same time as talking on their mobile phone!

Horse and Dung Cart

Fuel pats made from buffalo dung, mud and chaff are a very common fuel in the area. The mixture is also used as a kind of adobe.

Dung fuel drying

The dung pats are mixed and shaped and then piled up to dry in the sun.

Brick built house

Houses varied in structure from Brick built boxes (there are a lot of Brick kilns in the area)

Village housing

through to very basic huts. It was not unusual to see road side stalls selling the basic materials for hut construction.

Whilst there are quite a lot of tractors around, we did not see many on the fields, their most common use was for pulling a trailer loaded with people.

Two ox plough

Animals working in the fields were quite common such as these two oxen pulling a plough which will (in this case) create a single furrow as it goes along. 

We stopped some distance south of Badaun and the group were split into three teams to go to different villages (Rijola (Usawan), Basoma (Ujnani), Sateti (Bilsi)) in the area.

The team I was in (four people) continued on for a further 30 kms turning down progressively smaller and smaller and bumpier and bumpier roads which eventually turned into a dust track and we entered the village of Raja Rijola.

Google Maps picture of Rijola

According to the 2011 Indian Census, the village has 818 households and a population of just over 5300, 56% of whom are male.

The village is typical of those in this area with some

Best house in village

brick / concrete built houses (this one was originally the house of the person who owned the land upon which the village has developed) and some which consisted of nothing more than  mud walls with a wood and twig roof.

Village House

Typical village street

The village streets were brick paving in some places and earth tracks in others.

Village street 


Open drains were common and in earlier years, these would have been the means by which the Polio virus would have spread. The village elders were well aware of the need to improve village hygiene and in our discussions with them, they indicated that this was their next priority.

There is a large lake in the village and close to this, a twice

Village pond

weekly market is held – the vegetables on offer looked far fresher than those we saw at home in our local supermarkets since they were grown and picked in the fields around the village.

Village Market

This is a small village with about 600 children aged under 5 in the area. There were five Polio Booths in the village open at different times and we were to visit three of them.

Running to meet the vaccinatiors

Our arrival at the first booth created some excitement

Vaccination Centre

and above the booth (which was simply a table in the

Field worker and polio

street) there was a large yellow and red poster (the same colours as our uniforms) advertising that a vaccination would take place on the 24th.

The polio vaccine is stored in a cool box and a vial is only

Polio vials

taken out when it is to be used. In the summer months when the temperature is at least 40c, it can degrade very rapidly and the technique then is to hold the vial in a cold handkerchief which has also been kept in the cool box.

The vial has a metal cap on it, this is cut off and then a rubber nipple attached which you have to squeeze to get only two drops out. One vial did about 20 children in our unskilled hands, no doubt more for those adept at ensuring that only two drops are dispensed per child.

Pat administering vaccine

Some children were willing and had done it before and approached the vaccinator with their mouth already open. Others were less willing and some firmness was needed, and some were asleep and were protected without even knowing it. The youngest child I vaccinated was 28 days old and this was his first vaccination – a privilege for Rotary to be able to do this.

Pat marking a finger

Once vaccinated, the nail and skin just

Finger markingbelow the nail of the little finger of their left hand is marked with a special pen (hence the phrase “Purple Pinkie”) to indicate that they have been vaccinated.

Polio set

They then get given a present – balloons were very popular, pens and pencils less so although these were often taken by the parent. Also some children were given a mouse face mask or a small ball or a whistle (all with the Rotary emblem on them) from supplies held by the Indian vaccinators.

Score chart-1

As each child is vaccinated, the next box on the score chart is marked. They do not note names and addresses or any identifying data, the focus is on a quick vaccination of everybody in the queue. They also check any child standing near the booth in case they are there out of curiosity but not yet vaccinated – they are promptly taken forward and dealt with.

Some children over the age of five tried to get vaccinated because they wanted the present and certainly there were some suspiciously old looking children presented by one of the workers who was then keen to ensure the child got a present – this is India so it was not for us to argue.

When they could not find any more children to be vaccinated, we moved on to the next booth which was in a school about 500 metres away.

On the way there we had to ask to go to the toilet and were taken to a nearby house with good facilities. School Vaccination Centre

At the second booth the children were already assembled

awaiting the vaccinators


Awaiting vaccination-1

and inside one of the classrooms

Awaiting vaccination in the school

It then turned into a production line for the (by then)

Administering vaccine

experienced team and quickly, all those waiting were protected.

Checking vaccine

Finger marking after vaccination

Many children are brought by their big sister or big brother

Awaiting vaccination-2

who themselves may not be many years older than 5.

Kohl on eyes

Some children had kohl drawn around their eyes, this was to indicate that they had been found to be anaemic and therefore were receiving special health treatment as well.

The school was very basic – it had 200 children up to age 12 enrolled with three teachers. Each classroom was totally bare apart from a chalk board and a few mats on the floor. From what we gathered, they were taught in Hindi but also taught the English alphabet and a few words in English but not taught English per-se. They also learnt some Maths and Social Sciences.

School classroom

After tea, water, and biscuits we were taken to another house for the toilet again (perhaps they now realised such necessities were essential for us) together with some delicious freshly cooked snacks and biscuits by our host's wife – thank-you Dr Kumar.

It was amusing how many people came to the door of the room we were in to look at us and also when we left the house, there were at least 50 people sitting down in the street awaiting our reappearance.

Then it was off to our third booth to continue the process.

Mothers looking on

Whilst quite a number of women would come into the booth, a number would not enter but this did not stop them ensuring that their children were vaccinated nor peering through an adjacent window and recording the event for themselves.

Feedback and group congratulation is an important part of the process and our schedule included a series of meetings scheduled for the end of the day, gradually moving up the Polio hierarchy in the area.

Firstly we met the village “Mayor” informally with some of the villagers

Meeting the mayorand then we went to a formal meeting in the hall which was also attended by all of the polio workers and as many villagers as could be got into the hall.

Village meeting

 All parties gave their impressions of the

Addressing to community

day. We told them that we were very impressed with their achievement and proud to have been able to come to their village. We also thanked them for the welcome they had given us and their hospitality (which was tremendous and genuine).

Then it was garland time during which I was presented with four garlands and I presented some to the Indian team.

Having made our leave (being escorted out of the village by everyone living there with constant hand shaking , clapping and goodbyes being cried out), we went to the nearby Primary Health Centre and repeated the process

Meeting at Health Centre 

with workers and managers from a wider area who were collating figures and considering the successes and difficulties of the day.

Meeting with District Medical Officer

Then we went to the office of the Chief Medical Officer (CMO) for the District where we found that the other two Rotary teams were waiting for us and we discussed the success of the day with the CMO.

Rotary polio signThis sign outside of his office with the Rotary emblem on it expresses a determination to eradicate Polio.

We were told that during the day our team had vaccinated over 370 children and that they estimated that the presence of our three teams had increased the total number vaccinated that day in this area by over 500 because people came to see who we were.

Eventually we got back to our hotel just as a major thunderstorm started for a very late evening meal – very tired but elated at what we had achieved and very thoughtful about what we had seen.

We have no doubts at all that India has made great progress in eliminating Polio (and at a great financial cost) and that this results from considerable hard work by millions of people.

We also have no doubt that the contribution that Rotary has made is enormous and the respect and thanks giving to us as visiting Rotarians was truly humbling.

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