This year we have chosen to take part in the Delhi vaccination programme. Usually three options are offered: a rural; a city; and somewhere in Delhi. We chose to vaccinate in Delhi this year because last time we did a rural site (the same one is on offer this year) and we have already been to the city offering (Ghaziabad). Delhi is large enough to absorb any number of vaccinators and there are numerous booths set up everywhere in the city.
The arrangement is that we stand in the hotel foyer and representatives of local Rotary Clubs arrive and take a few off us to wherever they are vaccinating. We are collected by President Arvind Gupta of the Delhi Vivek Rotary Club and taken off by him to the eastern part of Delhi
where his club has built a vaccination booth on a street near to a village
which is sandwiched between a Private School on one side and The Railway Officers Club on the other. The school is a large, modern, clean institution providing education to the wealthy of the area, the Officers Club is a large social club in a large green park behind a high wall.
The village is the doglegged shape of housing roughly in the middle of the image above and is squeezed into the small space between them.
The theory is that children will come to the booth to be vaccinated, either on their own or with their parents. To turn the theory into reality, we have to go around the camp making sure that they are aware that there is a booth just outside and tempting them to come with the offer of a small toy.
How does one describe the village? It is almost impossible to convey what being inside the village is like. It has been built on a very small bit of land and is
cramped, noisy, dirty, occasionally smelly,
and is a very very densely populated chunk of land
with more people than you can imagine living close together
and carrying on their everyday life on the streets.
Everyone is very curious about us and crowds around us. That we are a curiosity is the reason we are there. All of the statistics show that when western rotarians dress sedately in bright yellow and red are present at a vaccination booth, the rate of vaccination increases considerably because children and their parents come to see what we look like.
We feel very safe in the camp and universally, everyone is welcoming and smiling. It is very common for people (who have nothing) to come up to you and offer you a drink or something to eat which they have just cooked. This of course presents a difficulty because hygiene is not what either we or our internals are used to. Water in a cup is a definite risk because usually it is pumped up from just below the ground and is likely to be contaminated (from a western health perspective). Food is less of a risk but there still is one. Our approach is to take water but not drink it, to drink cola if it is looks like it is in a clean new plastic cup and to eat a small amount of food. Last year we booth survived unscathed, this year I came down with a bad case of “Delhi Belly” and having a broad spectrum antibiotic in your travel pack is a good idea.
The vaccination process is very simple and very rapid.
The vaccine is contained in a small vial which contains enough for about 20 children.
This year we are vaccinating with the Bivalent Vaccine (there used to be three strains of polio but one has been eliminated) and now the bivalent is more effective than the trivalent.
The vials are kept in either a large ice filled cool box (if you are in a booth) or a small “round the neck” cool box if you are mobile in a camp because the vaccine rapidly deteriorates if its temperature rises above -20C.
The vials have a temperature sensitive tell tale marker on them which permanently changes colour if its temperature rises above the minimum safe level.
The theory is that the children line up in an orderly fashion,
willingly open their mouths, receive their two drops of vaccine,
have the little finger of their left hand marked (hence purple pinkie)
collect their toy
or mask or whatever
a tick goes onto the recording sheet
and the next child takes their place. This is repeated until all 172 million have been vaccinated.
In reality, some children are less than willing to approach this strange looking person and hence their mouth has to be prised open. Children crowd around the vaccinators and often try to come back again and again for vaccination so that they can collect as many toys as possible.
Teamwork is often required.
Many mothers prefer to approach a female vaccinator
and men a male vaccinator.
When the queue disappeared, we then went out on the prowl looking for children in the camp who had not been vaccinated.
As we walked around the camp (followed by crowds of excited children), we looked at the fingers of any eligible looking child we met or if we could not see them, we wiggled our little fingers at them.
If it was not marked, they were vaccinated on the spot.
Being vaccinated or not is not negotiable - all children who look under five are vaccinated. Parental permission is not sought and in reality,
parents were very eager for their child to be vaccinated. The Indian Government has done a very good job of educating everyone about the need for and advantages of vaccination
By the end of a very exhausting morning, we had vaccinated 620 children - the club target was 500 so we felt very pleased with ourselves. That we were so successful is down to the Vivek Rotary Club and their extraordinarily dynamic Club President.