Tuesday 24 February 2015

Tricycles, Wheelchairs and Home

Rotary Tricycles and Wheelchairs

Mobility is a problem for those who have had severe Polio. Rotary has sought to alleviate this by providing hand powered tricycles

Polio Victim in Tricycle

such as this. There are handles on each side connected to a wheel by a long chain. Steering and braking is done using a handle at the front. Hence you steer / brake with one hand and provide power to one wheel with the other.

Tricycle Banner

We were invited to a ceremony during which a number of tricycles (costing about £80 each) were to be presented to invalids.

New Tricycle

The tricycles were made in India

Trying a tricycle out

and are quite easy to drive although I never really got the hand of steering and powering at the same time.

Wheelchair

Rotary also provides wheelchairs (at a cost of about £50)

Wheelchairs

and a number were to be presented at the same ceremony.

This ceremony marked the end of our polio activities in India and the following day we flew back to the UK.

Route Back

The route was almost a reverse to that on the way out

View Flight Back

although the journey back was during daylight and so we had some beautiful views when the cloud cover allowed.

This was our third NID and because to the slight local opposition to vaccination and the need to actively find children to vaccinate, probably the most challenging of the three. We found it very rewarding and I know this was also the opinion of the rest of the team.

Hopefully we will be able to return to India in 2016 to take part in another National Immunisation Day.


Monday 23 February 2015

Follow up day at Mugalpur Urf Aghwanpur Mustahk

Having theoretically vaccinated all children on National Immunisation Day, during the following week all houses known to have children are visited and the children are checked for the “purple pinkie” mark. If they have not been vaccinated, they are vaccinated there and then, and if they are not at home when the house is visited, it is revisited every day until they are in and are checked. We are taking part in the first day of the follow-up week at a town / village close to Moradabad.

Follow Up Town

Mugalpur Urf Aghwanpur Mustahk is a large village located to the North West of Moradabad. The census says that it has a population of about 22,000 living in around 3300 houses and this is where we are going to participate in “Follow Up Day”.

To get there we have a long slow drive through the centre of Moradabad which is at a standstill because of a massive traffic jam (quite normal for India) and then we have a long wait at a level crossing whose signal box portrays the name of the town.

Town Signal Box

Unprepared to wait, many people nip under the gates to cross the tracks or push their bikes sideways under the barriers to get them through.

Town Main Street

The town main street is typical of many in India although slightly less congested.

Bullock Traffic

Some forms of transport however still have the ability to create a traffic jam.

Bullock Cart

The town Mosque is prominent

Mosque

and it also is home to a Madrassa.

Raj Architecture 001

The town shows remnants of its history in some of the buildings we pass as we are walking through. My favourite sight was an old but rather beautiful doorway in a courtyard

Raj Architecture

and elsewhere the remains of a decorative balcony and doorway.

To get to the block we have been allocated, we have to head into the back alleyways

Heading into the back alleys

through an open air market

Open Air Market

where there are a lot of children selling / guarding goods

Local Shop

past a local shop
 
Barbers
 
and the barbers

Drains

and past the ever present open drains - a potential source of the Polio Virus.
 
Medical Centre Office
 
At the end of this alley is the Block Health Office
 
Checking team
 
where the checking team assembles.
 
Then we set off and systematically go into each house
 
Carrying Vaccine
 
looking for children and asking to see their fingers 
Children with Polio Finger Marks
 
by holding up your hands and wiggling your little fingers. Unvaccinated children are vaccinated there and then
 
Pat Vaccinating
 
Found Child
 
and in our group of houses, we find about 6 children who have not been vaccinated.

Writing on the Wall

Once a house has been inspected, a simple code is chalked somewhere on the front of the house indicating the status of the children within.

Houses Checked 001

This code shows that Team 121 have checked houses 78, 79, 80 and 81 on the 23rd of February 2015 and from here they went left (note the arrow over the date) to the next house. House 78 failed (a child was at the market apparently) and the other houses passed (all the children were there to be checked). Also there is the signature of the Block Co-Ordinator who has responsibility for checking the work of the checkers. The checking team have a quota of 100 houses to visit each day.

The Records

Having checked a house, the paper record is updated here, there is a line for each house and each child within the house showing the date of the immunisation and who checked.  

The process is extremely thorough and carried out efficiently by the team. All of the houses we visited welcomed us inside and produced their children without complaint.

Children in House

Some of the children however complained

Complaining Child

particularly if they had to be washed first so that we could see if their finger had the purple mark.

Checking the numbers

Once the 100th house in our block has been done, then it is back to the office to check and update the records

Town Team

and the team celebrate another vaccination check well done.

Sunday 22 February 2015

National Immunisation Day in Moradabad

Today is National Immunisation Day and we will be some of the 2.5 million vaccinators across India who will be vaccinating any children they come across. It has been said for years that having Rotarians at vaccination booths improves the attendance rate and certainly personal experience tells me that this is true. However this year the Indian Government has said “We keep hearing this so let us try to prove it by sending Rotarians to areas where response has been dropping”.

So we are sent to Moradabad, a city which has a significant Muslim population and a city where achieving the required response rate has proved difficult for the past few years. The 15 of us are divided into 5 groups and we are driven into the city and dropped off at various locations.

Booth

Our booth is on one of the main streets in town and it is a tent erected on the pavement. Not a lot is happening when we get there so we decide to take a very high profile interventionist approach by going out and finding children in the passing traffic.

Traffic

Despite the traffic being very busy,

Road Traffic 

I go out

Standing in Road

into the middle of the road

Surrounded by traffic

and try to stop every vehicle going by to look for children. “Every" means anything that is moving including: taxis, tuk-tuks, motorbikes, cars, bicycles i.e. everything.

Standing in Road 001

In india it seems to be the norm to drive in both directions on both sides of the road and hence traffic comes at us from all directions.

Standing in Road 002

One has to assume that they will miss us rather than us having to get out of the way of them. Our Indian hosts express a certain amount of concern for our safety but by now we have gained sufficient confidence to enable us to work without worry (well, not too many of them).

Ox Cart

The only vehicles I have difficulty in stopping are those pulled by an ox or a donkey - they do not seem to understand the power of Rotary and tend to keep moving straight at you.

Man riding cart

The drivers usually have no inclination to stop, perhaps having no brakes is the reason.

As soon as I spot a child of the correct age group (0 to 5),

Vaccinating in Road

the vehicle is pointed out to the vaccinators and they rush over, check that the child has not already been vaccinated and try to ascertain its age (holding five fingers up) and then vaccinate.

Vaccinating on a bike

The numbers of children being carried on motorbikes is astonishing and they are vaccinated in-situ. 

Marking finger on motorbike

Vaccinating in TukTuk 1 

If they are in a Tuk-Tuk, they are vaccinated inside it. Pat became particularly skilful at this

Vaccinating in TukTuk 2

Vaccinating in TukTuk 3

and very few escaped from her without being vaccinated.

Vaccinating on Bus

Even if you are on a bus, you checked and get vaccinated - here Totan Nguyen from Kettering Huxloe Rotary Club is vaccinating a slightly less than willing child.

The guidelines say that to achieve immunity in an area (known as herd immunity), 95% of all children need to be vaccinated so we cannot afford to let many escape. 

Is your child vaccinated

A few are quite cooperative and accept their fate without complaint. 

I do not want to be vaccinated

Others are not so happy about it.

Vaccinated Children

Most children are then given a balloon and a lucky few get a prized face mask. 

By 2 pm, not only are we exhausted but also most of the children we are finding come displaying the Purple Pinkie mark, either because they have already passed by our booth or because they have been caught at another vaccination station in the town.

So we stop for lunch and a rest before this evenings meeting with the Rotary Club of Moradabad East - our hosts for this event.

Moradabad Team

Between us, the Moradabad team vaccinated approximately 2000 children today. As is always the case, Rotarians made a real difference by being there.