Tuesday 23 February 2016

Home again and what next for Polio ?

After the stress of the journey from Ludhiana to Delhi, it was a relief to have a relatively easy trip home.

Homeward Plane

Our plane took off on time and arrived on time

Homeward Route

and the route we flew avoided all of the current major trouble spots. 

The food on board was quite reasonable,

Homeward Selfie

there were plenty of films to watch and we managed to take our first (and hopefully last) selfie with our new camera. And so, some 16 hours after leaving our hotel in Delhi, we were home again.

Herts and Essex

An article about our trip also appeared in our local newspaper just after we got back.

What next for Polio?

As a part of their “End Game Plan”, India is switching from trivalent oral polio vaccine to bivalent oral polio vaccine in April 2016 and plans to withdraw all Oral Polio Vaccine in 2018/19 and move completely to the injectable form.

This sounds easy to do but currently the level of routine immunisation at birth is 65% and it has to reach at least 95% before “herd immunity” can be relied upon.

However because Injectable Polio Vaccine is not a  ‘live” vaccine, it carries no risk of vaccine associated polio paralysis which is one of the major disadvantages of the oral vaccine. It is also more effective as a vaccine.

The world will not see Year Zero in 2016 because there has already been one case in Pakistan. Year Zero cannot be that far away however and Rotary has committed itself to continuing the battle until it is won. There are two National Immunisation Days planned in India for early 2017 and we will probably go again, health permitting, and would like to continue to do so until Year Zero. Being part of the team responsible for the end of this disease is important to us.

Monday 22 February 2016

Ludhiana to Delhi - through the countryside

Our circuitous route to Delhi was to take a long time to cover.

Actual Route

About three hours down the road from Ludhiana, we stopped for a toilet break and then found out that the road ahead was blocked by another demonstration. The solution was to turn off and head for the state of Uttar Pradesh and then head down towards Delhi.

The rest of this blog entry has been written purely to remind us (in our older age) what a colourful, varied and packed place India is. It is also a record of the extreme poverty within which many Indians live and the wealth of many people.

Sugar Cane

India is the second largest sugar cane producer in the world and hence the roads are crowded with cane being taken for processing.

Sugar Cane 1

You might think this trailer is overloaded - actually it is quite conservatively loaded.

Sugar Cane 2

Parked across the main road near the processing plant was this lorry waiting to go into the mill. Every vehicle coming in either direction had to stop to work out how to get around it.

Sugar Cane 3

We only saw the cane being cut by hand (as in this photograph). Labour is usually cheaper than machinery here.

Sugar Cane 4

This obviously is a smaller trailer not loaded as much as the earlier one. 

Sugar Cane 5

It is being pulled by a bullock however and it walked along at a very slow pace making its way towards the factory

Sugar Cane 6

where there were hundreds of similar trailers awaiting unloading.

Brick Making

As we drove towards Delhi, we came across many brick kilns and it was common to see workers manually making unfired bricks in the fields and leaving out in the sun to dry before firing.

Brick 1

It is estimated that there are unto 150,000 brick kilns making India is the worlds second largest brick producer. Therefore brick manufacture is a significant source of airborne pollution.

Brick 2

For around 8 months of the year (not in the monsoon season), migrant labour families seek out jobs in kilns which are slightly better paid than other low skilled jobs. Workers are of all ages from children who are not in school through to the oldest adult.

Brick 3

The Government has estimated that 8 million people are involved in making bricks

Brick 4

There are reports of serf labour being used to manufacture bricks in some parts of India. Generally the poorest groups will be found working in the kilns. A report on brick manufacture and the almost slave labour involved can be read here from the BBC and here from the Guardian.

Town Life

Most small towns in India seem to be very similar. On the outskirts the roads are lined with small stalls selling everything.

1

Here sweets next to firewood -living in a shack does not stop the entrepreneurial spirit in India.

Town 1

What looks like very fresh vegetables are being sold under cover from a proper stall

Fruit Stall

and if you have no stall (yet), you sell from trolleys made from old bike wheels. 

Town 2

There always seems to be someone who is prepared to sell anything - here plastic shoes.

Town 5

Vendors sit patiently by the side of the road waiting customers for their single product - nuts.

Location never stops someone running a business.

Town 7

Although this house is almost in the town centre, cattle are being bred in the front garden.

Town 3

Further into town, shops and businesses take over the roads. This is a dry-cleaning delivery van!

Town 4

Buses are an essential part of travel in India and we attracted some attention as we went past the very crowded bus station. Riding on the roof of a bus is still common here.

Town 6

One characteristic of India which we do not quite understand is that all of the shops in an area sell the same thing. Here we are driving through the Lorry Tyre section of town. Every shop sells Lorry Tyres and is in competition with its neighbour. Elsewhere there was the wooden bed making section, the welding section,

Bike repair

the bike repair section ………...

Man and Monkeys

This photograph has little to do with town life even though it was taken in a town! As usual there is more than one person riding the bike, in this case three.

Town Rubbish

India does not pick up its rubbish. This piece of land is testament to the Indian ability to recycle anything of value and leave the remains lying about. If only there was a demand for small pieces of plastic bags……….

Roadside dining

A Dhaba is a roadside dining place usually serving cheap reasonably freshly cooked food. After about 8 hours on the road, we forced a stop for a meal if only to ensure that our driver got a brief rest.

Cafe

I think the name of this Dhaba translates into something like “The Pure Devotee of Lord Vishnu Restaurant”.

Cafe menu

The menu was extensive.

Cafe Meal

This was a vegetable pulaw which cost 70 Rupees (about 80p), tea was 10 Rupees

Cafe Bill

and very cheap. The total bill for 8 of us with bread etc came to about £10 - around £1.25 a head.

Cafe Toilets

One area for improvement was the toilets - we needed them but we wished we did not.

If this amount was to be thought too expensive, then there are millions of smaller stalls selling what looks like very nice food but obviously bringing with them a certain hygiene risk for a western stomach.

Food 1

Food 2

Typical of those we passed are these two establishments, I wish we felt brave enough to have tried them.

Health and Hospitals

Obviously we have been working as part of the Indian health system for many years and hence have visited a number of hospitals, health clinics, outreach centres etc.

Hospital

High quality health care is readily available to those with money. This brand new private hospital boasts that it provides the highest quality health care. Health tourism is a major foreign currency earner for the country.

Thind Dental Clinic

This Dentist (in Ludhiana) provides home visits for 1000 rupees (90 to the £) and basic consultations cost 200 rupees. Having been given a guided tour of the establishment,

Pat DentistsPat Dentists 2

and Pat having been a quick check-over, and being told “your teeth have been very well maintained”, I would have no concerns at all about hygiene and the quality of equipment available.

Hospital 2

Most high streets have First Aid / Health advice places such as this one

Hospital 4

Here I noted that some of the advertising is in English, perhaps because it is the common language across a country  with 22 official languages, 150 spoken extensively and 1652 languages (including those not native to the subcontinent) being spoken by the population.

Hospital 3

This place seems to be sell herbal products as well as some more conventional medicines.

The Roads

Driving on Indian roads is not of those of a nervous disposition nor for anyone who is not prepared to drive as if there were no other vehicles on the road. Lane discipline is an alien concept, white lines where they exist, are purely for decoration. You do not stop to let anyone out or in to your side of the road, you do not stop for anything unless you really have to. Your side of the road can be any side of the road, or all sides of the road at the same time or the middle road. Despite this, we saw very few accidents and only had one (as far as we know) vehicle hit our coach. Our driver took no notice and kept on going.

Marigold Moment

This is a good example of what we describe as a “Marigold Moment” (the scene in The Best Exotic Marigold Hotel where they are in a coach heading directly for another coach). We are overtaking someone who is already overtaking someone and driving as fast as the driver can go. Coming towards us is the same - a lorry overtaking a car which is trying to overtake a tractor. So everyone is heading directly for everyone else - however we all missed each other !

Eventually after nearly 13 hours on the road, we arrived back in Delhi in very good spirits. Our driver had been given one speeding ticket (which we gallantly paid for him - 200 rupees) and had only one accident for which we did not stop. Driving off the main highways is to be recommended but only if someone else is doing the driving and time is not important.

Follow Up Day Cancelled !

The normal way participation in a NID proceeds is Rally on Saturday, Vaccination on Sunday, Follow-up visits House to House on Monday. This year was to be very different.

The road from Delhi to Ludhiana (NH1) passes close to Rohtak in Haryana State which is an area lived in by the JAT Caste. 

Location of Riots

As we drove north along the highway to Ludhiana on Friday and were about 50 kms north of Delhi, we passed a large cavalcade coming in the other direction which occupied 5 lanes of the 6 lane highway. This was the start of the riot and over the weekend, the riot took over the area and the news.

Jat protest4

The JATs had decided to riot (aka Protest) because their caste was recently reclassified to a higher level in the Punjab and Haryana (they are still classified as Other BackwardClass in seven states) and because of this they now receive less preferential treatment when it comes to Government job appointments.

2400

The riot took the form of blocking the railway track (the main Delhi - Ludhiana - Amritsar line),

Jat protest2

setting fire to cars, buses, buildings etc,

Damaged Canal

damaging the canal which supplies Delhi with most of its water and

Hindustantimes Road Block

blocking the main highway along which we were driving (the NH1).

3391

NH1 Blocked

The military were sent in and by the time “an agreement to review the reclassification” was reached, 19 were dead.

Because the riots were 200km south of us and in another state, life proceeded as normal in Ludhiana. The difficulty for us was how to get back to Delhi on Monday in time for our fights on Tuesday. Cutting a long story short, we left Ludhiana early on Monday morning without participating in the follow-up because the highway was said to be open and it was felt we should make a run for Delhi whilst the going was good.

Planned Route

This was the planned route - the timings given on the map are derived from Google Map’s very optimistic view of Indian road traffic.

However as we were heading south, at about 11 am the riots started again on the main highway and we had turn off into the hinterland and follow a much longer cross country route back to Delhi.

Actual Route

Although this route took 12½ hours, we drove through some most interesting towns and villages and therefore the next blog entry records the trip back to Delhi rather than Follow-up day.

We were much more fortunate than the group which went to Karnal, a city closer to the riot than we were. They were unable to take part in any Polio activities at all and even though the highway was declared open on Monday, they were trapped in the traffic jams which resulted when the riots started again. Luckily for them, the police cleared the road and they arrived in Delhi some two hours after we did.

The Guardian’s version of the riots is given here and is reasonably accurate although it does not really give a feel for the amount of disruption which occurred. The India News website described the protests in more detail including the phrase 'Reports said NH-1 was blocked by protesters in Sonipat district, 50 km from Delhi, and thousands of people and hundreds of vehicles were stranded” which covered our predicament.