Monday, 30 January 2017

Thoughts on vaccinating in Bhiwadi

This was the fifth time we have been to India to vaccinate and every place we have been to has been different.

The Rotary Clubs in Bhiwadi have been by far, the most enthusiastic clubs we have worked with. On our penultimate night we all met to consider how the process might be improved next year and amongst the suggestions made were:

  • every group to carry vaccine with them and to vaccinate on the spot as they go door to door and down the street
  • the team approach of swamping an area with vaccinators was the most effective method we have used anywhere
  • it would help if we had one Hindi speaker within each group because having got them to the door, sometimes they need encouragement to allow their children to be vaccinated.
  • it would also help if we all learnt a few phrases in Hindi to say to people, we do not have to be able to hold a conversation, we just have to be able to talk to them

It was estimated that we vaccinated over 3000 children during our time there thanks to the Rotary Clubs of Bhiwadi.

We shall go back to India again next year, where we do not know but we will continue going until Polio is completely eradicated from the world.

Follow-up day in Bhiwadi

Follow-up day traditionally is the day when door-to-door checking starts and every house is visited to ensure the children inside have been vaccinated. This time however, follow-up was simply more vaccination and we started at a Ragpickers camp in the town. 

Squatter 1

Ragpickers are amongst the poorest classes in India and make their living doing what their

RagPicker Homes right sorting left

name suggests, collecting rags and anything else thrown away which can be sorted, recycled and

RagPicker Recycling Pile

then sold for a very very small amount.

Squatter 2

Here their “houses” are adjacent to some flats bit separated from them by a brick wall.

RagPicker Water Pump

The camp was relatively tidy and spaced out, water comes from hand pumps which bring up water from the water table which will be not more than 15 metres down (the maximum depth from which this pump will bring up water). This is also the depth to which water from the toilets or waste from open air defecation will sink to. Hence the obvious health hazard. 

RagPicker washing clothes

Despite their poverty and very basic living conditions, everyone (bar one whom you will meet later) was very pleased to see us.

Ragpickers Camp Geoff Bike

Their houses are made from anything they can find 

RagPicker Home outside 001

and hence look rather basic. 

RagPicker Home Outside

We were impressed with the general tidiness here 

RagPicker Home 

RagPicker Home Bed

when compared to those we have seen elsewhere. 

RagPicker Home Inside

Inside most of the houses evidence the relative poverty of their owners 

RagPicker Home Satellite Dishes

but poverty does not mean that you cannot have a satellite dish  (no doubt recycled) !  

Pat Vaccinating in Ragpickers

As usual, our vaccination process was fast and efficient  

RagPicker Geoff attracts children Geoff failing to stop child crying

and Geoff was welcomed by almost all of the children in the camp.

Geoff and RagPicker CHildren

 Having completed vaccinating here, we went off to our last vaccination point which was at a Rotary sponsored home for retired cows.

Retirement Home Entrance

For Hindus, cows are a sacred animal and hence they are not killed when

Cows greet me

they reach the end of their useful life but allowed to retire and die gracefully (at least that is what we were told).

The Rotary Clubs of Bhiwadi have established a methane project at the home and when we went their to vaccinate, we also saw how the project works.

Methane 1

Cow manure is placed into a container where is ferments. As it does so it gives off methane gas,

Methane 2

the waste products are collected 

Methane 3

dried and used as fertiliser

Methane 4

and the methane gas is collected in a gas holder (similar to the method used to store gas in gas holders in the UK).

Cow Gas Kitchen

It is then piped into a nearby house

Methane 5

for use on a cooking range

Methane 6

or a household light. A very impressive project and a great idea.

What does Polio Vaccine taste like?

Geoff Vaccinating Pat

We had always suspected we knew the answer and we found out when Geoff vaccinated Pat.

What does Polio Vaccine taste like

What do you think the answer is?

Sunday, 29 January 2017

National Immunisation Day January 29th 2017


Most of the team this year had been on at least one NID before but as always, there was a certain amount of nervous tension in the air as we assembled in our hotel foyer waiting for our bus to arrive. 

Coach being labelled

Just to ensure that people knew who we were, our driver affixed a banner to the front of the coach - we were amused by the fact that the coach said we were tourists -  we were of course nothing of the sort.

The NID was to start at the District Hospital

Market outside hospital

and as is always the case in India, what might to the inexperienced look like chaos outside was perfectly normal for India. 

Bhiwadi Hospital

When we arrived, Polio Vaccine was already being distributed from the hospital,

Geoff Delivers Vaccine

and Geoff the Polio Bear supervised some leaving on motorbike

Polio leaves on bike

in its insulated containers 

Polio leaves on foot

 or being carried by polio workers. 

Hospital Tent

A tent had been set up in front of the hospital 

NID Inauguration

with a banner proclaiming what we were there to do 

Inaugeration Speaches

there were speeches encouraging us all to work hard

Vial and Marker

Polio Marker pens were found plus the all important bivalent vaccine 

The First Vaccination Bhiwadi

and the first official ceremonial vaccine was given to a particularly unlucky child 

Geoff is vaccinated

followed by Geoff being vaccinated yet again. 

It was then into the coach and off to our first vaccination station which was on the side of the road in the middle of a nearby suburb of the town. 

Loudspeaker TT

Initially we were accompanied by a tuk-tuk with a loudspeaker on it to announce we were there to vaccinate. It disappeared however after a short time and was never seen again.

Our technique this year was to flood an area with vaccinators ensuring that every house was visited, every street was gone up and as much noise was made as possible. This should be compared with the technique of earlier years which was to go in threes to a vaccination station and either wait for news of our arrival to get out into the community or to walk around shouting out that we were there.

Roadside Booth

The reason that Rotarians go to India to vaccinate is because we are unusual and we attract far more children to vaccination booths than is the case if they are staffed only buy local vaccinators. 

It was soon obvious that the new technique was very successful because we were mobbed with children and their parents seeking vaccination.

Busy Booth

Soon we were swamped with children 

Bringing children in

and the team spread out into the surrounding streets and houses leading more children back for vaccination. 

Pat brings child

It surprised me how trusting parents were in letting us take their child to be vaccinated and how willing most children were to come with us.

Girl bringing sister to be vaccinated

Our efforts of the previous day were obviously successful because many older brothers and sisters brought their young siblings with them to be vaccinated.

Inside town

Vaccinating in the streets is an experience unlike anything you will experience elsewhere in the world

Town Street

and working in unsanitary conditions is the norm for most of the places we go to,

Next to the booth

Wildlife in the town

hence we are very careful with our personal hygiene (we also took three different types of antibiotic with us just in case).

Table ready for vaccination

A vaccination station is often no more than a table with an insulated box containing the Polio Vaccine.

Polio Poster

Sometimes there is also a poster on the wall. 

Pat Vaccinates

Mothers were often more willing to approach a women for vaccination than a man, hence we tried to ensure that all groups had at least one women in them.

Paul Vaccinates

Vaccination is a team task with one person giving the vaccine 

Paul Vaccinating

and another marking the little finger of the left hand with an indelible purple marker pen 

Pat and Paul Vaccinate

and often the child is given a small present such as a balloon. 

Score Chart

Counting how many are vaccinated is either done using a form like this where you cross off the next square on the form or simply counting up the number of vials of Polio Vaccine used - in the hands of a skilled vaccinator, each vial has enough vaccine for 20 children.

Polio patient

At one of our stops, we were assisted by someone who had suffered from Polio as a child and was coming down the street with a loud hailer encouraging parents to bring out their children to be vaccinated so that they did not catch the same disease which he had done.


Lunch was eaten on the run, a snack purchased from a roadside stall. As a general rule, we do not mind eating freshly cooked food if we can see how it has been handled. Salads are an absolute no and drink is also a no unless it is made with freshly boiled water or comes out of a new can or bottle.

Being Watched

When you have lots of people watching you,

Come Down Inside Flat Hallway

encouraging them to come out and be vaccinated is an important part of us being there and sometimes we have to go into hallways or houses to get them out. 

Middle Class Flats

As well as the poorer areas, we also visited some of the new high-rise flats occupied by the wealthier Indian middle classes.

Gated Flats

For vaccinators they present a very different problem because people often have no idea we are there to vaccinate or cannot be bothered to go out to a vaccination booth - they expect the booth to come to them.

Middle Class Park

Compare this children’s playground 

Just outside flats

to this child’s playground some 100 metres away. His parents had a business ironing clothes from a table / shop just outside of the entrance of the gated compound shown above.

We vaccinated over 3000 children on National Immunisation Day - the largest total we have ever achieved.