India

Vaccination campaign focuses on tackling social resistance to vaccine

© UNICEF India/2005/Biswas

A young boy in Painti Kalan villages receives polio drops.

By Pamela Bhagat

UTTAR PRADESH, India, 6 January 2005 - With its density of population, areas of severe poverty and varied cultures, western Uttar Pradesh is where the campaign to eradicate polio is at greatest risk of failure.

On the second National Immunization Day held on Sunday, 27 February the state was the primary focus of an effort to banish polio from India.

Uttar Pradesh is the country’s most populous state, with 180 million inhabitants. In the previous two immunization days more than 34 million children were vaccinated. But one million children are still being missed, most of them Muslim boys under the age of two.

The challenge of reaching these children is compounded by apathy and distrust towards the public sector, engendered by poor basic health and education services.

Afzal Hussain, the Community Mobilizing Co-ordinator, or CMC, has an air of confidence as he takes me on a conducted tour of Mohalla Qurashian, through a labyrinth of narrow lanes with open drains on either side.

“But for me, no one could have gained access to this area,” he says, as women and girls scramble to get behind closed doors. Since Afzal Hussain belongs to this community of Qurashis (butchers), his insights have helped in bridging the vaccination gap. Between May and November 2004 vaccination rates increased from 45 to 78 per cent.

© UNICEF India/2005/Biswas

Volunteers gather outside the local school on vaccination day.

“I have been successful due to two reasons”, he says. “Firstly I am a familiar face, so no house denies me entry. Another reason is that since my community is of butchers I have found acceptance and co-operation.” Afzal is also greatly respected since he is educated – unusual in a community where literacy standss at five per cent. 

“After I became the CMC, I went from house to house to tell people about the vaccine, and also to invite them to clear their apprehensions with the Imams and local doctors; people who had their confidence,” says Afzal. He also prepared a plan to draw up a list of children in the 0-5 age group here, as well as one of expectant mothers.

“Kunderkhi District has the highest incidence of any other district in the country - seven cases in 2004. In fact, just recently an 18 month old baby girl died of suspected polio. The case is still under investigation.”

These villagers are suspicious of the polio vaccine. In Aug 2004 almost 50 per cent of houses were marked ‘X,’ which means they refuse to let their children be treated.

“One mother of a month old infant feared for the life of her baby,” Afzal says. “I told her that I would give the drops to her day old chicks. If they survived the night, would she let me give the vaccine to the baby? She agreed and I lay awake half the night praying for the chicks. Next day I was able to give the zero dose.”

Azfal has also come up with other ways to apply community pressure to get children vaccinated.

“During the November National Immunization Day I had organised the older children of the community to form ‘bulawa tolis’ (groups) that brought the little ones to the
booth. In five hours these children brought 12 children whom the families had been trying to hide. Five of these received the vaccine for the first time,” he says.

“What really thrills me now is that the community supports our efforts and realises that a single child missed is a broken link in the chain of defence against polio.”