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UNICEF Executive Director Urges Focus on Most Vulnerable Children to Save Lives

© UNICEF India/2010/Graham Crouch

UNICEF Executive Director, Anthony Lake, administers polio drops to baby at an Anganwadi centre in Vaishali District in Indian state of Bihar.

By Angela Walker

RAMPUR RATNAKER, India, 7 December 2010 – Janki Devi cradles her five-month-old granddaughter in her arms as she is receives a life-saving DPT vaccination and polio drops to protect her against diphtheria, tetanus and polio.

Her mother, Nilam, cannot walk from her nearby home to this Village Health and Nutrition Day (VHND) site as she herself contracted polio when she was a child of two.
“People say if she gets the vaccination she can’t be affected by polio,” says Janki clutching the wriggling baby, Rani, dressed in worn “Tom and Jerry” pyjamas with streaks of kohl circling her eyes and dotting her forehead to ward off the evil eye.

Routine immunization coverage is critical for children to have adequate immunity against polio and other childhood diseases.

UNICEF’s Executive Director, Anthony Lake, visited the Indian state of Bihar today where he administered polio drops to babies brought by their families to be immunized at the VHND, which offers integrated health services to villagers once a month.

“We can save more lives, not by forgetting the poorest people and the hardest to reach places, but by focusing investment directly upon them,” Lake said. “India is in the process of proving that such an equity focus is not only right in principle, it is right in practice – providing returns in the poorest areas.”

Bihar is the third most populous state in India with 99 million inhabitants. Almost 42 per cent of the population lives below the poverty line. Nearly 56 per cent of children in the state are undernourished. Only four out of 10 children complete their primary schooling. Only 32 per cent have access to toilets.

In 2009, 1,606 children were affected by polio globally, of which 741 were in India. Of those cases, 719 were children from the states of Bihar and Uttar Pradesh.

The Polio Partnership in India is led by the Government, with support from WHO’s National Polio Surveillance Project (NPSP), Rotary International, the US Centers for Disease Control and Prevention (CDC) and UNICEF, with significant contributions by the Bill and Melinda Gates Foundation.

The partnership works with health workers, civil society groups and communities at all levels to make sure every child under 5-years-old gets immunized each time oral polio vaccine (OPV) is offered. Eleven polio campaigns have been conducted in Bihar in 2010, supported by more than 1,000 mobilizers spread across the state.

Only nine cases of polio have been recorded in the state of Bihar this year.

© UNICEF India/2010/Graham Crouch

Janki Devi takes her 5-month-old granddaughter to VHND site in Vaishali District in Bihar to receive life-saving DPT vaccination and polio drops. Janki's daughter in-law, Nilam, was unable to attend as she had contracted polio when she was a child of two.

Mobilizers also promote routine immunization, diarrhoea management with oral rehydration salts and zinc, hand-washing, toilet use and exclusive breastfeeding at the block and community level, where it is most needed.

“What you are doing here in India today – focusing on providing targeted services at the community and health facility level, strengthening the continuum of care and developing a framework for following up throughout a child’s life with other lifesaving interventions, is a blueprint for us all and the world should be watching your progress,” Lake said.

Bihar has witnessed a 400 per cent jump in full immunization coverage over the last five years. Even with this impressive gain, only slightly more than 49 per cent of children are fully immunized compared to 61 per cent throughout India.

Auxiliary Nurse Midwife Geeta Devi wears a baseball cap festooned with the logos of the polio partners and dark shades to protect herself from the bright afternoon sun. Booths are draped with bright spangled red, blue, orange and yellow fabric and dotted with colorful pictorial posters teaching the importance of exclusive breastfeeding, washing hands with soap and oral rehydration for diarrhoea treatment.

For each child that receives their two drops of protection against polio, Devi colors their pinkie nails with a black marker to show that they have been vaccinated.

“The rich have money, and they can go to another place. The poor people have nothing,” she explains. “It’s impossible to get to the health clinic because of the road and the transport costs. I’m helping the entire community’s pregnant mothers and their children with routine immunization.”

Nineteen-year-old Radha Devi has brought her baby boy, Rohit, to get his polio drops. Her husband works in a clothes factory in the state of Punjab, and she lives nearby the VHND site with her mother-in-law.

“The ASHA (community mobilizer) told me to come,” says the slight young mother, vermillion streaking the middle part of her hair, as her baby wriggles impatiently in her arms. “She says if I give my child this drop, it will help him get strong.”