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Reaching Every Child: Continuous Vaccination Sites, Transit Points In East Champaran Bihar

A vaccinator administering polio drops to a child at one of the railway stations in Bihar

MUZZARPUR, India – 15 October 2011 - In line with the recommendations of the India Expert Advisory Group (IEAG) the polio endemic states of Uttar Pradesh and Bihar are working to identify, map and include migrants and mobile communities in the microplans for SIAs and RI.

Both states have also set up immunization posts called continuous vaccination sites at the Indo-Nepal border and various railway stations to cover children moving into and out of the country. This is in addition to the transit immunization activities carried out in areas with large scale population movement such as during religious festivals.

Since the beginning of this initiative in May this year 3,630,964 children have been checked and 1,140,949 children immunized for polio at the Indo-Nepal border and major railway stations in Bihar. These figures become important in light of the fact that there were three P1 cases reported from Dhaka in Bihar last year which traveled to Bihar from bordering Nepal which had reported five cases.

The Indo-Nepal border is very porous with over 2.0m people in transit every day. In absence of these vaccination sites 30% of these children would have been missed. 

In Muzaffarpur, Raxaul and Sikta railway stations in the East Champaran district of Bihar the government has deployed vaccination teams who are trained by the Medical officer in charge (MOIC) and reshuffled every week. These vaccination teams work in two shifts from 7.00am to 7.00 pm and are facilitated by the WHO field volunteers and Unicef BMCs who monitor their day to day activities.

“Although it is difficult to work in such difficult circumstances with all the heat and dust, it gives me immense satisfaction to know that I have contributed to saving the life of a little child,” says Ganesh Kumar Soni a transit vaccinator at the Bihar-Nepal border in Raxaul.

Eighteen year old Ganesh is from the neighbouring Bhelai village and was trained at the PHC in Raxaul. For his efforts he gets a modest amount of Rs. 70 per day (for 6 hours of work) which goes towards the cost of his tuitions. Mr. Raj Kumar Sinha, MOIC Raxaul lauded the effort of all our vaccinators especially Ganesh saying, “These vaccinators are at work on these border posts every single day to ensure every child is immunised while moving in or out of the country. Theirs is an important contribution in this fight against polio.”

This initiative of the Government of India and supported by UNICEF, NPSP-WHO and other partners was launched in May this year and will continue till the end of the year. A difficult task, this initiative has help coming from many quarters.

The Nepali and Indian army at the border posts assist the teams in stopping all vehicles so that the vaccinators may check if there are any children onboard. In many cases they become counselors and helped convince families to immunize their children.

Maitrey is an NGO which works to prevent trafficking. They have a permanent post on the Nepal side of the border. Anil Kumar, the BMC in Raxaul can be credited with arranging for a letter of support from the health department for this NGO.

As a result Maitrey mobilisers have been supporting the transit teams during the various rounds. They counsel parents when there is resistance. This is especially helpful as they speak in their native language and are therefore much more effective.

Tremendous logistics and mobilisation support was provided by the UNICEF Bihar office which designed Information education and communication (IEC) materials for these transit sites. Dateless banners, posters and handbills in Hindi, Nepali and Bengali were printed.

A total of 50,000 posters, 1225 banners and 73,500 handbills were printed. There were 11 miking points and 33 kiosks at the various continuous transit vaccination sites at Indo-Nepal border and major railway stations of Bihar. 

It is being proposed to continue with these vaccination sites in the coming year too. The fight against this disease that paralyzes for life is a long drawn one and will require continuous and unrelenting efforts from the government and all partners.

As stated by Jones Itombra Okoro, UNICEF Polio Programme Manager in Bihar State, “these children without address constitute the majority of the less than 1% children still missed during polio campaigns in Bihar; hence every effort is being made to reach them through every possible means including this strategy.”