India

'The Final Inch': Oscar-nominated film looks at efforts to eradicate polio

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© UNICEF/NYHQ2006-2646/Pietrasik
Health workers administer oral polio vaccine in Uttar Pradesh state, India. UNICEF partnered with local religious leaders, school and universities to overcome resistance and promote immunization in some communities there.

By Elizabeth Kiem

NEW YORK, USA, 19 February 2009 – Fifty years after the development of an effective vaccine marked the beginning of the end of polio in the developed world, the paralyzing and sometimes fatal disease continues to stalk children in the poorest countries.

So far this year, polio has infected 42 people, most of them in Afghanistan, Pakistan, India and Nigeria – the four countries where the disease is still endemic. A new film provides an intimate look at efforts to push polio 'The Final Inch' towards eradication in these last pockets of humanity.

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Originally conceived by its producers as a documentary about polio eradication efforts worldwide – which have reduced reported cases by 99 per cent overall since 1988 – 'The Final Inch' ultimately focused on India's large and intensive eradication programme.

Immunization in India

"India definitely has, by far, the best polio eradication effort globally," says Senior Programme Officer Michael Galway of the Bill and Melinda Gates Foundation, which contributes generously to the effort. "If you picked up the India programme and put it anywhere else in the world that still has polio, you would finish up polio pretty quick."

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© 'The Final Inch' / Vermilion Films
An image from the film 'The Final Inch', nominated for an Academy Award for best documentary short.

But India, with its high population density and large number of births, challenges even the most efficient immunization programmes. 

Mr. Galway was a UNICEF Chief of Programme Communication in India when producer Irene Taylor Brodsky began filming 'The Final Inch'. UNICEF helped secure visas for the film crew and recommended some of the documentary's protagonists, including Munzareen Fatima, one of thousands of community mobilizers dispatched to convince Muslim parents in Uttar Pradesh to immunize their children.

Impact on Muslim communities

Five years ago, nearly 80 per cent of all the Indian children who contracted polio were from Muslim families, while followers of that faith represented just 17 per cent of the population. Once the Muslim community was identified as the group most in need of outreach, UNICEF quickly mobilized 5,000 trainers to knock on 2 million doors every month.

This is, says Mr. Galway, "the single largest public health communication work that UNICEF does anywhere in the world."

Today, the immunization gap for the Muslim communities of Uttar Pradesh, India's most populous state, has been reversed. Only a quarter of new cases there are among Muslim children. Still, transmission of polio has never been stopped for an extended period in either Uttar Pradesh or its northern neighbour, Bihar state.

"The onus of responsibility definitely is on us," says Afshaq Bhat, a doctor with the World Health Organization's National Polio Surveillance Programme. Dr. Bhat is shown in 'The Final Inch' travelling to villages along the Ganges basin by foot and by boat to ensure that children are immunized.

'Critical work' to be done

The Oscar-nominated film, produced by Vermilion Films and the Google Foundation, was screened at UNICEF House this week to specialists attending the fourth annual Global Immunization Meeting in New York.

It takes its title from a quote from the Russian dissident author Alexander Solzhenitsyn, who wrote: "The rule of the Final Inch [is] not to shirk critical work."

Indeed, agree health officials and development workers, reaching the children who are still vulnerable to polio is crucial not just to the young lives affected but to the health of future generations.

Towards global eradication

"Without eradication as an overall objective, then the funding and the commitment is going to wane," says UNICEF Health Communication Specialist Jeffrey Bates. "Once we back off from the intensive efforts in place to eradicate, you're going to see polio popping up not only in Africa and South Asia, but it will come back to Europe and back to the U.S."

'The Final Inch' has the potential to reach and motivate advocates' groups, donors and even health care workers, adds Mr. Bates.

"After a decade of striving toward the eradication of polio and not having attained it, a certain fatigue and frustration sets in," he explains. "A [film] like this can revive the moral commitment to keep going against what can seem like insurmountable odds."


 

 

Video

Watch a clip from the Oscar-nominated documentary, 'The Final Inch'.
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19 February 2009: UNICEF Health Communication Specialist Jeffrey Bates discusses polio eradication efforts in India.
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19 February 2009: Senior Programme Officer Michael Galway of the Bill and Melinda Gates Foundation talks about 'The Final Inch', filmed while he was UNICEF India's Chief of Programme Communication.
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