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Immunization: Reaching children by rail

© Anupam Srivastava/UNICEF/2005
A mobile vaccinator gives polio drops to a child in a moving train in Bihar. Approximately 8,000 children were vaccinated in the drive that started on May 15.

By Anupam Srivastava

INDIA, May 18, 2005 – The search for unvaccinated children in India has taken UNICEF to bus stations, railway platforms and busy street corners.  Now children are receiving polio vaccinations on passenger trains as they speed across the plains of the northern states of Uttar Pradesh and Bihar.  In mid-May, on just one route, nearly 8,000 children under five years received vaccinations during a five-day immunization drive – over 1,500 on the first day alone.

 “We were able to vaccinate half a million more children than in previous rounds,” says UNICEF State Representative for Bihar and Jharkhand, Bijaya Rajbhandari. “However, the search for ‘missing children’ is not over.”

Because many adults lead migrant lives, moving constantly between states in search of employment, a large number of children in the region do not benefit from regular vaccination drives.  “I wanted to get my children vaccinated, but there were many other priorities and I forgot,” says one mother.

Poliomyelitis, or polio, is a highly contagious and incurable viral infection of the nervous system which can cause crippling paralysis or even death within hours of infection. It is spread through water or food contaminated with human waste, and while once considered a global menace, it is now mainly a disease of poverty.  It is particularly devastating in crowded urban areas where sanitation is poor and children do not have access to basic health services.

© Anupam Srivastava/UNICEF/2005
A vaccinator inquires about the vaccination status of a child in a moving train in Bihar.

As many as two-thirds of the children travelling on the selected train routes had never been vaccinated against the disease.  This mobile vaccination program aims to reach children who are not able to get to health clinics.

“We needed(ed) to move with the children,” says Mr. Rajbhandari.

This program, recently employed in India, is a pivotal part of the strategy to drive polio out of India – one of only six countries worldwide where the disease is endemic.  UNICEF along with the World Health Organization (WHO), and the governments of Uttar Pradesh and Bihar are trying to reach every child in the country under the age of five – more than 118 million children.

To help achieve this objective the Indian Railways issued special travel passes to the vaccinators for the May campaign in Uttar Pradesh and Bihar, India’s last polio reservoirs.

Immunizing every child in these two states is critical to achieving a polio-free India and to eradicating the virus globally. So far less than 20 cases have been recorded in India this year and experts hope that polio will be completely gone from the country before the end of 2006.



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