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Community volunteers promote polio immunization in India

© UNICEF India/2010/Hellen
Zulfikar Ahmed (right) with his mother, Munni Begum (centre) and wife, Ayesha Parveen, in the Moradabad district of India's northern Uttar Pradesh state.

By Angela Walker

MORADABAD, India, 22 October 2010 – Some 30 years ago, baby boy Zulfikar Ahmed became seriously ill during the communal riots in the Indian state of Uttar Pradesh.

“It was a very dangerous time,” said his mother, Munni Begum. “He was three months old and he had a sudden, very high fever ... I cleaned him with cold water, but I realized that his legs could not stand. They were very soft.”

As she recalls the moment, her eyes well with tears. “I took him to the doctor and the doctor said, ‘He has polio,’” she said.

Simple and cost-effective

Her husband, who earned only a few rupees a day pulling a rickshaw, saved what he could for Zulfikar’s treatment – often sacrificing the money the family would have used to pay for food. But despite medication, therapy and an eventual operation, nothing could help heal their son.

“I didn’t know immunization could save my child,” recalled Ms. Begum sadly.

Vaccination is one of the simplest, most cost-effective health interventions available. UNICEF, with funds from the IKEA Social Initiative – the international furniture company’s philanthropic wing – is working to implement a 10-Point Child-Friendly Agenda, which includes immunization as a key priority in the ‘mohallas,’ or slums, of Moradabad.

© UNICEF India/2010/Hellen
Munni Begum is a volunteer 'change agent' in her community, working to identify babies that need to be immunized against polio and other diseases.

The project brings simple, inexpensive vaccines to children who, decades ago, would have suffered Zulfikar’s fate.

“It’s a great example of human-rights based, integrated programming,” said UNICEF Project Officer Nupur Pande. With 183 million inhabitants, Uttar Pradesh is India’s most populous state. An estimated 30 per cent of the population there lives below the poverty line.

Agents of change

“We are not developing any new structures, but we are building the capacity of service providers, like health care workers, and empowering people in the slums to demand for better services,” said Ms. Pande. “We are bridging the gap, but it’s a slow process.”

Today, to support the immunization programme, Ms. Begum has become a volunteer ‘change agent’ in her community. She and four other women work together to map the families in their neighbourhood, identifying babies that need to be vaccinated, mothers who need pre-natal care and children who should be in school.

“Generally, the families that are left are the most resistant. They need a lot of convincing. They don’t understand the reason why their child gets fever or may not be aware of vaccines or know the long-term, positive benefits,” said Ms. Pande.

Zulfikar’s wife Ayesha Parveen, who herself contracted polio when she was two years old, is now six months pregnant with her own child. Ms. Begum makes sure she receives her folic acid supplements and other pre-natal health care services.

Reaching every child

At less than 15 per cent, Moradabad has some of India’s lowest immunization rates and often suffers from inadequate health services. Children are exposed to poor hygiene and sanitation facilities in the slum areas, which increase the risk of transmission of polio.

In India, the Polio Partnership is led by the Government of India, with support from the World Health Organization National Polio Surveillance Project, Rotary International, the US Centers for Disease Control and Prevention (CDC), UNICEF and other partners. The partners work with health workers, civil society groups and communities at all levels to make sure every child under five years old is immunized with the oral polio vaccine.

During each vaccination campaign, more than 98 per cent of children under five in Uttar Pradesh and Bihar states are immunized. Nearly 2.3 million vaccinators visit more than 200 million homes for each National Immunization Day. To reach people on the move, mobile vaccination teams even immunize children at railway stations, inside running trains, at markets and construction sites.

“We need to take the time and effort to explain to these families the value of vaccinating their children so they can understand the benefits while dispelling the myths surrounding immunization,” said Chief of the UNICEF Uttar Pradesh office Adele Khudr.

“Trained community volunteers will know the families they need to reach out to and will be accepted by their neighbours as one of their own,” she added.



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