Meet the volunteers in New Delhi who are working to immunise the world against polio

As the mission to eradicate polio gathers pace, Rosamund Urwin joins volunteers in New Delhi in their final push to immunise the whole world
An Indian boy receives anti-polio vaccination drops
AFP/Getty Images
Rosamund Urwin17 March 2016

WHILE fighting to rid India of polio, volunteers visited an area where the people were fervently opposed to immunisation. There, they found a mother with her baby. The team, led by Deepak Kapur, asked if they could immunise the child. The woman nodded but bristled. Kapur feared something was wrong. “What are you planning to do after we administer the drops?” he asked. She replied: “It’s simple. I’m going to take this infant, dash his head against the ground and kill him.”

Kapur recalls his hair standing up as he heard this. Why would she do that? “If I don’t, my husband will come home and kill me,” came the response. The team didn’t administer the drops.

That was a few years ago. Kapur, a businessman who has chaired Rotary’s National PolioPlus Committee in India since 2001, tells me this story to illustrate how much attitudes had to shift to eradicate polio. In another area, Kundarki in Uttar Pradesh, health workers were pushed off roofs when they came to immunise children. Some broke bones.

Travelling around Delhi with Rotary International’s volunteers, you don’t see any opposition now. Members of the organisation — Rotarians from the UK, Japan, the US, Belgium and Canada — have flown out to take part in the latest national immunisation programme. The aim is to deliver the drops to 173 million under-fives. As soon as children see the yellow bibs of Rotary, many open their mouths in anticipation.

I witness this first-hand in a ramshackle New Delhi slum. The smell there is overpowering. This is a favoured hang-out for flies and mosquitoes. A stream of slate-coloured water — spiked with an acid yellow liquid and packed with flotsam and jetsam— flows between the houses.

As I, a Rotary volunteer and a local health worker navigate our way through — the latter carrying ice packs to keep the vaccine vials cool — babies and toddlers are brought out. A teenager laughs as he drags his wailing brother, whose tears flow faster after the bitterness of the drops. But most of the others loosen their jaw, knowing what is coming, then proffer their little finger so their nail can be painted as a mark of immunisation. Elsewhere, the children happily follow the Rotarians to booths, as though they’re philanthropic Pied Pipers. The Rotarians give out pens and toys to children who’ve been immunised, and I hear a teenager joke: “Colour your finger to get free stuff!”

Until recently, polio was a terrible blight on India. It can kill but it’s much more likely to maim, leaving victims without muscular control of some limbs. It was common to see children and young people dragging themselves about on their hands. “You’d never find an old person though because they died,” says Kapur. “They would be neglected, ostracised.”

He recalls a visit in 2003 to a toddler recently stricken with polio. “I asked the child’s name. The parents said, ‘Why would we name him? He’s going to be a burden on us, on the community, on society and be dead soon’.”

The last registered case of the virus in India was on January 13 2011. It has now been declared polio-free. Yet when Rotarians first approached politicians and bureaucrats in the early Nineties about replicating the eradication efforts being made in Brazil, Kapur says they were met with laughter: “They thought it could not be done, that it was like Don Quixote tilting at imaginary windmills.”

With a new health minister, that changed. The first National Immunisation Day was held in 1995. Case numbers began to fall.

"They spread two rumours. That the vaccine had parts of animals in it, so it would be haram [forbidden] under Islam, and that it was a plot by the US and Indian governments to limit the number of Muslims"

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Kapur says it was among the Muslim population where there was greatest opposition to immunisation. This was due to misinformation spread by local political leaders. “They spread two rumours. That the vaccine had parts of animals in it, so it would be haram [forbidden] under Islam, and that it was a plot by the US and Indian governments to limit the number of Muslims. Both were nonsense.”

Rotary put great efforts into getting Muslim leaders on board. Now, some imams even allow polio booths to be set up outside their mosques.

There is no cure for polio but there is corrective surgery and rehab available. The only hospital in India with a dedicated polio ward is St Stephen’s in New Delhi, which Rotary helped fund. When I visit the women’s ward, the patients are all sitting on their beds, giggling. They want to pose for photos. Around many of the beds are heavy metal frames, with what look like pulley systems with ropes and weights holding the patients’ legs in the air.

"We tell them they need to do this for 23 hours a day so they’ll do 15 hours," says Dr Mandeep Singh Bajaj, who works on the ward. "If we said 15, they’d do eight.” They can spend from three to five months like this, depending on the level of deformity.

All the patients are in their twenties. Dr Bajaj explains that when the ward first opened it treated children but the age has shifted upwards as word has spread to those who’ve been living with the side-effects for many years.

Many of the women used to have to crawl. Rabiya has had her right leg amputated. One is a teacher, another is studying medicine but Dr Bajaj says that polio is socially restricting: “They have difficulties getting a job and find it hard to find someone to marry.”

Bajaj’s colleague, Dr Mathew Vorghese, has already shown photos of some cases: a girl who had to propel herself with her hands, like a monkey, who can now walk with a frame, and a boy with feet facing backwards who couldn’t wear shoes — post-surgery, he’s pictured in boots. “The aim is to make them as independent as possible,” Dr Vorghese says.

"Hopefully, they can support themselves, go to school, get a job."

Alongside funding the ward, the Rotarians help raise awareness. On the Saturday they hold a rally at the Maharaja Agrasen public school with around 800 students at which a boy performs a rap song about polio. Then they walk around New Delhi, the children waving banners with slogans like “Say nolio to polio”; one hadn’t got the memo and carries a road safety flag.

On the Sunday the Rotarians help at immunisation booths, before going door-to-door on the Monday — including to a tented camp where a nomadic population live. There, people have to wash out in the open, and many children have no shoes.

I suspect there will be those who decry this as "aid tourism" but there are advantages of non-Indians assisting. “In a place like this, they don’t often see foreigners so word gets around on the street much faster that something’s happening," says Rotary's Mike Yates, who's been organising these trips for 21 years. "Fatigue also sets in among local Rotarians. Us coming out here encourages them. And we get a higher turnout at the booths when we have foreigners there." It is likely to be the volunteers' last chance to help, as India is moving from using drops to jabs which need a trained medical professional.

It is likely to be the volunteers’ last chance to help, as India is moving from using drops to jabs, which require a trained medical professional.

Global eradication of polio is now in sight, although more money is needed to finish the job. When I interviewed Melinda Gates last year, she stressed the importance of such victories for making the case for aid: “If you can eradicate a disease off the face of this earth... people can say ‘Wow, that’s possible’.”

Pakistan remains a problem, though. There, the mission to eradicate polio has been beset by violence. In January, a suicide bomber killed 14 policeman protecting an immunisation centre in Quetta. Polio eradication became politicised due to a belief that the US used it to help flush out Osama bin Laden, taking DNA from children to try to trace him. However, this had nothing to do with polio: the doctor who assisted the CIA, Dr Shakeel Afridi, was actually running a fake vaccination programme for hepatitis B.

“The Osama bin Laden hype lasted some time in the Northern provinces,” says Aziz Memon, Kapur’s counterpart in Pakistan. “It disrupted our campaign for some six months, but we are back on track... The attack on centres and security personnel is mainly to instil fear in the people.”

Back in India, Kapur is desperate to be out of a job. “You bet! It was a three-year assignment. The first year being 2001. I’d rather do something else — but only after polio is eradicated everywhere.”

Follow Rosamund on Twitter: @RosamundUrwin

To learn more and donate visit endpolio.org

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