Scourge of polio in Pakistan

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On the verge of eradication

On an unseasonably hot mid-April day at around high noon, one negotiates the narrow and circuitous back streets off Beadon Road (a neighbourhood of the-then New Lahore developed during the Raj, and, which, in popular parlance mercifully still retains its title from those days). Starting at the Union Council’s office, where a young couple has come on its own to get their first-born vaccinated perhaps influenced by the awareness campaign, one is accompanied by two Lady Health Visitors going door-to-door armed with what they call a tally-sheet, a bunch of multi-coloured chalks and other paraphernalia – a refrigerated box containing polio vaccines the most important of these.

The two ladies, LHVs for short, seem to be familiar with the area and its environs – and most of the residents too. More importantly, they know how many of the young ones in every household have been immunised, with their tally-sheet containing the entire info down to the minutest detail guiding them as to how many under-5 kids live in a house, how many have been immunised and who still needs to be administered the critical drops. The follow-up rounds are meant to cater to those children who have yet to be immunised.

With the support and funding coming from various multilateral bodies and foundations, it is the business end of an elaborate plan to rid the country of the scourge of polio. Pakistan unfortunately still has the dubious distinction of being amongst the last three nations in the world (the other two being Afghanistan and Nigeria) where the virus remains in circulation. Owing to the endeavours of the aforementioned global organisation and a vast, nationwide network of volunteers and vaccinators, the crippling disease is on the verge of eradication.

For the uninitiated, the no-side-effects vaccine is imported under special conditions, with the mandatory cold chain maintained at every step of the way – until the drops are administered. Whether it is cities or boondocks, there’s not the slightest compromise on the ‘special conditions’ and the ‘cold chain’ – as well as quality assurance. Other than the expiry date, the bottle has a ‘vial monitor’ – its changing colours revealing the state of the vaccine.

Pakistan unfortunately still has the dubious distinction of being amongst the last three nations in the world (the other two being Afghanistan and Nigeria) where the virus remains in circulation

The vaccinators are the foot soldiers who brave all sorts of resistance (Not of late though, but previously, at multiple occasions, they have most unfortunately come to grievous physical harm at the hands of the bigoted). And, yet meticulous to the core, they continue to discharge their duties in the field – come rain or shine, knocking on every door, from densely populated cities to far off rural hinterland of all hues.

Coming back to the Beadon Road and the brace of Lady Health Visitors going about their work: the LHV knocks a door, already in the know through the ubiquitous tally-sheet that only one little baby girl remains unimmunised with her siblings already having imbibed the drops. The mother of the child appears on the balcony, and with a cheerfulness that comes with familiarity, shouts down that the kid is asleep but she would wake her up. After a spell, the little one comes out with jittery steps, and with her mother bucking her up the usual drops are served from a vial taken out of the temperature-controlled little box. With chalks in various colours whipped out from her bag, the LHV updates the markings on the steel door – reference points for the next visit.

The entire exercise takes around 15-20 minutes, but loads of patience. In this neighbourhood of the cosmopolitan though, shares the older LHV, it doesn’t take much by way of convincing the people to get the kids vaccinated. But the same cannot be said for all places.

Skipping a few houses, the same process is repeated all over again, with the only difference being the young man opening the door offering refreshments that were politely declined. A slew of children hanging on the coattails of their mother trudges to the threshold, each getting the mandatory quota from the vial. Another few houses down the street, in addition to still unimmunised kids, there are a few out-of-city visitors from a small town as well. The LHV makes a pitch for them to get immunised here, instead of postponing it for back home. It takes a bit of convincing, but the acquiescence was finally won. Another few jottings with the chalk, updating the info incorporating the latest, not to mention some more scribbles on the tally-sheet.

This self-generated data is the treasure trove that remains the mainstay of the countrywide immunisation campaign. Having been relentlessly pursued against all odds – ignorance and bigotry in the forefront of all obstacles – the campaign against the crippling virus is close to finding fruition in the form of eradication.