MONEY, ENERGY, manpower, and time. Everything that goes into running a campaign has been put into the pulse polio immunisation drive to fight the virus with seemingly never-ending rounds of vaccinations. But a reality check ahead of yet another pulse polio round on Sunday, February 11, shows the end-result is not up to the mark as desired by the policy makers.
Health authorities are making all efforts to ensure maximum coverage at vaccination booths set up at various points along with mobile vaccination teams. But problems are plenty and round after round over the years, the coverage at booths (number of children administered oral polio drops) has not been satisfactory even as the officials claim that “reach has increased” in terms of the area covered.
One of the reasons is ‘programme fatigue’ as is being whispered in the department due to rounds of immunisation. Lethargy on the part of the workers and migration of population are the two other main reasons that account for the poor results.
However, according to Joint Director (Health) Dr S K Shrivastava, “Over the years, the coverage at the booth is increasing. Except for a few places with erring workers, most of the booths achieve 90-95 per cent target.” But he agrees that the migratory population —- both in urban and rural areas —- does create problems.
For example, he says, “A large number of people from far-flung areas in Jhabua go to other places, sometimes in neighbouring Gujarat, in certain months of a year for work. We are trying every year to cover children of such parents but then, if the child, which was administered polio drop during the last round, has moved out of the area with the parents, what can we do?”?”
Similar is the problem in urban areas too. Indore attracts a large number of labourers, including construction workers, agriculture labourers and also those working in brick kilns etc. Construction workers at a site go to another area once the construction of the building is over.
Agrees District Immunisation Officer Dr Mukesh Bachchawat, “Migrating population is a major problem.” He also agrees that there are some lacunae in the system but maintains, “Our reach has definitely increased over the years.” When his attention was drawn to the 13 per cent children left out during the January 7 round this year, he says, “That is my major worry. Booth coverage has been affected due to various reasons. We are trying to plug the loopholes.”
But what is the need of so many rounds of pulse polio immunisation when there is already the Universal Immunisation Programme? Does the epidemiology of polio require to keep on increasing the rounds of polio vaccines if it is not being controlled? Experts give the reason as different vaccines (monovalent or trivalent) given at different times and area to fight different strains of polio.
Social scientists ask when we know that poliomyelitis is a viral disease transmitted through drinking water, then why do we not improve drinking water standards? Says Dr Salil Sakalle from the department of community medicine at MGM Medical College here, “A micro-sized devil running in water cannot be controlled fully by just giving rounds of vaccines.”
He suggests optimum public health standards coupled with safe drinking water, which would take care of a major chunk and then the rest can be taken care of by effective vaccination.
“On the one hand we say we are a poor country, we cannot spend as much as the developed countries have done on raising public health standards, but ironically on the other hand, we have spent much more on vaccination rounds over the last many years,” adds Dr Sakalle, who has been a member of the Rapid Response Team of WHO/Government of India twice in Bihar for monitoring the pulse polio programme.