Drops

This morning when I got this prompt, it took me back in time.. the period from 2003 to 2005 to be precise.. During this period, I worked for Polio Eradication Program which is a joint venture of World Health Organization and Government of India. The slogan of our nationwide mass vaccination program with oral polio vaccine was 'Two drops of life', 'दो बुंद जिंदगीकी '.

For most people in the western world today, Polio probably doest strike a bell.. but it was not so far ago, that we actually had epidemics of polio killing many people and disabling the survivors for the life time. In the museum of Centres for disease control in Atlanta, one can see the pictorial journey of Polio and mankind's battle against it. The most striking image for me has been the one of rows and rows of iron lungs... the only treatment possibility then where pressure chambers famously called 'Iron Lungs' assisted patients to breath when polio paralysed their respiratory muscles. We have President Franklin Roosevelt and his famous 'march of dimes' where the general public in US contributed dimes which were eventually used for research on vaccines against polio. And then we have beautiful work of fiction 'Nemesis' by Philip Roth, set in the summer of 1944 when major epidemic of polio claiming lives of many children and inducing panic in the community. Roth has elegantly used the backdrop of polio to narrate the struggles of his protagonist, a sports teacher, a firm believer that children need to play outdoors, when he himself turns out to be the carrier of the deadly virus thus endangering the lives of children around him...

This assignment on polio eradication program in rural India was my first work assignment in the field of public health. There is only one disease in the history of mankind that has been eradicated.. that is small pox and this historic moment happened even before I was born.. but I am proud to say that I have played a tiny part in fighting the battle against polio, with hundreds and thousands of polio eradicators around the world. A disease eradication is an ambitious project with loads of money, manpower and other resources at stake.. we have come a long way in India since 1997, when this program was officially launched with the goal of eradicating polio. But the fight is still on in few other countries around the world.. and no one is safe till the last virus has been knocked out...

Two drops of life campaign in India basically referred to the fact that you could influence a life of a child towards health and free of paralysis and disability by giving two drops of oral polio vaccine at defined moments in time. The idea is to cover all the children below five years of age with the vaccine drops at the same moment, so that the wild or infectious virus cannot find a child to infect. We have millions of lay vaccinators, men and women, old and young, from all walks of life going door to door in each village, each city, each transport hub, train stations, airports, bus stations, public parks, cinemas, on the dumping grounds, in the slums, in high-rise urban settings, in the farms and fields, on the islands in the middle of the rivers.. giving children two drops of oral polio vaccine. If even one child remains unvaccinated, there is a risk that virus will establish infection in that area...The vaccine has to be stored cold, otherwise it looses its effect.. and I am proud to say how these disease fighters on the ground have risked themselves in scorching heat of 45 degree Celsius  sometimes walking 12 kilometers with the vaccine in ice box to reach a small village where there was no other transport option available except walking. Only driving force for them has been immense dedication and firm belief in the cause of global polio eradication. They hardly got paid for this work... but that never pushed them to do a half hearted job. Many vaccinators have risked their lives in this endeavour, survived the floods and freezing colds, have been hit by strokes of lightning and have been bitten by snakes.. but the polio vaccination drive continued.. The effects of this immense hard work and dedication are now visible. For the year 2012 in India,  in-spite of very strict and rigorous surveillance, which is careful look out for any suspicious case that might be due to polio, we have not been able to confirm a real case of polio. This is a huge achievement in itself. If we manage to maintain same level of mass vaccination in the community along with continued surveillance of suspected cases for three consecutive years, India will be certified 'Polio free' which is the first step towards polio eradication..

This opportunity transformed my personal life. It took me closer to the masses in my country, particularly poor rural parts of India.. It showed me what real India looks like. It gave me a closer insight into lives of those thousands of men and women who had to make very difficult life choices all the time.. this assignment made me realize the limitations of my training in medicine when it comes to addressing public health issues. I learned to listen to the communities, I learned to understand their concerns. It pushed me to be creative in extremely resource poor settings and it also taught me that the best solutions to the problems often come from the people themselves.... I truly understood what public health means, health interventions at community level for the people, by the people and with the people. This assignment in four different provinces of India, gave me first lessons in cultural sensitivity and acceptance. I learned local languages to be able to better communicate with the people. I learned local traditions, how to dress, how to speak so that I will be accepted in the community, so that women will trust me with the health of their young children, so that women will see me as one of their fellow sisters and openly tell me about their concerns.

I gave three years of my life for this cause but the community gave me more in return... they cared for me, they protected me in scary and dangerous situations. They offered me food when they had hardly anything to eat for themselves and a place to sleep when I got stuck in far off villages. They seriously got concerned about me not having a husband and family and even tried to find a husband for me. It just showed me that these communities trusted me... and without that trust, I would not have been able to make any difference in the situation. I ran a office of about 25 men in a highly male dominated state of India.. but this experience taught me that as long as I could set an example through my own actions and dedication towards my work, my gender did not make me weak or any less than my men colleagues. I realized that I had strong leadership skills, I could inspire my team, I could take them all with me to achieve a larger goal.. The bond between me and my staff remains rock solid even today after 7 years. I still get their phone calls and every significant news in their lives.. the challenges at work were humongous and for the first time in my life I realized the metal I was made up off.. this assignment brought the best out of me.. and it paved the path for the first big switch in my career from clinical medicine to public health....

I have not been back to the districts where I worked in those three years.. I hope some day soon, I will revisit these places, be with my staff, travel to those villages again..  will the people in the community recognize me? I wonder... will I recognize the kids that I have cared for..... they have grown at least by 5 years... I dont know when will I be able to visit... but I really hope I will some day.. go back to those roots of mine... and relive those moments.... we will see..