The unwillingness of Bihar’s high-income groups towards participation in pulse polio drives has health officials worried

With Bihar being polio free for two consecutive years now, it has to retain this status for three more years, before it can get a temporary eradication certificate. However, the reluctant attitude of high-income groups to the government’s pulse polio drives is a key concern for health officials in Patna.

“The high-income group in Patna is our concern. We find they are distrustful towards the government’s pulse polio drives. Polio vaccines in private hospitals are kept under refrigeration or even in the freezer whereas we store the vials in a temperature-controlled environment of two to eight degree Celsius. Anything above or below this range compromises the effectiveness of the vaccine. So even after routine immunisation, the pulse polio drive immunisation is as important,” Dr. S.P. Veenayak, District Immunisation Officer, Patna, told The Hindu.

While routine immunisation is carried out round the year, special drives like the Centre’s National Immunisation Days (NID) and the Sub-national Immunisation Days (SNIDs) are conducted in January and February. A second round of NID was held from February 24 to 28 this year.Patna, say officials, has increased its routine immunisation rate from a dismal 17 per cent to 83 per cent as per one estimate. A survey report of the World Health Organisation pegged it at 77 per cent though.

With a view to retain its polio-free status, Bihar has turned its focus on high risk areas. “We have concentrated our efforts on brick kiln areas with its migrant population, slum areas and transit points such as railway and bus stations,” Dr. Veenayak said.

At the Gandhi Maidan, a key transit point in Patna, two volunteers, supervised by an Auxiliary Nurse Midwife (ANM) and aided by two NCC cadets, spotted and administered polio vaccines to babies on the go.

“Since the ANM cannot run behind people, the cadets do that job. If they see a baby on a bus, they will go after it and stop it,” Dr. Parmanand Kumar, Medical Officer In-charge, added.

In the current NID round, 1,079,439 children were immunised in Patna of which 28,677 were from brick kiln areas. “Patna has four high-risk blocks -- Patna Sadar, Phulwari Sharif, Danapur and Maner. We are also focussing on newborns and have made special booklets for them to track their dosage,” Dr. Kumar said.

Aanganwadi workers play a key role here. They mark the houses in their area with a blue and a red bindi. The blue dot indicates neonate or who has not been immunised and the red one for children up to five years. These markings are done between polio rounds or start of a fresh drive.

The onset of monsoon when the polio virus is transmitted through sewage water is a big concern. “There was no flooding for the past two years. That helped the situation,” Aziz Satma, a UNICEF worker said.

Since the past two years, the government has undertaken environment sampling or sewage water sampling to check for the polio virus. The rate of sample collection has been increased from fortnightly to weekly. Routine surveillance is also carried out, where any weakness in a chid is immediately reported. In 2011, 1,094 cases and in 2012, 948 cases of acute flaccid paralysis (AFP) were reported for Patna.

Social mobilisation of UNICEF coordinators and WHO workers — adding their manpower to the government drives, makes the pulse polio drive a massive exercise. “We have also chosen influential people in the community — it can be a local doctor, a health volunteer, an aanganwadi worker, an imam or anyone whom the community trusts. They listen to him or her and allow their children to be immunised,” said Rituparna Bishnu, UNICEF’s sub-regional coordinator.

“We have been polio free for just about two years now,” said Dr. Kumar. “Five years of this good run and we will get a temporary eradication certificate. And a few more years later we will be finally certified for eradicating polio. We want that certification,” he said.