India vs Polio: How India won the Battle

The word child isn’t just a word but an emotion in itself. It elicits joy, warmth, hope, reminds us of carefree attitude, own childhood and at times fear and confusion too. Children, moreover, don’t just belong to and are the responsibility of parents, but the family and society too. Today’s toddlers are tomorrow’s adults and how well we care for them today determines how the future of our society is going to be. As such, children must be given proper care for their all-round growth and development.

Physical well-being forms the fundamental pillar of measuring a child’s growth. Determinants of good physical health include nutrition, infections and infestation, genetics, environmental surroundings and more. Efforts to ascertain proper physical health in children starts early in the womb. Proper nutrition in pregnant women is the key to secure health aspects in children that are linked to nutrition. After birth too, breastfeeding initially and then wholesome food ensures that the child isn’t malnourished and is safe from illness arising due to it.

To prevent infections and infestations too, the efforts start in the pre-natal stage itself. Pre-natal immunization, tests, sonography etc. are done to determine any diseases that might trouble the foetus. After birth, immunization is provided against various diseases. However, some diseases require more than just one single dose of medicine.

A Persistent Enemy

For India, it took almost 70 years after independence to free itself from Polio, a disease notoriously hampering the growth of muscles in children and often rendering them unable to move and in acute cases, death.

Polio or Poliomyelitis is an infectious disease that finds its mention in ancient art and was first recognized in its current form by the English physician Michael Underwood in 1789. The virus causing the diseases was first identified by the Austrian immunologist Karl Landsteiner. The virus generally spreads through infected faecal matter through the oral route. Consuming food or water that bears the virus is how the virus spreads, often taking down a close area with it. In 1908. The 19th and the 20th Century saw a major outbreak in Europe and the United States. Jonas Salk developed the first commercially available polio vaccine in the 1950s. In 1988, the World Health Assembly launched the Global Polio Eradication Initiative to eradicate Polio. It was a time when polio paralysed more than 1000 children worldwide every day. Since then, the Initiative has been witness to more than 2.5 billion children being immunized, binding together more than 200 countries and 20 million volunteers to reach the common goal.

What Made India Susceptible

Up until 2009, India reported over 60% of all global polio cases. The country, with its huge population, of which the majority was living under the poverty line, was a hotbed for the disease. Several factors made the disease so widespread, including:

Tropical Climate – The climate in India is conducive for the virus to propagate around the year. The temperature differences in various seasons are gradual rather than sudden which lets the virus be active around the year.

Open Defecation – India had been and still is struggling to curb open defecation. As already said, the poliovirus spreads through faecal matter. Defecation in the open puts everyone, especially young kids at high risk of infection.

Untreated Water – Floods, nullahs, stagnant water, lack of proper water treatment ensured that the potable water consumed by the poor was possibly laden with poliovirus among other microbes. Consuming infected water has always been the easiest way to infection.

Social-Discrimination – The remotest parts of India are also the ones where social discrimination is prevalent. Prejudices based on caste, religion etc hampered the plan of the administration of the vaccine to every child.

Rumours – The early years saw many rumours emanating in the remote and uneducated areas on the side effects of the vaccine. Some claimed it causes infertility, some linked it to other diseases. There were also rumours that the vaccine contained blood or fat of animals and rodents to make people lose faith in it.

The Pulse Polio Program

In 1995, India launched Pulse Polio immunization program which aimed at 100% coverage. The Vaccination campaign by the Government of India looked forward to eliminating Polio by vaccinating all the children under the age of 5 years. By this time, it had been established that one dosage of the vaccine wasn’t sufficient for most of the children. Malnutrition and continuous exposure to the contagious environment had made the children weak and sickly. Hence they required multiple dosages to boost their immunity against the disease. The program gave repeated dosages to the children to help the cause.

The Steps Taken:

The Pulse Polio Program aspired to reach every single child in the remotest of location. A program at such a huge level required single-minded commitment and lots of careful social mobilisation plan for success. The primary plan was to:

• Immunize every single child under the age of 5.
• Cases, if any, need to be reported immediately by the local health care workers, stool specimen be sent for further tests and the Outbreak Response Immunisation program to be carried out immediately to prevent the disease from spreading.
• Follow-up or mop-up operations to be performed in areas where Polio cases have not been reported for a significant time(suggesting the eradication of Polio in the area)

Once the basic guidelines of the objective were determined, the next step was to put the plan in action. This required:

• Setting up of Polio booths in all parts of the country with prior notice.
• Ensure a steady supply of vaccine by preparing cold rooms, freezer rooms, cold boxes etc.
• Arranging the manpower which included healthcare employees and volunteers.
• Ensuring that the vaccine vials are safe and under constant monitoring.
• Immunising every child that makes it to the booth.
• Identifying children who missed the dates, following up with them and immunising them.

Apart from the action, educating parents and all citizens was the key to the successful execution of the Program. To ensure that the message reaches out to one and all, the Indian Government reached out to many celebrities in different walks of life to send the message across. Many celebrities themselves volunteered for the cause, spreading the message and administering the dosages at certain polio booths. Catchphrases like “Do boond Zindagi ke” and “Ek Bhi Baccha choot gya, Surakhsha Chakra toot gya” were coined and repeated to stress on the relevance of vaccination.

The Big Win

Owing to the singular commitment of the Indian Government, the employees and the volunteers, partners of the Global Polio Eradication Initiative – WHO, Rotary International and UNICEF, India raged a war against Polio for the next decade. The results came positive in 2014 when WHO declared India to be Polio-free. There have been no incidents of Polio reported since then.

Currently, poliovirus (wild) is in circulation in only two countries. The global incidence of polio cases has decreased by 99%. With the war won in India, which was considered to be a herculean task, an example has been set for the world to follow. The program continues to fight back the disease which still might be lurking around in some form. With every country and citizen pitching in their efforts, the world and WHO wish to see a polio-free world soon.