There is a place in India where the road ends. It isn’t even a proper road as the last six kilometers coming into the town are thick mud and if you are unlucky enough to have to travel in the rainy season you’d have to walk these last six as no jeep will take you there. Beyond this little town in Bihar lies the flooded area of the Kosi river and the only way onwards is by boat. Electricity is not a part of the services rendered to this small town and if you want the fan to work at night you must carry your own generator that will play its sweet music outside your door throughout the night. It is Kusheshwar Asthan East (yes, there is also a West) and it is the place where the World Health Organization (WHO) and UNICEF had to open a satellite office as a part of the far-reach of the polio eradication campaign in India. If an office was not opened here the polio vaccine would never reach more than two hundred villages scattered on the flood plain of the Kosi river. Bihar is considered a high-risk state for polio eruption and it is here that the hardships faced by the volunteers of this incredible campaign are best seen.
Polio (also called poliomyelitis) is a contagious, historically devastating disease that was virtually eliminated from the Western hemisphere in the second half of the 20th century. Although polio has plagued humans since ancient times, its most extensive outbreak occurred in the first half of the 1900s before the vaccination created by Jonas Salk became widely available in 1955. The polio virus spreads from person to person, primarily via the fecal-oral route.
In a world of AIDS, malaria and other health crises, the eradication of polio would demonstrate that humankind can triumph over nature. The polio eradication campaign is the largest non-military, global enterprise in history. The size of the campaign in India is nothing less than amazing; 2.3 million vaccinators and 155,000 supervisors go house to house to 209 million houses and vaccinate 172 million kids under 5 years old twice a year during the national immunization day (NID). A sub-national immunization day (SNID) takes place up to eight times a year in high-risk areas like Uttar Pradesh and Bihar where more than 550,000 new babies are born every month. After sixteen years of the campaign in India, following an enhanced vaccination efforts led by the World Health Organization, UNICEF and Rotary International, India has finally been declared polio free on February 25th, 2011 with the last polio case dated January 13th, 2010.
The following images, commissioned by UNICEF, are a part of the last documentation of the polio program in India. The images were exhibited in NYC and worldwide, and published in the book ‘Triumph Over Polio’.
Workers pass by IEC material put up on one of the chimneys of the brick kilns on the outskirts of Patna, BiharA family accommodation next to the brick kiln on the outskirts of PatnaCommunity mobilizers put up a banner of the polio campaign across a narrow lane at a muslim area on the outskirts of Patna, BiharA block mobilization coordinator (BMC) supervising the display of IEC material on a mosque wall outside of Patna, Bihar.IEC material on the wall at a rickshaw stand in Patna,Bihar.Muslim religious and community leaders shake hands with unicef staff after a successfu meeting. unicef staff regularily meet mulanas and leaders of the muslim community to sensitize them about the campaign and promote cooperation at local community level.3am at Kusheshwar Asthan east, on the Kosi river flood plains. The town has no electricity connection and the only light comes from a random generator. In the rainy season the roads become a knee deep mud that prevents any vehicles from coming any closer than 6km away.3:30am. To the light of a single candle, the ice packs are taken out of the ice factory and placed into the cold boxes. They are then carried on the head and on bicycle carts, bare footed through thick mud, to the river were they are loaded onto boats that take the vaccine to a sub depots to be distributed to vaccinator teams and reach more than two hudred villages on the flood plains of the Kosi river. Kusheshwar Asthan east, Bihar.3:40am. The cold boxes containing the ice-packs are carried on the head and on bicycle carts, bare footed through thick mud, to the river were they are loaded onto boats that take the vaccine to a sub depots to be distributed to vaccinator teams and reach more than two hudred villages on the flood plains of the Kosi river. Kusheshwar Asthan east, Bihar.3:50am. The cold boxes containing the ice-packs are carried on the head and on bicycle carts through thick mud to the river were they are loaded onto boats that take the vaccine to a sub depots to be distributed to vaccinator teams and reach more than two hudred villages on the flood plains of the Kosi river. Kusheshwar Asthan east, Bihar.3:55am. The cold boxes containing the ice-packs are carried on bicycle carts, bare footed through thick mud, to the river were they are loaded onto boats that take the vaccine to a sub depots to be distributed to vaccinator teams and reach more than two hudred villages on the flood plains of the Kosi river. Kusheshwar Asthan east, Bihar.4:00am. The cold boxes containing the ice-packs are carried on bicycle carts, bare footed through thick mud, to the river were they are loaded onto boats that take the vaccine to a sub depots to be distributed to vaccinator teams and reach more than two hudred villages on the flood plains of the Kosi river. Kusheshwar Asthan east, Bihar.4:49am. The cold boxes contatining the polio vaccine are loaded onto the boats at Kusheshwar Asthan east, Bihar.A vaccinator team on a boat on their way to a village on the flood plains of the Kosi river.Vaccine carried on bicycle on the flood plains of the Kosi river near Kusheshwar Asthan east, BiharA supervisor carries the vaccine cold box during a vaccination day at a village on the flood plains of the Kosi river near Kusheshwar Asthan (E), Bihar.The polio vaccineVaccinating a child at a village on the flood plains of the Kosi river near Kusheshwar Asthan (E), Bihar.Finger marking for a vaccinated child during vaccination day at a village on the flood plains of the Kosi river near Kusheshwar Asthan (E), Bihar.Finger marking for a vaccinated child during vaccination day at a village on the flood plains of the Kosi river near Kusheshwar Asthan (E), Bihar.House marking during vaccination day at a village on the flood plains of the Kosi river near Kusheshwar Asthan (E), Bihar.A vaccinator team approach isolated houses during vaccination day on the flood plains of the Kosi river near Kusheshwar Asthan (E), Bihar.Vaccinators reaching under-served communities at Alauli block, Khagaria, Bihar.
Click on this line to see more images of the polio eradication campaign in Bihar from this assignment for UNICEF. I first documented the polio eradication program in India for the World Health Organization in 2004. Some of the color images from that assignment can be viewed HERE and on my archive HERE
