17 Nov.

afternoon – Directorate of Public Health and Preventative Medicine

C’s Notes from our conference with:

Dr. S. Murugan, Director of Public Health and Preventive Medicine for the government of Tamil Nadu,
Dr. K. Subramani, Joint Director of Immunisation for the gov. of Tamil Nadu,
Dr. K. Surendra, Sureillance Medical Officer for the National Polio Surveillance Project of the WHO and government of India

(Add’l note – our meeting was videotaped by Terry Lowe, independent filmmaker working on a documentary about humanitarian aid, peace, and polio eradication in Tamil Nadu in hopes that the film will be broadcast by the CBC.) –

This facility is responsible for handling measles, malaria and tuberculosis, as well as polio, in the Chennai area.

They have made great strides in the area of polio arrestation (not really polio eradication – goal is to stop children from contracting polio, even if the virus is not be wiped out), and have had only one case of polio in the past few years.

High risk areas for polio – slums, border areas, new settlements (immigrant workers), remote areas, polio case-reported areas, areas with poor surveillance.  Diligence in immunization is particularly needed because of the high birth rate.

The Chief Minister (whose picture is on billboards, etc.) has initiated a huge campaign to educate families to have their children immunized.  Public awareness is increased through billboards, posters, danglers, banners, education, etc.

Why program is called Pulse Polio – Vaccine is given to the population at regular intervals, the way a pulse beats (instead of continually providing the vaccine to a few people each day).

Next stop: Rotary Centre in the Air India building

Presentation by Dr. Raja Meenakshi, People’s Project Coordinator, Pulse Polio Immunisation Programme covering the city of Chennai.  (Powerpoint presentation included slides of statistics and a logo for kicking polio out of India.)

The District Familiy Welfare Medical Ofice of Pulse Polio (government) works hand-in-hand) with Rotarians.  Chennai has a population of 4.8 million.  The city is divided into 10 zones, each with 10-12 health posts, and a total of 1126 polio booths. 

Reasons number of cases of polio are being reduced in the Chennai area – sanitation is getting better and there is slightly less crowding.

Additional speeches –

Responsibitities of Rotary clubs in the immunization program:
Vaccine procurement
Publicity
Banner and poster printing
Mobilization
Food

Other groups are responsible for telecasts and broadcasts. The railway department hosts booths at train stations for 2-4 days per each NID.  These booths have a minimum of four people – 1 to give drops, 1 to put purple marking on finger, record keeper and 1 to gather children

Dr. CSR on the history of Rotary’s involvement in the project –
Rotary made the vaccine available to the people of India.

Initially, there was resistance to immunization by the fathers. While Rotarians and health workers could educate mothers about the program, fathers were at work and weren’t available to be educated.  Rotary asked the most popular film stars to create a film about polio immunization.  The beautiful actress, Menorama, idolized by the men, convinced the male population to have their children immunized, and for a while the vaccine became known as “Menorama drops.” The actor, Rajnikanth, also played a large part in the film.

The next challenge to overcome was resistance because of religious differences and fear of sterilization. Rotary’s personal contacts helped break through barriers and educate people about the safety of the vaccine.

The next step was to educate unmarried women.  The girls were taught that after they were married and had children, first the babies were to be given “the drops,” then milk.  After the girls got married, they insisted that their children be immunized, even to the point that they would stand up to any resistance from their husbands.

Finally, they began to educate teachers. They ran seminars on other subjects and worked in education about polio eradication.  They talked about the success in the U.S. and how it was polio free to convince teachers of the importance of the project.

In addition to cultural challenges, Rotary, WHO, UNICEF and the government solved other problems.  In India’s hot climate, some of the vaccine was spoiling as it sat in the sun.  They couldn’t tell if the vaccine was getting overheated (and therefore, becoming useless), so a special vial was invented that had a border that changed color if the vaccine got warm. Those administering the drops were taught to keep the vaccine in the cooler or in a cup of ice and to check the color of the vial before administering a dose.  In each batch, one vial of vaccine is sent back to the lab to make sure it’s still potent.

Still, they work to overcome challenge of transient laborers who change locations and geographic areas that are inaccessible during the monsoon season.  Rotary has responded to all these challenges by providing more hands.

Rotary will continue to work on the project until the goal of arresting polio’s transmission is achieved.

District Chairperson for Polio Plus

What has increased the program’s success recently is the formation of teams, each with doctors, nurses and Rotarians.  The team members became acquainted with each other and attended a seminar together. They learned how best to support one another.

Further publicity – blasting NID announcements (with requests for mothers to have their children immunize).with top songs in the background, banners, etc.

This year there has been participation by all avenues of Rotary –

Inner Wheel – responsible for mobile units at locations like bus stops and train stations (set up booths and administer the drops)

Rotaract and Interact – lead children as they get off trains or buses to the booth at the platform