All in a day’s work: Fighting polio for Rs250 a day

Teams of two health workers, two cops cover entire neighbourhoods for work that is part-financial, part-humanity.

Health workers mark the house a ‘success’ in pink chalk when the children have been administered the drops. PHOTO: EXPRESS

KARACHI:


“How many for today - I just need to know how many policemen.” As soon as he got his answer, he hung up the phone to text the response to someone waiting on another line. “We have about 50 men.”


This man is one of three responsible for on-ground planning and implementation of a Supplementary Immunisation Day - a polio campaign - in a District East union council (UC). Health workers, policemen, World Health Organisation and COMNet (Unicef’s social mobilisation arm) representatives, district health officers sit inside a dispensary which serves as the nerve centre for the drive. They gather here at the start of the day before sending off teams of two health workers and two cops each to the field.

Even with a loudly whirring pedestal fan, the room inside the dispensary is sticky and suffocating. Outside five tired-looking policemen struggle to stay put on the bench as they sweat profusely in the shade. Their comrades are worse-off as they have to walk in the UC with polio workers who have an invisible bulls-eye on their heads.

I leave the dispensary to accompany one team. The two workers walk from door to door holding a blue ice-box. “Polio drops. Are your children home?”


“Go away,” a disembodied voice comes through the gate. “There are no children here who need drops.”  The health worker shuffles away, but Aliya*, the area incharge, gestures to stay.

The sun continues to rise to full height over their heads, casting shadows longer than their burqas and the team discusses the best way to approach the door again. Eventually, the MO intervenes. The neighbourhood is native Sindhi and these residents are Brohis, he tells the team, adding it was time to apply a different approach. A few smiles and convincing later, the one child living in the house is brought out. “He isn’t older than four,” exclaims the MO. Five is the cut-off age for polio vaccination. The refusal was ‘converted’ and the door was chalked with success.

“This area is easy because they are Sindhis,” he explains. “They have never resisted much. If you go to interior Sindh, you’ll take one step and the residents will take 10 steps forward to get their kids vaccinated. It is not the same in IDP camps from the north.”

In all this fuss, a motorcycle pulls up with a small girl in front. Her father sports reflective shades and a handlebar moustache, with three tots clinging behind him. He asks for the polio vaccine for all four. Out comes a new vial and a dropper to be attached to it. Mouths open, drop, drop. Finger marked with long-staying ink. On to the next child, drop, drop. Drop drop. Off goes the family, protected against a disease the children cannot even pronounce, by women paid Rs250 per day.

By now, the sun has become stronger. The workers who were hesitant to talk at first are now loosening up. One of the volunteers whispers something to Aliya as they wait outside another gate. “She says the money is just not enough.” Both the women were brought on board by Aliya. They are all from the neighbourhood and claim the motivation is part financial, part humanity. But there is no humanity in being paid Rs250 for the work they do and the risk they take. Aliya gets Rs750, having climbed the rungs in three years. A coffin costs much more than their daily stipend.

Published in The Express Tribune, June 20th, 2014.
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