Distrust Reopens the Door for Polio in India

"The little girl sat somberly, eyes large and sad, mouth an unmoving bow, legs as lifeless as a marionette's. Her face contorted in pain and frustration. Tears streamed down her cheeks. She clutched at her mother, who berated herself for her child's agony. In trying to do what she thought was right for her daughter, Tehazib Jahan had done something irrevocably wrong...Three months ago, Uzma came down with a fever. Then the paralysis, polio's calling card, set in. Today the once playful 4-year-old cannot stand without help."

This article examines the factors that conspire to make some Indian parents, like Mrs. Jahan, reluctant to vaccinate their children against polio. Rumors circulating throughout certain Muslim neighborhoods have led some parents to refuse to vaccinate their children against polio due to fear that the oral vaccine - which is inexpensive and widely available - is part of a government-organised forced sterilisation plan. As a result, official predictions that India could eliminate the disease by the end of 2002 were dashed. There were over 1,500 new cases of polio in India in 2002 (as compared with 239 in 2001), the majority of which were in Uttar Pradesh, a poor and populous state. In fact, Uttar Pradesh accounted for 68% of the polio cases worldwide. This trend is exacerbated by religious and cultural issues. In Uttar Pradesh, Muslims - among whom the virus is spreading most rapidly in India - are typically landless labourers with lower literacy rates and a heightened sense of mistrust of the Hindu-dominated government. According to Naseem Ahmad, Vice Chancellor of the Aligarh Muslim University in Uttar Pradesh, "Because of the political setup at the moment, with the B.J.P. [the Hindu nationalist Bharatiya Janata Party] in power, the impression from the illiterate and semiliterate is that anything from the present government would be to their detriment."

In an attempt to address this growing problem, the Indian government and the World Health Organization, in partnership with Unicef and Rotary International, initiated a drive in early 2003 to immunise 150 million Indian children, many of them in Uttar Pradesh. This campaign involves sending health workers door-to-door with oral drops to areas who share the same religion and class as the families who are visited, where possible. Accomplishing this aim has proven difficult, but health workers persist, despite obstacles like the following encounter with the mother of a three-year old child living in Rampur district. She refused to open her door to the vaccination team, instead shouting through it "You are dishonest! I don't have time! I have so many other things to do! My children are already grown! I will not give the medicine to my child!"