Hindustan Times (Delhi)

In Mewat, health workers fight rumours to immunise kids

- Sonali Verma sonali.verma@htlive.com

VACCINATIO­N In March 2017, rumours that immunisati­on campaigns are a conspiracy to make children sterile had spread in Mewat

GURUGRAM: When 26-year-old Shehnaz, an accredited social health activist (ASHA) in Pinangwan in Puhana tehsil of Mewat, knocked from door to door, asking residents to let her vaccinate their children last year, she was greeted with nothing but closed doors.

“We don’t need any injections, most people would say without even opening their doors. Please leave now, they would scream from inside,” Shehnaz recalled, adding that most people feared that their children would develop rashes or get a fever if they get vaccinated. “You are from the government, why should we believe you, they would say,” she said.

According to the National Family Health Survey 4 of 2015-16, the rate of immunisati­on in Mewat is a dismal 13%. So when the Haryana government launched the Measles-rubella (MR) vaccinatio­n campaign on April 25 this year, a special focus was laid on the region.

And after sustained efforts, the health department met with a unique success this year.

The campaign, which aimed to cover approximat­ely 74 lakh children in the state —both previously vaccinated and unvaccinat­ed— between the ages of nine months and 15 years, ran for eight weeks and by the time it came to an end, 99.01% of the state target was achieved.

However, health workers maintained, a lot had to be done to achieve the target — especially changing people’s attitudes and mindsets towards vaccinatio­ns.

Around March 2017, rumours that the government’s immunisati­on campaigns are a conspiracy to make children sterile spread like wildlife in the region dominated by the Muslim Meo community. A few weeks later, a doctored video, purportedl­y showing a child with signs of breathless­ness after being injected at a government school, did the rounds on Whatsapp. The video had originated from Karnataka and Tamil Nadu, where the government had just begun its MR campaign. Although no such campaign was planned for months in Mewat, the damage was already done.

“The locals started believing that vaccinatio­n is both dangerous and futile. Fearing that the vaccines were meant to sterilise children, parents would turn us away from their houses. The children would run away and hide whenever they saw health workers approachin­g. Some even asked us to give it in writing that getting vaccinated would guarantee lifetime protection against diseases,” said Dr Manpreet Singh Tewatia, medical officer at the primary health centre at Pinangwan in Punhana tehsil that has a population of approximat­ely 1,25,000 people, as per the 2011 census.

According to official records, the immunisati­on rate in the area was a mere 20% in June 2017.

In Pinangwan and the villages around, the rumours spread mostly through word of mouth. “Not a lot of people have access to the internet here. People went outside of the village, heard the rumours, saw videos and came back with gossip. And when a rumour spreads here, it is very difficult to erase it. You see, people aren’t very educated here,” said Khursheed Ahmed, an elder of Ter village in the district and grandfathe­r to 10 children.

He said he too had doubts about vaccinatio­n till the health workers reached out to him. Ter, according to health officials, had one of the highest rates of vaccine refusal in the district.

Over the next few weeks, attendance in many schools in the area – where the vaccinatio­n drives were planned – fell to as low as 20%. For many weeks thereafter, the government school in Ter, which has a strength of about 500 students, saw only half of the students turning up, said Duli Chand, the head teacher. “Parents of the students in my school would stand guard outside till classes got over to keep a check on them,” Chand recalled.

According to health workers, the rumours also hindered other health campaigns such as polio, tuberculos­is and school nutrition programmes in the region. “For weeks, children started refusing iron and folic supplement­s in schools. No child turned up for their routine immunisati­on for at least the next three months,” said Tewatia.

Dispelling the rumours required involvemen­t of the community – mostly of the village elders and teachers of religion.

The gritty health workers held multiple meetings with village sarpanchs and religious heads to explain why vaccines are impor- tant over a long period of time. “We presented them with facts and logical arguments, and in the process, gained their trust,” said Tewatia. Ahmed and his fellow elders, over the course of the last one year, went to schools and madrassas in Pinangwan to encourage parents to send their children to schools and get vaccinated. They were initially received with scepticism and refusal. “Some families in Akbarpur even said that only an announceme­nt from the village mosque would convince them that the rumours were false,” said Ahmed.

But soon, as a couple of madrassas and schools started opening their door to health workers, and the others followed suit.

“We told the teachers why not get it done with as it is only for our longest time. According to multiple health department officials, there is no gynaecolog­ist in the whole of Mewat currently. The Primary Healthcare Centre in Pinangwan has no lab technician, no pharmacist and no gynaecolog­ist despite the five to six deliveries that take place on an average day. The lack of facilities led to a mistrust in the public health system.

However, Shehnaz said the situation has now improved to a large extent. She said it is a lot easier to go to schools and administer vaccines now and the children don’t run away. In fact, she said, more children have now started turning up for immunisati­ons than they used to last year.

“Earlier, I would stand outside benefit,” said Ahmed, adding that doors for 15-20 minutes, asking everything in these villages runs families to come for their chilon trust. The madrassa in Ter has dren’s routine immunisati­ons since started announcing schedbut no one would answer. Now, if ules for immunisati­on campaigns I knock on 13 doors, at least 10 of from their community loudthem turn up later in the day,” speaker. she said, adding that she tells

As of today, 22 of 50 governever­yone not to believe rumours ment schools in Pinangwan have as they are always untrue. an immunisati­on coverage of VK Bansal, director, mother more than 90%. The overall and child health, in the National immunisati­on rate in the PHC, Health Mission, said the Pinangwan, in November 2018, improved coverage was a result was 58% — a jump of about 38% of micro planning in Mewat. “We from January last year. had involved local leaders in the

Ahmed recalled that during campaign and frequently held his conversati­ons with the villagsemi­nars with them explaining ers, he came to realise that the the importance of vaccinatio­n. disbelief in government camWe also increased the number of paigns stemmed from two larger ANMS in the district to ensure issues — locals’ distrust in the wide coverage. There was no government in the state and poor deadline for the campaign as we health services in the district. wanted the health workers to

Medical services in the district bond with the locals first,” he have been in a shambles for the said.

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 ?? YOGENDRA KUMAR/HT ?? (Left) A woman gets vaccinated inside the primary health centre at Pinangwan in Punhana tehsil (above) that has a population of approximat­ely 1,25,000 people.
YOGENDRA KUMAR/HT (Left) A woman gets vaccinated inside the primary health centre at Pinangwan in Punhana tehsil (above) that has a population of approximat­ely 1,25,000 people.

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