Dr Madhulika Jonathan
(The writer is Chief of Field Office for UNICEF, Assam. She can be contacted at email@example.com)
"Get the COVID-19 vaccine so that you can be safe to ensure your children receive routine immunization. It will shield them against preventable diseases." – This World Immunization Week, I urge all parents to act, to protect.
Vaccines are among the greatest advances of modern medicine, saving millions of lives worldwide. Getting the COVID-19 vaccine will not only play a major role in ending this devastating pandemic, but will allow you are parents, family members to take better care of each other, especially the young ones. This will, in a way, lay the groundwork to eradicate preventable diseases, which is currently costing the lives of millions of babies globally – many, who didn't receive any vaccines due to the COVID-19 induced disruptions and overburdening of the health system.
However, my faith is restored thinking of 24-year-old Robi Nag and his 22-year-old wife, Munki Nag, who reside in the Sealkotee Tea Estate. I met them during a recent visit to the eastern part of Assam's Dibrugarh district. They were blessed with a son three months ago, who they named Rihan. And irrespective of the pandemic, the young parents have ensured that Rihan is shielded with the essential immunization. I recall Robi mentioning - "having an unwell infant, especially in these times, is a double-burden both financially and emotionally". Understanding the importance of immunization, Munki also ensured that she received a tetanus shot during pregnancy to avoid any complications during birth. Little Rihan was administered the BCG vaccine after birth and has not missed any subsequent immunization programme held at the tea estate base hospital.
The good news is that most people (about 7,000) residing in the Sealkotee Tea Estate are aware about the importance of continuity of essential services such as immunization of children, pandemic or not. The communities living in the tea districts are among the most vulnerable in the state and sometimes, not able to access all essential services part of the government's flagship programmes. But witnessing the awareness levels of the tea tribes living in Sealkotee, coinciding with the increase in the full immunization coverage of children between 12-23 months in Dibrugarh, from 71 per cent in 2015-16 to 84 per cent in 2019-20 (NFHS-5), is very encouraging.
UNICEF India works with the most vulnerable and marginalized communities worldwide, to ensure benefits of development sustainably reach every child, everywhere. In Assam too, UNICEF India has been collaborating with the Department of Health Services (Family Welfare), Government of Assam, district administrations with the majority of the tea estates in the state, and also with the private actors including the Indian Tea Association (ITA), to address the social development needs of the tea tribe communities in the state. A comprehensive life-cycle approach of programming has been implemented, emphasizing on early childhood development and adolescents' empowerment.
And a critical area of work in early childhood development is maternal and infant health, which includes immunization. UNICEF works and advocates with partners including the government to ensure access to essential services. The Department of Health Services (Family Welfare), Government of Assam, for instance, has been working towards making health systems more acceptable, affordable and sustainable for all. The state conducts over three lakh sessions to ensure full vaccination of more than six lakh infants annually, reaching the hard and remote areas of tea estates and Char areas. Currently, the State Government has also undertaken a massive COVID-19 vaccination drive across 33 districts.
Until 20 April 2021, a total of over 18.13 lakh vaccine doses were administered to more than 14.50 lakh people — including healthcare and frontline workers, and people above 45 years of age (NHM, Assam media report).
To support these efforts at the community level, concerted efforts of sensitized frontline workers and volunteers operating in the tea estates, have ensured that more and more community members are accessing services and platforms such as the Village Health, Sanitation and Nutrition Days (VHND). About a decade ago, the situation in the tea estates was different. The community members were hesitant to attend the VHSND. They feared vaccines caused more harm than good, as some children developed mild fever after getting vaccinated, while others thought that if a mother is provided with more food during pregnancy, she would bloat up, causing complications during birth. But the change in knowledge patterns, behaviours and adoption rates over the decade, thanks to volunteers' part of the mother's groups, ASHAs, ANMs and anganwadi workers, among others, is evident with new parents like Robi and Munki.
Now, with the country facing its second surge of the COVID-19 pandemic, there will be more information coming our way that may sometimes be conflicting to our understanding of the virus, our cultural beliefs or our living situation – that may impact access to routine immunization for children. But the one thing that I would reemphasize, being a parent myself, is that we remember that our children's health comes first and remains in our hands. Annually, India still loses about 36 per 1,000 children before they reach the age of 5 (Sample Registration System 2018), and all due to diseases such as diarrhea, pneumonia, measles etc that can be easily prevented with vaccines. In Assam, currently, 66.4 per cent children from 12-23 months have been fully vaccinated in 2019-20 (NFHS-5), which is an increase from 47.1 per cent in 2015-16 (NFHS-4). Around 94.5 per cent mothers have also been protected against neonatal tetanus (2019-20), which plays a crucial role in safeguarding the mother and her child from maternal and/ neonatal death (NFHS-5).
I leave you with you these facts, and a message - 'vaccines bring us closer' – they help improve health and wellbeing of everyone, everywhere, throughout life.