Resisting the Resistance in the ‘Land of Rivers’
Overcoming the myths and beliefs against vaccination during Mission Indradhanush
“I was scared and angry. I decided not to immunize my children anymore”, as Abdul Hai Seikh was narrating his trepidation, the climatic mugginess of Dhubri at the bank of Brahmaputra and ‘mora’ Gadadhar was creating droplets of perspiration on his forehead. Abdul, the father of two, became firm in his resistance against vaccination after his younger child developed fever post vaccination.
Established in 1883 and known for its fascinating colonial history as well as mythology, Dhubri is a densely populated town located in the western part of Assam and is the border district of the state. The major component of the population of this district traces its roots to the neighboring country Bangladesh, from where families have been migrating to Assam for livelihood. Dhubri was identified as one of the 201 districts for Mission Indradhanush due its low immunization coverage (20.1% ) Launched in 2014, Mission Indradhanush aims to cover all those children under 2 years who are either unvaccinated, or partially vaccinated against seven vaccine preventable diseases. Because of the high rate of illiteracy, myths and religious beliefs about immunization as well as large number of hard to reach areas such as the chars there were substantial number of left outs and drop outs in the district. Having received an opportunity to improve its immunization coverage the district went out of its way to ensure that it reaches out to all left and drop out children through Mission Indradhanush (MI) sessions. However, this is easier said than done. Abdul’s trepidation is one such example which exemplify how illiteracy and false beliefs creates barriers difficult for the frontline health workers and how it was overcome.
“I was not aware that fever would come after the vaccination, as my family took my daughter, Asma for immunization”, Abdul continued to narrate how he developed his scare and panic. Abdul became worried as the little girl developed fever after receiving a vaccine. “Which father would like to see his child suffering?” Abdul was narrating his concerns, “and hence I decided not to immunize my children further.” Abdul’s apprehension was augmented with the ill advice from few of his neighbours.
Since December 2017, Abdul’s daughter’s name has not been included in the list of children due for immunization. Having noticed this, the ASHAs of the area – Renuka Bala Roy and Asma Khatoon as well as the ANM, Radhamoni Pradhan became concerned. The trio visited Abdul and tried to convince him to bring his daughter for vaccination but were unsuccessful. But perceiving his resistance, they conveyed the information to the Block Programme Manager, Salima Khatoon. Salima, accompanied by the ASHA supervisor, Promila Roy visited Abdul a few times but failed to convince Abdul as the set of circumstances became worse. At this juncture, Arif Ahmed, the District Community Mobiliser (DCM) joined in the venture. Well-versed about the history, geography, culture and tradition of Dhubri, Arif applied his ground level experiences and skill of interpersonal communication to convince Abdul.
“In my experience, communication breaks barriers, if only one communicates in such a manner in which the person sitting on the other side understand the information clearly. Here, people are illiterate and if one tries to explain the things too scientifically, the whole aim of communication would be jeopardised”, Arif was sharing his ground level experience in Dhubri as the DCM for the last 5 years. It took almost a day to council Abdul and his family. First Arif put his effort to make Abdul understand that fever for a day is a usual occurrence after certain getting certain vaccines and it’s a physiological phenomenon, not abnormal. He along with the team counselled the family by informing them that not receiving vaccines on time would affect his daughter‘s immunity and make her vulnerable to various diseases. Later, he convinced Abdul to bring his daughter for the subsequent vaccines.
In August 2018, Abdul brought his daughter to an MI session and she was finally given her due vaccines. A transformed Abdul subsequently became the influencer in his village. “Most people in my village do not know much about these injections. They also hesitate and have some thoughts and doubts in their mind for which they sometimes do not like to vaccinate their children. Now after my own incident and the support I received from the government team, I feel these are baseless doubts. Whenever I get the opportunity, during our local meetings and religious gatherings, I speak of the benefits of the vaccines and try to convince my ill-informed neighbours to immunize their children”.
While this narration was continuing, the muted light of the setting sun on the “land of rivers” lit the face of little Asma. Continuing her siesta in her mother’s lap without any scare, she is secured and immunized. According to the ASHA duo of Renuka Bala and Asma, “We have been doing our work, going from house to house to make sure all the children in our area get vaccines. But when we were told about Mission Indradhanush and that we need to go for the missed children, we were alert. Arif Sir and Salima didi also go with us and teach us and this gives us confidence. When we go together, the same family who do not listen us when we visit them along treat us differently and accept our suggestion.”
