The mystery of the administered vaccine

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Guleria Sarai village in Chargawan block of Gorakhpur district is commonly called Saraiyya, has 2,325 people according to the last census, and is just a few kilometres outside Gorakhpur town. Two people have died of je here recently: Manoj Kumar, about 10; and Karmi Devi, about 35. It is in the midst of its third year of je vaccination, as per district administration papers. But nobody in the village knows this. Down To Earth (dte) visited and enquired in more than 50 households. Nobody — not one person — here was aware of je vaccination in the village. Ever.

dte tracked the auxiliary nurse midwife (ANM, a primary health service provider in villages) in charge of Saraiyya, Premlata Singh, at her residence in neighbouring Gulriha village. She said all vaccines were given as shown in the official records, maintained at the primary health centre (phc) in Chargawa. The records show the first vaccination drive occurred in 2002, as part of a pilot project of the Uttar Pradesh (UP) health department. 255 children aged 5-15 years in the village received a first dose, the second dose and finally the booster shot. In 2004, 122 children aged 1-3 years got all three doses, while 163 got only the first dose. In 2005 — the records show — 140 children 1-3 years old were vaccinated (see table: Perfectly rounded).

Singh says most children of the stated age groups, living in the village at the time of vaccination, were covered in the door-to-door drive. But in the very lane of the village where her one-room office is located, no families had heard of the JE vaccine. Shubhawati Devi is the elected gram pradhan of Saraiyya. She is completely unaware of the JE vaccine, like her husband Bharat Lal.

Community health experts say it isn't uncommon for villagers to deny actions taken by the government; they want more. But the villagers are largely unaware of how the disease spreads. That defeats the very purpose of having community-based health workers such as ANMs.

In addition, it isn't just the illiterate who can't recall JE vaccination in the village. "We are educated people and would be the first to get our children inoculated against this killer. But the JE vaccine isn't available. That's what the papers say all the time. How will we get the vaccine?' asks Vijay Kumar Gupta, who runs a public call centre and photocopier in his shop on the main road to Gorakhpur. Dhruv Lal, 25, is in the wood carving trade, has worked in Delhi's Tilak Nagar for years and appreciates the value of vaccination. His wife Nita produces the vaccination cards of their two children, showing that all the vaccines have been administered to the children as recommended. But they've never heard of the JE vaccine.

Household after household had the same story. The immunisation cards the parents maintain don't have a column for the JE vaccine. So all one can go by is word of mouth, and official records. Both tell completely different stories.

There are three logical possibilities to explain this contradiction:

• Vaccines were partly/never administered, and records fudged;

• A majority of the villagers are lying; or

• Mass amnesia has affected a majority of the villagers, forcing them to forget three vaccination drives.