Reaching the unreached: Measles Rubella campaign in riverine islands of Brahmaputra

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Popularly known as gateway to western Assam, the historic town of Dhubri is often called the ‘land of rivers’. With Brahmaputra and Mora (dead) Gadadhar rivers on three sides, the peripheries of Dhubri are mostly riverine and the hundreds of tributaries of both the rivers have created thousands of braid bars (locally known as ‘char’) because of their meandering nature. For generations, these braid bars have been the habitat of the underprivileged population of Dhubri. The Measles Rubella (MR) campaign of the Ministry of Health and Family Welfare is under way in Assam, and reaching these communities for immunisation is challenge for health workers. The photograph on the left is of the Golakganj Block Public Health Centre (BPHC) from where the vaccines are ready to travel to the session site. (Photographs: MoHFW)

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Teams of health workers (ANMs and ASHAs) are working relentlessly to ensure success of the campaign. This is a photo story of one such effort undertaken in August 2018. The extremely humid subtropical climate with an average temperature of 37 degrees Celsius makes things really difficult. From the cold chain point, traversing merely a distance of 3-4 km to reach the session sites often takes 2-3 hours. With their relentless hardwork, the ANMs and ASHAs of this area are creating magic by reaching the far-flung places of Assam, mobilising communities and saving millions of lives. Established in 1905, the historic BPHC is one of the oldest health centres in the area, and it serves as a well-maintained cold chain point.

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It’s 9.27am, Jalil Sheikh, the person responsible for Alternate Vaccine Delivery (AVD), is headed to the designated distribution point along with the distinct blue box -- the vaccine carriers filled with the Measles Rubella vaccine.

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Jalil, in his fifties, is a daily wage worker in the local market of Golakganj. He is sincerely delivering these vaccine carriers to the session site. “It makes me feel that I am doing something for my society,” says Jalil.

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Jalil reaches the distribution point, and it’s 10.01 am. He arranges all the vaccine carriers, and it’s time for distribution now. From this point, ANMs take their respective blue boxes and head to the different session sites.

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At the distribution point, the Block Programme Manager (BPM) supervises cold boxes brought in by another AVD person.

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It’s 10.10 am. ASHA Manibala Roy starts her journey with vaccine carriers to the session site located in the braid bars - Mora Gadadhar’s ‘char’. She will be accompanied by other team members from a meeting point.

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Manibala Roy reaches the meeting point where the other team members were already waiting. It is time now to move. There are no vehicles to ferry this team. It’s a long journey ahead for them.

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10.17 am. The team crosses the first water body on the way. It’s covered with water hyacinths. The team uses a temporary and weak bamboo bridge to cross the water body.

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At 10.43 am, the team reaches a wetland, having walked through villages flanked by bamboo grooves and green paddy fields. They will need a rudimentary raft, made with banana trees and jute stems, to cross the wetland.

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The raft is ready. But it would not move without the manual effort by ASHA Abaron Bibi. The temperature is touching 39 degrees Celsius, and it is extremely humid.

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The team members now board the raft holding their vaccine carriers carefully. The vaccines must be safe and secure.

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Every time they come to visit this side of Golakganj, Abaron is the only person who takes them to the other side. “It’s my village and I’m the ASHA. If I refuse, who else will do it,” replies the widow and mother of five.

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The raft is a makeshift one and weighs light. It can only carry one person at a time. Abaron will go back with the raft again to the other side and will bring the other members one by one in three more attempts.

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(File Photo)

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After crossing the river, Abaron joins the team and is now carrying a vaccine carrier.

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Reaching these far-flung places requires dedication and team effort. Some vaccine carriers are heavy, and these women share the carriers between them. Being a riverine area, water is aplenty and creeks have been created to channelise water to the paddy fields. But the sediments make these creeks slippery and difficult to cross.

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The team is crossing yet another water body to reach their destination. It is 11.17 am.

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The walkers continue without a break. Now, they are shifting the weight of the vaccine carriers from one shoulder to another, sometimes taking support of the head too.

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Bunches of fresh jute plants come to the rescue of the team to prepare makeshift rafts

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At 11.45 am, the team finally reaches their destination — 2463, West Mora Gadadhar Local Primary School.

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The children will soon receive Measles-Rubella vaccine and will be safe for life. Once the children are vaccinated, the health workers' team will take the same path back to return to the mainland.

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Reaching the unreached: Measles Rubella campaign in riverine islands of Brahmaputra

The Measles Rubella (MR) campaign of the Ministry of Health and Family Welfare is under way in Assam to cover all children aged 9 months to 15 years

It’s 9.27am, Jalil Sheikh, the person responsible for Alternate Vaccine Delivery (AVD), is headed to the designated distribution point along with the distinct blue box -- the vaccine carriers filled with the Measles Rubella vaccine.

Jalil, in his fifties, is a daily wage worker in the local market of Golakganj. He is sincerely delivering these vaccine carriers to the session site. “It makes me feel that I am doing something for my society,” says Jalil.

Jalil reaches the distribution point, and it’s 10.01 am. He arranges all the vaccine carriers, and it’s time for distribution now. From this point, ANMs take their respective blue boxes and head to the different session sites.

At the distribution point, the Block Programme Manager (BPM) supervises cold boxes brought in by another AVD person.

It’s 10.10 am. ASHA Manibala Roy starts her journey with vaccine carriers to the session site located in the braid bars - Mora Gadadhar’s ‘char’. She will be accompanied by other team members from a meeting point.

Manibala Roy reaches the meeting point where the other team members were already waiting. It is time now to move. There are no vehicles to ferry this team. It’s a long journey ahead for them.

10.17 am. The team crosses the first water body on the way. It’s covered with water hyacinths. The team uses a temporary and weak bamboo bridge to cross the water body.

At 10.43 am, the team reaches a wetland, having walked through villages flanked by bamboo grooves and green paddy fields. They will need a rudimentary raft, made with banana trees and jute stems, to cross the wetland.

The raft is ready. But it would not move without the manual effort by ASHA Abaron Bibi. The temperature is touching 39 degrees Celsius, and it is extremely humid.

The team members now board the raft holding their vaccine carriers carefully. The vaccines must be safe and secure.

Every time they come to visit this side of Golakganj, Abaron is the only person who takes them to the other side. “It’s my village and I’m the ASHA. If I refuse, who else will do it,” replies the widow and mother of five.

The raft is a makeshift one and weighs light. It can only carry one person at a time. Abaron will go back with the raft again to the other side and will bring the other members one by one in three more attempts.

(File Photo)

After crossing the river, Abaron joins the team and is now carrying a vaccine carrier.

The team is crossing yet another water body to reach their destination. It is 11.17 am.

The walkers continue without a break. Now, they are shifting the weight of the vaccine carriers from one shoulder to another, sometimes taking support of the head too.

Bunches of fresh jute plants come to the rescue of the team to prepare makeshift rafts

At 11.45 am, the team finally reaches their destination — 2463, West Mora Gadadhar Local Primary School.

The children will soon receive Measles-Rubella vaccine and will be safe for life. Once the children are vaccinated, the health workers' team will take the same path back to return to the mainland.

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Reaching the unreached: Measles Rubella campaign in riverine islands of Brahmaputra

The Measles Rubella (MR) campaign of the Ministry of Health and Family Welfare is under way in Assam to cover all children aged 9 months to 15 years

It’s 9.27am, Jalil Sheikh, the person responsible for Alternate Vaccine Delivery (AVD), is headed to the designated distribution point along with the distinct blue box -- the vaccine carriers filled with the Measles Rubella vaccine.

Jalil, in his fifties, is a daily wage worker in the local market of Golakganj. He is sincerely delivering these vaccine carriers to the session site. “It makes me feel that I am doing something for my society,” says Jalil.

Jalil reaches the distribution point, and it’s 10.01 am. He arranges all the vaccine carriers, and it’s time for distribution now. From this point, ANMs take their respective blue boxes and head to the different session sites.

At the distribution point, the Block Programme Manager (BPM) supervises cold boxes brought in by another AVD person.

It’s 10.10 am. ASHA Manibala Roy starts her journey with vaccine carriers to the session site located in the braid bars - Mora Gadadhar’s ‘char’. She will be accompanied by other team members from a meeting point.

Manibala Roy reaches the meeting point where the other team members were already waiting. It is time now to move. There are no vehicles to ferry this team. It’s a long journey ahead for them.

10.17 am. The team crosses the first water body on the way. It’s covered with water hyacinths. The team uses a temporary and weak bamboo bridge to cross the water body.

At 10.43 am, the team reaches a wetland, having walked through villages flanked by bamboo grooves and green paddy fields. They will need a rudimentary raft, made with banana trees and jute stems, to cross the wetland.

The raft is ready. But it would not move without the manual effort by ASHA Abaron Bibi. The temperature is touching 39 degrees Celsius, and it is extremely humid.

The team members now board the raft holding their vaccine carriers carefully. The vaccines must be safe and secure.

Every time they come to visit this side of Golakganj, Abaron is the only person who takes them to the other side. “It’s my village and I’m the ASHA. If I refuse, who else will do it,” replies the widow and mother of five.

The raft is a makeshift one and weighs light. It can only carry one person at a time. Abaron will go back with the raft again to the other side and will bring the other members one by one in three more attempts.

(File Photo)

After crossing the river, Abaron joins the team and is now carrying a vaccine carrier.

The team is crossing yet another water body to reach their destination. It is 11.17 am.

The walkers continue without a break. Now, they are shifting the weight of the vaccine carriers from one shoulder to another, sometimes taking support of the head too.

Bunches of fresh jute plants come to the rescue of the team to prepare makeshift rafts

At 11.45 am, the team finally reaches their destination — 2463, West Mora Gadadhar Local Primary School.

The children will soon receive Measles-Rubella vaccine and will be safe for life. Once the children are vaccinated, the health workers' team will take the same path back to return to the mainland.

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