Spread across 23 wards in Barackpore sub-division of North 24 Paraganas district in West Bengal, Titagarh is arguably one of the most densely populated urban settlements in Asia (1,16,216 people in a 3.24 square kilometre) and has one of the highest concentration of migrant workers in the state. Very soon, it will be completely immunised.
Under the Intensified Mission Indradhanush, Titagarh has already immunised 2,500 of its 4,215 children and 513 of its pregnant mothers.
Much of the credit for the successful numbers goes to the 3,500 workers across the state — particularly volunteers (20 per municipality) and dozens of ‘mobilisers’ — who have been involved in each phase of Mission Indradhanush.
Pratibha Banerjee, 44, a volunteer for over 22 years, believes the mission owes its success to the Pulse Polio programme launched in 1995. “During the polio drive, we had to go from home to home to talk to the families and convince them of the need for the vaccine. There were lots of rumours floating around. One was that if you got the drops, the babies would grow up to be infertile. It took 10 years of the polio programme for the situation to be where it is today — where there is hardly any apprehension about vaccines. When Mission Indradhanush was launched, we simply had to inform the families and they would turn up,” says Banerjee.
A supervisor, Banerjee manages the ‘UPSC II’ centre on SP Mukherjee Road in Titagarh. Today, on the last day of immunisation in December, her deputy has collapsed from exhaustion. “She was a little unwell during this round. But there has been immense pressure from the government to get this done. So we’ve all been working round the clock,’’ says Banerjee, who earns Rs 3,600 a month.
There are 24 women under Banerjee — most of them mobilisers whose job is to go from house to house, first checking to see if anyone needs immunisation (at the survey stage) and then when the programme actually gets underway, to make sure that every child and pregnant mother in their areas are immunised. Both the voluntary health workers as well as the mobilisers are always women and recruited from the community.
Asha Chowdhury, 48, has been a mobiliser for 23 years. She, along with others, get paid Rs 75 a day. “Over a period of time we become a part of the families that we engage with. Just the other day, I was in the market and this boy in Class 12 came up to me and told me that I had got him immunised. And he’s going to college now. Imagine that,” says Chowdhury.
But for the workers, Titagarh poses a challenge because of its largely migrant population, making it difficult to keep track of them. Muslims make up nearly 50 per cent of the population in Titagarh’s 51 slums, while the rest are a mix of Hindu Bengalis, Biharis, Tamilians, Oriyas and people from other parts of the country.
“We locals call it a mini-India,” says Tavassum Nigar, 30, whose husband is a jute mill worker. Nigar, who hails from Bihar, has brought her two-year-old daughter to one of Titagarh’s centres, an old dilapidated CPM office converted by the health department into a camp. “They’re giving us an injection for some mosquito disease (Japanese Encephalitis) today. The didis explained everything to us, so I know this needs to be done to keep my baby healthy,’’ says Nigar.
“The migrant workers have been the biggest challenge. There are two kinds of people we need to cover. The first category includes those who have never been immunised. This is really a very small number — 0.5-1.5 per cent of children. The second category are the defaulters — those who have come for immunisation but never follow up to complete the course. This is the main category we are targeting and they form about 8 per cent of the total children,” says Dr Ajoy Chakraborty, Director, Health and Family Welfare, West Bengal government.
He says that before the Intensified MI programme began, the state’s immunisation rate was around 64-65 per cent and that it has now set itself the “ambitious target” of 90 per cent. “We have reached 90 per cent in most areas and in some places, even 95 per cent. Urban areas have been far more challenging because of the robust private health sector. Those better-off prefer to go to the private sector and therefore it is difficult to determine how many children and pregnant mothers have actually been immunised,” says Chakraborty.
So far, the state has immunised 5,000 children in October, 9,700 children in November and around 7,000 children by December 14.