The battle against polio in India officially began in 1978, when it adopted the WHO’s Expanded Programme on Immunisation, an international initiative for global eradication of polio. India’s problems were manifold — a crumbling healthcare system, poor sanitation, contamination of water supply, along with endemic belts such as Bihar’s Kosi region and western UP, which were often difficult to access and in the 1990s, started showing resistance to vaccination because of misconceptions about it. In western countries, sanitation measures and water purification efforts had a huge role to play in the eradication of the virus. To achieve eradication with only immunisation, given India’s sanitation and water conditions, was considered near impossible. An article in The Indian Journal of Medical Research in May 2013 said, “India’s success has silenced critics who predicted that polio itself was non-eradicable; or that polio was not eradicable in India with its low standards of sanitation and hygiene; or that wild polio viruses cannot be eradicated using live OPV; or that polio was not worth eradicating.”
Reserved for polio
The polio ward at St Stephen’s Hospital in Delhi is one of the few such facilities in the country where beds are reserved for polio patients. The nine-bed ward was started in 1987 by orthopaedic surgeon Dr Mathew Varghese, and unlike other hospitals, here not just children but patients in their 30s and 40s paralysed with polio since childhood get admitted for corrective surgeries.
“In general hospitals, most beds and operation theatres in the orthopaedics department are taken up by road traffic accident cases, which are generally emergency ones. Having a dedicated ward means we can accommodate polio patients always, and they come to us from across the country — from Srinagar to Chennai,” says Dr Varghese.
Doctors say that delay in corrective surgery after the onset of paralysis reduces the chances of operation’s success. “In older patients, surgery is more difficult as the joints are stiffer and complications increase. Most of our patients are poor, daily wage labourers with limited education. It is no wonder they come to us so late,” he says.
From 3,000 patients who would get admitted every year in the 1990s to no case of wild polio virus being reported in the last three years is a huge achievement, Dr Varghese says. “While the celebrations are justified, we do need a dedicated national programme for existing patients already diagnosed with polio. We as a country have failed to curtail a preventable disease through natural means like providing clean water and sanitation. We opted for technological solution — vaccination. Having done that, we owe proper rehabilitation, medical and social, to patients,” he says.