An Immunization Camp in Badgaon

In April we visited another of the immunization camps that Seva Mandir runs every month in a number of remote rural hamlets. The government does have an immunization programme, but in these rural areas staffing of the camps and surgeries can be erratic, and it’s tough for mothers to walk miles with babes in arms only to find that the doctor or nurse hasn’t turned up this time.

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An alarmingly small percentage of India’s rural children are fully immunized (35% in a recent study of the children attending Seva Mandir’s day-care centres) so providing a reliable service is very important.

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Records are kept and mothers who cannot read or write make a fingerprint in the register.

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In these remote areas one problem is making sure that all those who need the service are aware of when the camp will be held.  Another is ensuring that mothers understand what to expect after their child has been immunized (that it is normal, for example, for their child to run a low temperature and be a bit under the weather after some injections) and also how important it is to complete the series of inoculations.

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As an incentive, each mother receives 1 kg of lentils each time her child is inoculated, and a set of stainless steel serving dishes and utensils when the course is completed.

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Seva Mandir has trained a team of nurses to administer the inoculations (mainly diphtheria, whooping cough, tetanus, measles and hepatitis as well as oral polio vaccine)

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and to give antenatal check-ups to pregnant women.

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We drive out to a small hamlet in Badgaon block, north-west of the city, and take with us members of the SM team and a doctor who will have a look at any children in need of medical attention.

In attendance are Bal Sakhis (local women who specialize in the care of infants) and Traditional Birth Attendants,

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all trained by Seva Mandir. In an area where much so-called medical care is provided by totally untrained quacks, with frequently disastrous, sometimes fatal, results, this is a huge contribution to the region’s health.

As on our previous visit to an immunization camp, this one is held in a building which also houses an anganwadi, a government-sponsored mother- and childcare centre.

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This room, like others we have visited, is decorated with illustrations from Aesop’s fables, which seems curious in the wilds of rural Rajasthan!

Immunization camps are not quiet places: babies go instantly from contentedly lying in their mothers’ arms to curiosity when the nurse approaches, to noisy shock and outrage when the needle jabs!

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The fact that no child I have ever seen in rural India wears a nappy also makes for the odd accident, but that’s one of the advantages of sitting on a mat on the floor – easy to clean and quick to dry!

Immunization Camp

On the 4th of every month, Seva Mandir holds an immunization camp in a small village in Saru Zone, Girwa Block.  The village itself is no more than a few simple huts scattered across the hills

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and a few goats.

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The camp is very well attended by pregnant women and mothers with young children.  They know they can count on the regular attendance of Seva Mandir-trained medical staff who administer inoculations and antenatal care competently and hygienically, and are also at their disposal for advice.

Girwa is a rural area south of Udaipur.  We head out at around 10 am in a trusty Seva Mandir vehicle on the main road to Mumbai before turning off after about an hour to wend our way through fields

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(a stretch of the route which tests the trusty vehicle’s suspension) to reach the camp.  The local dwellings are basic and the cattle shelters appear somewhat temporary. The hillside is starting to show the signs of several months without rain.

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We are accompanied by Dr Kusum, a retired medical practitioner who now works in Seva Mandir’s health unit, Sana, who works in the Resource Mobilization Unit with special responsibility for website and e-newsletter communications and with whom we worked closely on the recently published brochure on Seva Mandir, and Nicola, a Scottish volunteer, with whom we also worked on the brochure.  Our mission is to make a photo essay of the proceedings for the e-newsletter while Sana and Nicola film interviews with the mothers and health attendants.

The vehicle slows to a stop and we survey a riverbed with little water in it.

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We leave the vehicle to walk across the riverbed and up a gentle hill to the small, two-roomed building in which the camp is held.

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The second room houses an Angawadi, a small pre-school centre with a dozen or so young children of different ages.  One had been herding goats as we walked up and was now sitting on the floor with her classmates.  Perhaps the smallest goatherd we have ever seen!

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Big brown eyes stared enquiringly as our party arrived.

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We are invited into the larger of the two rooms with Aesop’s fables depicted on the walls

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to find two female Traditional Birth Attendants (TBAs), two female Balsakhis (infant health advisors)

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and two male inoculation staff,

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all trained and equipped by Seva Mandir, already hard at work.

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Dr Kusum kindly explains proceedings to us,

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and keeps a close eye on the care being given as well as offering guidance and advice to young pregnant women and mothers.

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In ones and twos, mothers arrive on foot carrying their children.  Some have walked a considerable distance.

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Over the course of a couple of hours, the two men administered inoculations against DPT (diphtheria, pertussis or whooping cough, tetanus) measles and hepatitis,

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as well as oral polio vaccine to about 20 children.

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The infants ranged from three months to just a year,

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and before long the small room was ringing with cries as startled babies objected to the injections.

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All the mothers were sitting on the floor

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or standing to rock their little ones in their arms,

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and all comforted them by breastfeeding them.

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The little ones soon recovered their composure.

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As an incentive to bring children for immunization, mothers receive 1 kg of lentils after each inoculation, and a set of stainless serving utensils when their child finishes his or her course.

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Each child has an immunization booklet with notes, a growth chart and a space for recording the regular immunizations, and the health workers keep careful records.  Mothers sign with a thumb print to acknowledge their child’s treatment and receipt of their gifts.

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The Balsakhis examine the children and give mothers advice on feeding (exclusively breast milk up to six months), introducing solids, and also help with advice on common ailments and contraception.

After the babes, it is the turn of the pregnant women, who are examined by the TBAs.  Their eyes, nails, abdomen, blood pressure and weight are checked and their urine tested, and they receive iron and folic acid tablets.  The empty packaging appears to be a delicacy for some of the infants!

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As the process of inoculation continued, we kept an eye on the Angawadi.  Inquisitive looks were changing to beaming smiles.

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But one wonders what the future holds for these beautiful children …

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Slowly, mothers and children started to drift away safe in the knowledge that they are protected against many debilitating and potentially fatal diseases,

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even finding the time to pose for the photographer.

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Antenatal checks and the immunization of infants are the responsibility of the government, and there is a clinic in the Zone, but it is even further for pregnant women and mothers with infants to walk, so they prefer to attend Seva Mandir’s regular and reliable camp.  A great job being done by dedicated and competent staff!

We too departed, enriched by the experience.

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