Polio

India: Learning To Be More Effective
Story From a STOP Team Volunteer in the Field

You were right about the final month in the field being our most effective period. I actually feel very comfortable in the field now, like I know which questions to ask and when to refuse that third cup of chai (tea). I've verified three ORIs (outbreak response immunizations) and they are really being done and very quickly.

I heard of a case of acute flaccid paralysis yesterday in Mirzapur, so we headed there this morning. The MOIC (medical officer in charge) had already completed the outbreak response immunization, and the child had just returned home to the village. The child was definitely malnourished, and I felt, along with the MOIC, that the present neck weakness was secondary to hypokalemia and dehydration. The child was continuing to have 4-5 bouts of diarrhea a day but was eating, according to the mother. Anyway, the MOIC wrote out a prescription for some supplements, and I asked that an auxiliary nurse midwife return with the child to the public health clinic for oral rehydration at least. The villagers have been educated about homemade sugar/salt solution but prefer the ORS packets. We'll have to return after the child is hydrated and diarrhea is gone to reassess and make sure that the neck weakness has resolved. This is one of those iffy cases -- hard to call right now. It was a Muslim village and the first time I encountered real resistance to vaccination. They were pretty much OK with oral polio vaccine since it's oral but completely refused injectable vaccines. Some think the vaccines will sterilize their children.