Community Health

-a dispatch from the grief process

Today I came across this CNN article Global health success: India certified free of polio which said:

India has been certified polio-free by the World Health Organization after going three years without an endemic case of polio. The eradication of polio in India is heralded as one of the biggest achievements in global health efforts….

Health workers determined that the children of migrants or those growing up in difficult-to-reach areas were not getting access to vaccines. So they deployed immunization efforts to reach the most vulnerable, according to UNICEF.

India launched a massive effort involving a surveillance network and almost 2.3 million vaccine administrators, who identified communities falling through the cracks.

To counter rumors and misgivings about the vaccine, social mobilizers, religious leaders and parents were included to increase understanding about immunizations.

I am so glad to hear this. I notice over the 13 years I’d been coming to India that there was gradually fewer young people seen around with the effects of polio.

I come across things pretty much every day that trigger cascades of emotion and memory. Not always sad, though tinged with that, but also happy memories. Here’s something that came to mind related to the above story.

One thing Manoj and I used to do on some Saturday afternoons (when school is in the morning only) or on Sundays, was pick up some of the teachers who had been trained as health workers and drive them (in his Bolero-that’s like a jeep-see picture below) with all their supplies to the villages and more remote farms in the valleys, particularly in the Yamuna River valley (on the way to Yamnotri) and those valleys that joined up to the Yamuna valley, so they could give the kids polio drops and do some health teaching. While other kids would get drops at school or in some central place in larger villages like at the temple, these outlying areas (where a lot of the kids didn’t go to school) were hard to reach. The teachers would go there on foot sometimes, taking the walking paths through the mountains rather than on the roads, but there’s a limit to how far you can walk carrying stuff in a day. Manoj knew a lot of the people and the geography of the area by having grown up there (Tehri Garhwal, though he was born in Pauri Garhwal). Many of the teachers came from outside the area, so that knowledge made it easier to get the job done. My role was limited to carrying stuff and serving as an object of amusement for the children.

Here is a picture of Manoj with the Bolero that we all went in. It could seat 7 plus cargo.


I think this is just a few days after he bought it in 2005. That car really got around. It took us up to Leh in Ladakh (Jammu and Kashmir state) and back again, to Rajasthan and Punjab, to Delhi more times than I can remember, through Uttar Pradesh, Himachal Pradesh and to Badrinath in the north east of Uttarakhand and as close as we could get the borders of Nepal and Tibet, where many Bhotiya people live. They are primarily Indian Buddhists related to Tibetan people (as are Ladakhi people in Leh), though some practice a syncretic version of Buddhism that includes Hindu practices as well. They are native to the Indian Himalaya and border areas.

All in all that’s a lot of terrain covered. When we weren’t going somewhere the car was used as a taxi for which Manoj hired a local driver. This helped pay for the expenses and upkeep. I have to say it was a fantastically study vehicle. He sold it in 2012 when it could no longer be used as a taxi due to road regulations regarding the taxi industry and the age of vehicles legally allowed to operate as taxis. I think it may be up in the villages now used as a shuttle (sort of like a taxi but not really—a grey market hybrid commercial-personal vehicle). But I don’t know for sure and if I did I wouldn’t really say anyways.

Most of the times when we took a trip we’d bring other people along and drop them off or carry some cargo for delivery to places along the way. This is a very common practice. We’d also pick up people walking along the road if they flagged us down because distances are very great, terrain is sometimes difficult as is weather. This is also a very common practice in the mountains.

Sometimes, when we went to Uttarkashi there would be Tibetan refugees on the road. They had often just completed the crossing of the mountain border. Manoj could speak some Tibetan so we would stop if we saw any, feed them something because they were always hungry, and take them to the nearest Tibetan colony so they could then get to Dharamshala (McLeod Ganj actually), meet HH Dalai Lama (who greets them all in person), and get registered with the Tibetan Government in exile so they could get services like housing, education, identity papers like refugee certificates from the Indian government and so on. There is a whole informal (and formal) system in India for taking care of refugees. It involves the cooperation of not only the Tibetan community but local Indian community as well. The informal system is not transparent to outsiders but is well known to the local populations and the authorities there. I’m saying this here because it’s something a lot of “white saviors” are unaware of when they come barging in and telling Tibetan and Indian people how to run their business. You know my feelings about that by now.


Here’s a picture just off of the Yamuna Valley in the Uttarkashi District, which is just northeast of Tehri Garhwal District where our teachers did their work. Terrain is very similar. 

When you look at the top of the mountain across from the temple there are stepped areas where cropping is going on. That’s either remote farms or possibly a small village. Those are the kinds of places that had to be reached to give vaccine. There are no roads to get up there so you drive as close as possible to find the walking path and start climbing (usually about an hour or two). Sometimes there is a fairly well used path that is even paved with stones and stone steps, like the path up to this temple, but most often there is only a dirt path that’s been pounded down by footsteps over the decades and in some cases centuries or millenia…some of these villages are very old. 

So that all occurred to me today after reading one news article. Usually I put this kind of write up on my other blog just to journal it for when I’m old and my memory gets even more foggy, but I thought it might be informative or of interest (however slight) for some people here this time.