03-Mar-2009 -- I am a member of Rotary International, a service organization of 1.2 million members in over 200 counties. Since 1985, Rotary's primary goal has been the eradication of polio. We have partnered with UNICEF, the World Health Organization, the US Centers for Disease Control and the governments of many countries. As a result of these efforts, polio is now endemic in just 4 countries: Nigeria, Afghanistan, Pakistan and India. When an opportunity arose to participate in a Regional Immunization Day (RID) in Uttar Pradesh, India, I signed up. Of course, I also began looking for an unvisited confluence to visit too.
I traveled from my home in San Diego, California to Chicago, Illinois, and then flew to Delhi, India. I enjoyed asking our group of 12 Rotarians this geography question: if you are in Chicago, which way do you go to get to Delhi? I bet most confluence hunters will know the correct answer is: north. Our route took us within 800 miles of the north pole, and it's fun to think that you go north as far as you can and then suddenly you are going south.
A 2 day RID provides oral polio vaccine to 85 million Indian children. The logistics of distributing the vaccine are very difficult, considering that it must be kept cold to be effective. Cold boxes with ice packs are used to transport the vials. Each vial will provide about 14 - 2 drop doses and has a color sensor that turns blue if the vial gets too warm.
On the first day of the event, we worked in a tent that was set up in an area that appeared to be a dump. Parents and grandparents would walk up with their kids, and the older ones knew the drill; their mouths would pop open and in the drops would go. Some babies however were not so cooperative and we had to squeeze their cheeks to get the drops in. Cries of anguish usually followed but soon stopped. After a while we moved to a street location where parents would drive by in a variety of vehicles. On several occasions members of the local team would spot a baby on the other side of the street and run after the vehicle to see if the child had had the drops. The left pinkie finger of every recipient is marked with a special indelible ink so you can tell by looking.
On the second day of the event, we did outreach. Two Rotarians were paired with local women and we went door-to-door looking for un-vaccinated children. We were assigned to a very poor area in the north of Delhi where the average family dwelling size appeared to be about 100 ft2 (9 m2). After each visit the door was marked in chalk with the date and a code for the visit results. There was an open trench in the walkways here that contained raw sewage. Like the day before, the kids were beautiful and friendly and many came up to pose for pictures so they could see themselves on the digital display. Our team visited 194 dwellings and gave drops to 44 kids.
Our last day was our only free day and while the rest of the group went shopping, I went line hunting. I hired a driver and showed him the map. We went south on NH2 to Mathura and then ENE passing through Hathras and Kasganj. We crossed the Ganges River on a single lane railroad bridge about 10 miles (16 km) SW of the confluence. There were of course many people bathing in the river and there is a new bridge being constructed to the east. We reached the confluence vicinity after a 180 mile (300 km) trip that took 8 hours (more on this below). The confluence was an easy 0.25 mi (400m) walk from the road through a wheat field and I met two wheat field guardians along the way. We could not communicate, but I gave them my best smile and "Namaste" with pressed palms and they let me pass. The confluence is between the wheat field and some dwellings. I did not zero out the GPS because the point appeared to be covered with human feces. Just like the day before, a tall white guy with a camera attracted a bunch of kids, who posed for me. I walked back to the car and it took another 8 hours to get to the Delhi airport.
India is a fascinating country. The population is now 1.1 billion, and we were told that at current rates India's population would surpass China's in 2030. It is a democracy with amazing technical prowess and a strong middle class, but at the same time several hundred million people are living in huts or slums like we visited during the RID. There were two things that struck me that I was not prepared for. First, the traffic is unbelievable, and not just in the Delhi. Every town we drove through was incredibly jammed with ox carts, bicycles, rickshaws, tricycle taxis, lorries, busses, trucks and cars. Our speed in these areas was less than 5 mph (8 kph) at best. And they drive on the wrong side of the street whenever they can.
The level of air emissions control appears to be like the US in the early 20th century, meaning none. I saw power plant stacks in Delhi that had visible plumes; not from steam but from particulate. It's the same in the country, but the point sources there are brick kilns, fueled by straw and cow dung. So no matter where I went, there was a particulate haze in the air that made breathing difficult. The health effects of fine particulate are profound, and my driver had the hack to prove it. I hope that India will devote more resources to reducing particulate emissions as it grows and prospers.