At sharp 6 am, Ram Girja Paswan pedals his way to Jai Prakash Narayan Hospital in Gaya, Bihar, 15 km from his home in Chakand village. There he packs vaccines in two ice-boxes given to him by the auxiliary nurse midwife (ANM) at the vaccine collection centre. He is also given a list that contains details of the nine identified vaccines and their quantity.

Boxes in hand, he takes off for the vaccination drive in village Simaria, 19 kmfrom the hospital. The unmetalled road to the village that runs along river Phalgu is bumpy. During the monsoon it becomes impossible to cycle on the muddy track, so he parks his bicycle on the way and treks the last few kilometres on foot.

Paswan is a vaccine courier — an important link that covers the ‘last mile’ to reach the vaccination site. This has been his routine every Wednesday and Friday for the past decade. Many a time he has had to miss social and family functions and gatherings like marriages and deaths.

“Irrespective of weather conditions, I cycle on the uneven, broken down road, risking accidents and injuries. In winter, visibility too is poor. I have no option but to perform this important task of reaching the vaccines on time to the identified villages,” says Paswan, providing details about his daily routine. He says he is well aware that the ice-boxes he ferries have vaccines crucial for the health of infants and pregnant women who wait at the session site.

His job does not end here. After delivering the first lot of vaccines, he continues the trudge to the next village a few kilometres away. Here he waits till 4.30 pm till all the identified children and women have been vaccinated and returns to the collection centre with the stock that is left over. By the time he is home, it is already dark.

Paswan points out that both the sites are “difficult to reach”, but he is given ₹150 only for one site and half that amount for the other. As per the rules, ₹150 is given to the vaccine courier for a site which is either 25 km away or is considered difficult to reach, for other sites it is ₹75. “Yes, it is a pittance for the effort that I and others make but the satisfaction of being able to serve society is our reward.” Money is not everything, he reiterates.

Paswan, who holds an honours degree in sociology, also supervises the Pulse Polio and other health-related campaigns. But all that is insufficient to make both ends meet, so for a living he works as an LIC agent.

For Kameshwar, another vaccine courier boy, the job is no less challenging. Kameshwar lives around four kms away from JPN hospital, but the village where he delivers the vaccine is across a small seasonal river. “I start from my home on a bicycle, collect the vaccine boxes from the hospital and park my vehicle in Kusari village which is on the banks of the river. I then wade through knee-deep water to cross the river and reach the site. When it rains heavily and the river is in spate, I take a train, get down at the nearest station and walk for over 30 to 40 minutes to reach the village vaccination site at village Bemtanawadhi. For all the trouble I take, I receive ₹75 per session.”

Echoing the sentiments of Paswan, Kameshwar says he has never thought of discontinuing the work through which he is contributing to the good of the people in his small way. “The amount given to us has remained the same since the programme began, though the cost of petrol has more than doubled,” say the other courier boys, Vinodkumar and Aashuprasad. Both use their motorbikes to deliver the vaccines assigned to them. Both also double up as daily wagers or farm hands on other days of the week.

“The government rate for daily wage is ₹282 and for the two vaccination centres that we get to cover in a day it is only ₹150. We start at 6 am and return at sundown, so on two days a week we can’t work as daily wagers”. The wives of both the courier boys are anganwadi workers and they know the importance of their work. “Many a time we have thought of leaving this job, but the fact that it involves saving children from fatal diseases is what makes us stick to it,” they say.

In Gaya district, there are 24 blocks and nearly 5,500 vaccination drives are organised in a month involving over 3,000 vaccine courier boys. To make an immunisation programme a success, the assembly line has to move smoothly — from the supply of vaccines to its distribution, from mobilising the community to reaching them to the required spot.

In 2013, the routine immunisation coverage in Gaya district was 42 per cent. In 2017, it jumped to 82 per cent, the credit for which no doubt goes to the enormous effort put in by these committed foot soldiers for whom their work is a mission.

The writer is a senior journalist based in Delhi

Published on May 4, 2018