Polio Programme :

Polio Programme with Médecins sans frontières Background

From 1991 until 2005 Médecins sans frontières collaborated with Share and Care in the Polio Programme. It began when polio was ubiquitous in India; tens of thousands of children were becoming handicapped, unable to walk or use their limbs. The main aim was to help post-polio children become functional, and lead as normal a life as possible. A major emphasis was to have the children attend school through tenth standard/grade. Poliomyelitis was at its height in the late 1980s in India. Particularly in lower socio-economic areas, the disease spread rapidly because of the lack of knowledge of immunization, the need for sanitation, and fear.

Government hospitals were performing surgeries that helped the children become more mobile. But because of the huge demand, hospitals became overloaded waiting times were very long. The children and their parents often had to travel some distance to the hospital and pay for accommodation they could ill afford. After surgery children registered at a government rehabilitation centre where measurements were taken for callipers and crutches. But delays of up to six months in getting the supports to the children were not uncommon, and frequently the devices no longer fit properly. This created a situation where the child had to repeat the process, sometimes developing infections and other complications in the interim. Many parents decided to abandon the procedure, and so the child was left idle at home and often developed even more deformities.

Programme Activities and Impact :
In 1991 Share and Care stepped in with MSF. Over the next fourteen years, eight hundred and fifty children received surgery, physiotherapy and counselling. The Polio Programme had a team composed of an orthopaedic surgeon, a physiotherapist and a professional social worker. As soon as they opened the clinic references came from government hospitals and NGOs. In a typical week the team saw between fifteen and twenty cases. Twice a week the clinic was open; on Wednesdays the children were registered, parents were counselled to learn the options, and the physiotherapist did muscle testing. On Fridays the orthopaedic surgeon, along with the other team members, reviewed the information and decided the best course of treatment.

If surgery was recommended, the child was scheduled for the operation within two days at the closest well-equipped private hospital. Here the child received excellent pre and post-operative care, and five days after surgery the child was discharged and returned home. (If the child lived in a hut, Share and Care housed mother and child for a month.) A week later the child returned to the clinic to have the wounds dressed. Three weeks later the child was given a calliper or crutch, along with physiotherapy. Usually within a month the child was able to walk and attend school. Where once there had been a child who could only crawl on all fours, there was now a student who could walk to school using a crutch and carrying a school bag.

A major accomplishment was that in all the surgeries performed through Share and Care’s Polio Programme, there was not one case of infection resulting from the procedure. However, there were several typical problems during the course of the programme. Sometimes a patient was not regular in attending therapy; these children were sent a reminder postcard, and if they still did not turn up, the social worker made a house visit. A “good” problem was the ongoing need for repair of boots and callipers caused by wear and tear, necessary because the children were so active. Some of the children had short legs, and had to have pin traction, a procedure that gradually lengthens the limb. This started in the operating room, and then continued at home. The doctor or nurse visited them periodically to check on improvements and make any needed adjustments.

Most importantly, Share and Care oversaw the children’s education, particularly if they were poor. Usually the polio children were very eager to study, so they attended school regularly. But occasionally they ceased to attend due to lack of funds, and then Share and Care supported the families and gave financial assistance.

In the fourteen years of the Polio Programme, more than three hundred surgeries were performed, and over eight hundred and fifty children were given callipers and/or crutches. The children were given a new lease on life because they were now able to walk and go to school. Families were very grateful for the help; some had waited many months at government hospitals. Most of all they were thrilled that their child could now have a normal life.