India is a developing country with a significant presence in different fields like science and technology, medicine, agriculture, etc. For a country like India, using communication for its efforts development is a basic necessity. There are plenty of examples where development communication has been employed as a tool of development. Be it a Satellite Instructional Television Experiment using television as a tool for the development of rural areas or a “Hum Do Humare Do” family planning campaign by the government. These efforts or examples had the intent of getting a sustainable improvement in the lives of the affected population.
One such campaign was ‘Pulse Polio Programme’ which was later dubbed by many as ‘Do Boond Zindagi Ki’, a campaign targeted at eradicating Polio from India.
Poliomyelitis or what is commonly known as ‘Polio’ is an infectious disease. Caused by ‘poliovirus’, it causes flaccid paralysis in the central nervous system. The virus has the ability to transmit from person to person. Also, 1 in 200 polio infections lead to irreversible paralysis. Among those paralyzed, 5% to 10% die when their breathing muscles become immobilized. The affected population is usually the children below the age of 5 years.
Among developing countries, India was the worst affected by polio. Approximately among the globally reported cases of this infection, India contributed 60% of those cases. By the 1990s there was a decline in the number of cases being reported. But still, India was witnessing a caseload of 50,000–1,50,000 every year. It had become endemic in the Indian subcontinent, with regular cases being reported from India, Pakistan, and Afghanistan. It was believed, that it is next to impossible for India to eradicate Polio from its country. These amounted to several reasons. One was the huge population. As polio infects from person to person, the Indian population was susceptible to infection very easily. As per WHO, an infected person (even asymptomatic) can infect others for several days, thus experts believe it was easy to spread of infection in India.
The second reason which was given by the experts was the hygiene. Like any other infection, polio breeds and prosper in unhygienic place. A bad sewage system was quoted as the reason behind the spread of infection.
World Health Organization in its forty-first world health assembly in 1988 had adopted a worldwide resolution for the eradication of polio. This led to starting of the Global Polio Eradication Initiative (GPEI), spearheaded by national governments, WHO, Rotary International, the US Centers for Disease Control and Prevention (CDC), and, UNICEF. India had its own initiative called National Immunization Programme (later changed to Universal Immunization Programme in 1985) launched in 1978 covering tuberculosis, diphtheria, tetanus, and oral polio vaccine. But when it was witnessed, a dip in cases globally while India's status quo was maintained, the Government of India, launched the national campaign for the eradication of polio. On 2nd October 1995following GPEI, India launched the ‘Pulse Polio Programme’ which aimed at 100% coverage of the country.
Preventive Pulse Polio
Pulse Polio campaign had a target to cover every corner of the country. It aimed that not a single child should miss the immunization. For such coverage it was required, a large-scale mobilization of logistics, knowledge about the causes, debunking of myths regarding vaccines, and surveillance of disease-prone areas. Emphasis was laid on faster testing as well. It was ordered if cases of acute flaccid paralysis are reported, officials need to conduct the test for polio infection within 14 days. As there were chances of an outbreak, Outbreak Response Immunization (ORI) was followed if the report came positive.
The surveillance and ORI were important as in the early phase of its immunization program, neither the WHO nor India kept a tab. absence of polio surveillance, neither the total number of cases nor the proportions accounted for by 3-dose vaccine failure was under scrutiny. Another failure that India witnessed in its earlier attempt was ‘failure to vaccinate’. On an aggressive footing, India started tackling this issue as well.
Across the country, several booths were made. These booths were in proximity of every resident of that particular area. Cold facilities, a freezer room, and ice-lined refrigerators were provided to volunteers for the safe keeping of vials. From 1995 to 1999, India conducted National Immunization Days, in these fixed booths. Initially, the target age group was children up to 3 years of age. In 1995, this was increased to children up to 5 years of age. The increase in the age bracket resulted in a decline in reported cases. In 1999, the Government of India constituted, the India Expert Advisory Group for polio (IEAG) for suggestions and actions to be taken for the eradication of polio.
In 2000, the two rounds of NID under Pulse Polio Immunization were increased to four rounds. Eight states which reported continuous cases of polio, Assam, Bihar, Gujarat, Madhya Pradesh, Orissa, Rajasthan, Uttar Pradesh, and West Bengal were selected for more measures. In these states, two sub-national rounds were conducted in these states. While the other states showed a decline, states with poor health infrastructure, Bihar and Uttar Pradesh were still the worst-performing states. At the suggestion of IEAG, it was decided, door to a door campaign should be launched. Through door-to-door campaigning, the missed child was covered as well.
In 2003, the ‘under served strategy’ was introduced as part of better communication efforts in Uttar Pradesh to reach out to and get the support from marginalized sections of the society especially those living in poor Muslim communities, lacking access to basic sanitary and health care services, and were often missed in polio rounds, and thus were more likely to receive fewer doses. The strategy was aimed at engaging universities, religious leaders and groups, local associations, and individuals from under-served Muslim communities to broaden ownership and accountability for polio eradication.
‘Do Boond Zindagi’
By the early 2000s, television had become popular. The liberalization in government policies has made, advertisement from every aspect a common part. The government too decided to aim at the audience through advertisements for their different policies which included a pulse polio campaign too. Indian actor, Amitabh Bachchan was roped in as the brand ambassador, who decided to do it as ‘pro-Bono. Meanwhile, India witnessed another outbreak of polio in 2002. The director of the advert thus asked Bachchan to scold the viewers on screen, reviving his angry young man image. The campaign was named ‘Do Boond Zindagi Ki’.
In the very first advertisement, in the heavy voice of Bachchan, “Dhikkar hai hum par, Polio ke booth par itne kam log?” echoed on television sets and radio. As a result on the next NID, rural area booths witnessed hundreds of mothers lining up for vaccinating their wards. When asked what made them come, the reply was “Amit Ji got angry”. Over the years, this came became a synonym for the Pulse Polio Campaign. Celebrities like Shah Rukh Khan and AR Rahman were also roped in to join Big B in doing the greater good and spreading awareness about ‘Pulse Polio’ and ‘Do Boondh Zindagi Ki’ on a larger scale. Various emotional and action-oriented ads were broadcasted.
Further mass media channels were equipped with personal and emotional appeal. Several other actors and sports legends joined Bachchan in the campaign. The Polio awareness would end with the actor raising two fingers with the message- ‘Pulse Polio Immunization- Do Boond Zindagi Ki’.
Posters, campaigns, exhibitions, village seminars, wall paintings, Kala Jatha, wall paintings, folk drama, and community meetings were some other means which were used to communicate the message to everyone.
With the effective use of communication methods, the Pulse Polio campaign became a success. India recorded just 66 cases in 2005, down from 135 cases reported in 2004, 225 in 2003, and 1,600 in 2002.
Leveraging the popularity of daily soaps on TV, the makers and the initiative helmers ensured the integration of polio and other health messages into storylines and episodes for subliminal messaging. As India reached close to the eradication of polio, the campaign motto changed, and the “We are this close” campaign was launched. Simultaneously the previous campaign continued with Bachchan.
Eventually, on 13 January 2011, India reported the last polio infection in Howrah, West Bengal. Since then, India has been free of the disease, officially receiving polio-free certification from the World Health Organization on 27 March 2014. This was possible with effective use of communication along with efforts by the government.
