Connecting With Community: My experience as an External Monitor for WHO

I am currently living in the hostel of my college and our teachers are nice enough to give us several opportunities. On 17th September, my friend and colleague Smruti called me and asked if I am interested in working as an extrenal monitor for Pulse polio Sub national Immmunization day from WHO. I was overjoyed and said yes immediately. Who will say know to this opportunity? I was not exactly aware of the work of an EM(External Moniotr), but was waiting for the training.

 As I do not like going unprepared, I started reading every document I can find on pulse polio and guidelines. Still, was not able to find that what was my work? Next day, our training was taken by Surveillance Medical Officer of Ahmedabad. We had three hours of training in which through presentations and forms we learned the process of how to conduct this monitoring! The best thing was that attention at every single point is important. It goes for our normal teaching too. If you ignore even a single slide or zone out, there were chances of error. Awareness and attention was required. We were also made aware of what was being expected from us. Which was to conduct our duty properly. I was like, oKie big deal.. I know all the points I should be fine.

 HOW WRONG I WAS? I am sure you all must know that field experience and academic learnings are quite different. I see all things from A to B, but forgot one of the most important variable, HUMAN. The biggest learning I had from this experience was how to communicate with humans? They are all very different and have very different contect from us. Be it a community, Public health workers or My driver or My friend who was accompanying me. When you are in a different situation, different behaviour of a person comes out which you might have not seen before. I learned it that my friend is not so easy to work with as we have different and stubborn approach.

 Also, I only had one thing which was do monitoring but people who were getting their kids vaccinated, Field health workers who were delivering it and kids themselves had very different priorities. Because of our mask and blue boxes, kids ran away from us and I literally had to run to catch one. Just because I was going from the top, did not mean that kid understood who I was. THAT WAS AMAZING. The field health workers have different struggle going on.Me sitting in front of my laptop, looking at news that COVID cases are increasing and government is not efficient, well Let me tell you. All the field health workers were quite equipped with all the gears and in humid heat they were wearing it for hours. Each and every kid was found and was being vaccinated in front of their mothers / family members. Asking each and every preganant women we met on the way that how they are doing, are they immunized? These people are dedicated. They love the community they serve. Once or twice problem comes but they are also humans. I salute these field workers who did their work quite diligently for more then three days.

 Community was a different treat altogether. For those who might not know, Pulse polio on Sub National Immunization Day targets only high risk and vulnerable populations like Slums with migratory, slum with difficult to reach area, construction sites are some of the examples of that. I know that how it can be but what I saw was quite different. People were aware of the immunixation going on and were very cooperative with the vaccine. Kids were sometimes not so cooperative but older kids 4 to 5 years were quite receptive to it. Mostly no one was wearing mask and for once I thought that they might have forgotten that corona is going on. 

We did encounter corona positive patients and also areas that were isolated, and field health workers as well as their neighbors were quite supportive to them. At one place we actually asked that why are you not wearing the mask and why go to work if you have fever? The answer I got was, "Madam, I will die of hunger if not corona. I have to choose lesser of the evil." I was shocked and feeling helpless about it. What do you do if your house is situated in a crowded space. If there is no way to keep the social distance or money to buy masks and sanitizers?

 At my last day at urban health centre, One of the ASHA behen was diagnosed with COVID. She was standing there and crying. I was thinking that should I go and tell her that it will be alright? but her co workers beat me to it. They were all supportive and the point they made was, "You are seeing a lot of people being diagnosed and get cured of COVID. Just go home and take rest. We are here with you." Interesting to see this when I have seen much more educated and higher level officials of being very stigmatised about it. The spirit was exhilariating , I was happy to see it.

 In the nut shell, I learned that never assume anything.You can not sit in a chair and make decisions when you do not even know the field. NOTHING REPLACES FIELD EXPERINCES, which makes you use all of your senses. Working hard and smart is very important when we want to eradicate any disease. One needs to proactively seek childern and vaccinate them. Being ounctual, thorough and not living single house that was how I worked. No one told me that, but it came from the inside, from being responsible and realizing seriousness of the mission. Learned a lot about how to interact and conduct this whole exercise in which dealing with from MO to community. Taking time and not doing exercises just for the sake of it was a biggest take away. I am looking forward for more experiences and interaction with my hardworking system and community.