Rx for Survival — A Global Health Challenge

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Dispatches from the Field:

Mike Beckham

Polio Warrior

By Mike Beckham
New Delhi, India

October 2004

David Heymann from the World Health Organization is sitting by a dusty roadside in northern India. We're here to film the operation he's running. It's one of the largest public health initiatives in the history of mankind — an attempt to eradicate polio from the face of the globe. It's a program he knows mustn't fail.

A boyish figure in spite of his years, Heymann sits joking with our film crew's local drivers, apparently unconcerned with the weight of history on his shoulders. Yesterday he was in Saudi Arabia raising money to keep his huge polio program on track, and after a few hours of jet-lagged sleep in a hotel in Delhi, he's eating rice for breakfast with his hands at a roadside stall. "The only way I combat the fatigue of world travel is to run each morning when I wake," he tells us. And he was doing that in Delhi before we were up. He then graciously agrees to ride in our bone-shaking crew van to a location in northern India where his polio program has hit trouble.

The man riding in our van turns out to be a cool customer with impeccable credentials for the task. At the tender age of 24, David Heymann was one of America's D.A. Henderson's all conquering 'smallpox warriors —' the young idealists who successfully vaccinated that disease off the face of the earth in the 1970s. He was then part of a Centers for Disease Control 'swat' team that tracked down the fearsome Ebola virus in Zaire in the late 70s: it's a disease that even today can mean instant death. In 2003, David Heymann coordinated a brilliant search and destroy operation for the WHO (World Health Organization) on the new SARS virus. By hooking up ten of the world's top research laboratories and tracking the disease in real time on the Internet, he and his team stopped the spread of SARS.

Heymann clearly likes having film crews around him, and he wants us involved in the problems of polio eradication. As we rattle along the broken roads in an old bus, he explains why he's suddenly come to India again. When the polio eradication campaign began in 1988, a thousand children a day were becoming paralysed in the world. Now it's down to less than three a day. In India in 1988, there were 175,000 polio children. Today it's fewer than 100. But a pocket of 19 paralysed children has been found near the city of Moradabad in the densely populated state of Uttar Pradesh west of Delhi. Heymann wants to know why. At the speed the polio virus spreads, those 19 cases could quickly turn into thousands; enough to derail the whole program here.

Global health on the scale of WHO's, UNICEF's and Rotary International's joint $3 billion polio eradication program, is about good management. And Heymann listens intently in Moradabad's District Headquarters as Indian health officials try to explain the sudden upsurge of cases. He tells them not to be disheartened, and exhausted vaccinators who've come in from the field to listen are praised for their work. This is a morale boosting exercise from the head of a program who knows the eradication attempt in India now teeters between triumph and miserable failure. Years of backbreaking work will be wasted if this outbreak spreads.

Out at the infected village, Heymann explains the factors that have made polio eradication such a mountain to climb. Open sewers that doubtless still harbor the polio virus from the feces of infected children, run past houses. Heymann, a qualified doctor, cradles a small girl whose legs are lifeless.

Despite the sad case, a third of the village is Muslim, and Islamic leaders have always been wary of Western medicines, even if they're life-saving vaccines. Many of the polio children were hidden when the vaccinators made their rounds a few months earlier. It'll be the burden their parents will have to live with for the rest of their lives. Now they're friendly and want to share their anguish with a foreign film crew.

Heymann holds a morale boosting session with the Indian vaccinators. "You've got to build a wall of immunity throughout the entire area, so the virus no longer has a human host to hide in. Put more women on your teams so you can get into the houses of resistors." Money will be found to blanket vaccinate the whole of northern Uttar Pradesh again, he tells them. The vaccinators know this will be no mean feat; if Uttar Pradesh was a country, it would be the fourth most populous in the world.

On the bone-crunching 5-hour ride back to Delhi, David explains the philosophy behind the big public health projects he's worked on over the years. Successful global health is not only about money and management, it's about will power. It's also an adventure, he says. "To have adventure and do something for humanity is not something everyone can achieve. When we succeed in eradicating polio, and we will, we'll all feel 12 feet tall." Then as an after thought, "Your film is important. It'll help." We're suddenly part of David Heymann's adventure in global health. Standing 12 feet tall.

Then he adds quietly, "I believe those children you saw today, will be some of the last cases in India. By the time your film goes out, we'll have cracked the problem here."

The next day, David Heymann jets off to the Emirates states to beg for more money. The virus has suddenly popped up in polio free Yemen and Sudan, spread by a pilgrim from Muslim Nigeria who went to Mecca. Heymann needs $20m quickly to fight the new outbreaks.

Heymann and his polio warriors are on the brink of success. There are less than 600 cases of polio in the world, but the last ones are always the most costly and difficult to stop.

About the author:

Michael Beckham is the producer of Disease Warriors in the Rx for Survival series. He has spent 25 years filming documentaries on all the world's continents. He's specialised in humanitarian and anthropological programs in developing countries and covered war situations in Africa, the Middle East and Latin America. Beckham has also produced several feature length drama documentaries on historic, scientific and political subjects.

Dr. Heymann and a local doctor examining a young polio victim.

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