A place at the end of the road

There is a place in India where the road ends. It isn’t even a proper road as the last six kilometers coming into the town are thick mud and if you are unlucky enough to have to travel in the rainy season you’d have to walk these last six as no jeep will take you there. Beyond this little town in Bihar lies the flooded area of the Kosi river and the only way onwards is by boat. Electricity is not a part of the services rendered to this small town and if you want the fan to work at night you must carry your own generator that will play its sweet music outside your door throughout the night. It is Kusheshwar Asthan East (yes, there is also a West) and it is the place where the World Health Organization (WHO) and UNICEF had to open a satellite office as a part of the far-reach of the polio eradication campaign in India. If an office was not opened here the polio vaccine would never reach more than two hundred villages scattered on the flood plain of the Kosi river. Bihar is considered a high-risk state for polio eruption and it is here that the hardships faced by the volunteers of this incredible campaign are best seen.

Polio (also called poliomyelitis) is a contagious, historically devastating disease that was virtually eliminated from the Western hemisphere in the second half of the 20th century. Although polio has plagued humans since ancient times, its most extensive outbreak occurred in the first half of the 1900s before the vaccination created by Jonas Salk became widely available in 1955. The polio virus spreads from person to person, primarily via the fecal-oral route.

In a world of AIDS, malaria and other health crises, the eradication of polio would demonstrate that humankind can triumph over nature. The polio eradication campaign is the largest non-military, global enterprise in history. The size of the campaign in India is nothing less than amazing; 2.3 million vaccinators and 155,000 supervisors go house to house to 209 million houses and vaccinate 172 million kids under 5 years old twice a year during the national immunization day (NID). A sub-national immunization day (SNID) takes place up to eight times a year in high-risk areas like Uttar Pradesh and Bihar where more than 550,000 new babies are born every month. After sixteen years of the campaign in India, following an enhanced vaccination efforts led by the World Health Organization, UNICEF and Rotary International, India has finally been declared polio free on February 25th, 2011 with the last polio case dated January 13th, 2010.

The following images, commissioned by UNICEF, are a part of  the last documentation of the polio program in India. The images will be exhibited in NYC and worldwide and published in the book ‘The SNID’ that is scheduled for publication on February 2013.

Putting up the display of IEC (Information, education and communication) material at a brick kiln outside of Patna.

Workers pass by IEC material put up on one of the chimneys of the brick kilns on the outskirts of Patna.

A family accommodation next to the brick kiln on the outskirts of Patna

Community mobilizers put up a banner of the polio campaign across a narrow lane at a muslim area on the outskirts of Patna

A block mobilization coordinator (BMC) supervising the display of IEC material on a mosque wall outside of Patna.

IEC material on the wall at a rickshaw stand in Patna.

Muslim religious and community leaders shake hands with unicef staff after a successfu meeting. unicef staff regularily meet mulanas and leaders of the muslim community to sensitize them about the campaign and promote cooperation at local community level.

3am at Kusheshwar Asthan east, on the Kosi river flood plains. The town has no electricity connection and the only light comes from a random generator. In the rainy season the roads become a knee deep mud that prevents any vehicles from coming any closer than 6km away.

3:30am. To the light of a single candle, the ice packs are taken out of the ice factory and placed into the cold boxes. They are then carried on the head and on bicycle carts, bare footed through thick mud, to the river were they are loaded onto boats that take the vaccine to a sub depots to be distributed to vaccinator teams and reach more than two hudred villages on the flood plains of the Kosi river. Kusheshwar Asthan east.

3:40am. The cold boxes containing the ice-packs are carried on the head and on bicycle carts, bare footed through thick mud, to the river were they are loaded onto boats that take the vaccine to a sub depots to be distributed to vaccinator teams and reach more than two hudred villages on the flood plains of the Kosi river. Kusheshwar Asthan east, Bihar.

3:55am. The cold boxes containing the ice-packs are carried on bicycle carts, bare footed through thick mud, to the river were they are loaded onto boats that take the vaccine to a sub depots to be distributed to vaccinator teams and reach more than two hudred villages on the flood plains of the Kosi river. Kusheshwar Asthan east, Bihar.

4:00am. The cold boxes containing the ice-packs are carried on bicycle carts, bare footed through thick mud, to the river were they are loaded onto boats that take the vaccine to a sub depots to be distributed to vaccinator teams and reach more than two hudred villages on the flood plains of the Kosi river. Kusheshwar Asthan east.

4:49am. The cold boxes contatining the polio vaccine are loaded onto the boats at Kusheshwar Asthan east, Bihar.

4:49am. The cold boxes contatining the polio vaccine are loaded onto the boats. The boats with the vaccine and the vaccinating teams left at 5am sharp. Kusheshwar Asthan east, Bihar

A vaccinator team on a boat on their way to a village on the flood plains of the Kosi river.

Vaccine carried on bicycle on the flood plains of the Kosi river near Kusheshwar Asthan east, Bihar

A supervisor carries the vaccine cold box during a vaccination day at a village on the flood plains of the Kosi river near Kusheshwar Asthan (E).

The oral polio vaccine must be kept at a temperature of 2 to 8 degrees Celsius and is carries around in cold boxes.

Newborn immunization during the vaccination day on one of the flooded Kosi riverine area near Kusheshwar Astan East, Bihar.

Finger marking for a vaccinated child during vaccination day at a village on the flood plains of the Kosi river near Kusheshwar Asthan (E).

Finger marking for a vaccinated child during vaccination day at a village on the flood plains of the Kosi river near Kusheshwar Asthan (E).

House marking during vaccination day at a village on the flood plains of the Kosi river near Kusheshwar Asthan (E).

A vaccinator team approach isolated houses during vaccination day on the flood plains of the Kosi river near Kusheshwar Asthan (E).

Vaccinators reaching under-served communities at Alauli block, Khagaria, Bihar.

Click on this line to see more images of the polio eradication campaign in Bihar from this assignment for UNICEF.
I first documented the polio eradication program in India  for the World Health Organization in 2004. Some of the color images from that assignment can be viewed HERE and on my archive HERE

  • Bishmoitra

    Super pictures, Sephi

  • Sandeep

    Thanks for this story

  • uurmimehul

    Speechless………..just amazing. A true fact of India, captured in pictures.

  • Soumen D

    Lovely Photo story …. Just too good ..

  • Atul Pratap Chauhan

    After long time i saw your documentary work..Really loved it..I think you must do documentary work very regularly…

  • Sachdevanikhil73

    some pictures wer vry nyc…spcly a truck nd d masjid..:)

  • Rajeev44

    Excellent…Proud of you !!

  • http://www.sephi.com Sephi Bergerson

    Thank you Rajeev. I thought about you often when I was there.

  • http://www.sephi.com Sephi Bergerson

    I cannot agree with you more! :)

  • akash das

    Brilliant effort to capture such moving and strong B&W photographs.

  • http://www.sephi.com Sephi Bergerson

    Thank you Akash. Means a lot coming from you!

  • Udit

    great work Sephi… !

  • Dinesh Khanna

    Superb, Sephi . . . a moving story told with the awe and tenderness it deserves . . 

  • sharik verma

    Respect… :)

  • http://www.sephi.com Sephi Bergerson

    Thank you Dinesh. It means a lot.

  • Omanath

    Very moving photos bihar will never leave you once you have experienced it….. Will look at these again and again. Shabat shalom

  • Rina

    excellent photos Sephi…it’s just brilliant

  • http://www.sephi.com Sephi Bergerson

    Thank you Rina :-) It was an amazing trip indeed

  • Raviprasad

    Great Pictures. You have showed that the foot soldiers matters the most in any successful programe.
    Who build TAJ MAHAL is not important but  the craftsmen and women who constructed it on the sandy shores of Yamuna is important

  • cloud9

    Cheers Sephi!
    Fotowala with a story.

  • http://twitter.com/epstein_dan Dan Epstein

    Outsdanding photographs in tough conditions. Congratulations. Reminds me a bit of some of the hardest, most remote areas in polio vaccination campaigns in South America.

  • Ramesh Jha

     Hi Sephi, Thanks a lot, I really went in past because I belong to this place. I spent my childhood there. Great work. 

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