Two women break geographical and cultural barriers to vaccinate children in the remote, cannabis-growing village of Malana

Reaching Malana, a village in Himachal Pradesh nestled among the lush green forests and the snow-capped mountains of the Parvati Valley at an altitude of 8701 feet (2652 meters), is not easy. With a population of only 1,935 from 220 households, Malana remains isolated from the rest of the country. Devoid of public transport connectivity, one has to trek 40 km, through the tough terrain for an hour and a half to reach the village. Apart from the locals, those who endure the travel are there for the high quality cannabis that is grown locally.

It may almost seem like the village has kept a deliberate distance from civilisation.

“The village is orthodox in its views and the education level is very low. The villagers do not allow any outsiders to come inside Malana as well,” says Dr Ramesh Chander Guleria, the District Immunisation Officer of the region.

However, this distance was costing the villagers dearly. The entire administration of the village is controlled by the deity ‘Jamblu’ through a village council.

“For several years, this council was against giving any vaccines to the children as per the directive of Jamblu devta. This meant that when we went to the village for any medical camps or immunisation drive, we were ignored and sent away,” Dr Guleria says.    

For immunisation officials of Kullu, Malana remained outside the ambit of immunization as no one was willing to travel out to it. However, things changed in April 2015, when 38-year-old Meena Kumari, from Uttar Pradesh, joined as the Auxiliary Nurse Midwife (ANM) in Pini subcentre in Kullu. Undeterred by the geographical toughness of Malana, Meena set forth on a mission to immunise the children of the village. Since Alternate Vaccine Delivery was not possible due to the hilly terrain, Meena carried the vaccine carriers herself, travelling partly by public transport and partly on foot.

“When I started working in Malana, no one would come to the Anganwadi center for tika (vaccination),” Meena tells YourStory. “So I decided to go to them.” She went door to door, explaining the importance of immunisation. “I told them that a sick child is not due to a God’s curse. Rather, deaths can be prevented by these injections,” Meena says.

Immunisation is a proven cost-effective and powerful public health intervention to prevent mortality and morbidity for Vaccine Preventable Diseases. Yet, despite multiple interventions from the government, immunisation coverage among children in the country aged 12 to 23 months has not improved in the last seven years, rising only from 61 percent in 2009 to 62 percent in 2015-16.

Hence, with an aim to achieve 90 percent immunisation coverage by 2020, the Ministry of Health and Family Welfare launched a campaign called Mission Indradhanush, in December 2014. Meena was part of this mission.

Today, come rain or snow, Meena shows up at Malana to conduct vaccination sessions. Over the past four years, she has vaccinated over 180 children and this has resulted in 95 percent immunisation coverage in the village.   

“It was all about winning people’s trust and letting them know that this was for their own good -- for the welfare of the children, for their future health, for their finances, and for the continuity of their family lineage,” Meena explains.

A village stuck in the past

The entire administration of Malana is controlled by the deity Jamblu through a village council. The council comprises 11 members, believed to be the delegates of Jamblu, who govern the village in his name.

Due to the deep faith in their deity and their belief in casteism, the Malanis keep a safe distance from outsiders visiting their village. One cannot touch them or their deity (and temple) without their permission. In case of any contact with an outsider, they rush to bathe. These social taboos have developed because the Malanis believe that they are ‘pure’ Aryans and descendants of Alexander the Great.

Apart from the geographical difficulties to reach Malana, Meena - an outsider - also faced these social taboos, which stood in her way while trying to immunise the Malani children.

The winds of change

As the ANM head of the Pini subcentre, Meena was in charge of both the anganwadi centres and ASHA workers. When she first inquired about the abysmal rate of immunisation cover in the village, she was informed that people did not want to visit their centre. She decided she would visit the households herself.

Fortunately, during the same time Nirma Devi had joined as an ASHA worker. Nirma was the first ever Malani who had agreed to work as an ASHA worker for her village. Nirma began accompanying Meena on her house calls.

The language of Malanis is called Kanashi; the villagers don’t speak or understand any other language while the rest of Himachal does not understand Kanashi. With Nirma’s help, Meena would visit the houses, and try to talk to the mothers first.

Meena recalls, “Initially people abused me and used cuss words at me. They would stand outside their homes as guards to ensure that we did not step inside their house. They would run behind me, and say, ‘Madam ji, please do not come here’.”

Both Nirma and Meena faced ‘malediction’ and threats. As per villagers, Nirma was violating the order of the deity, which would be harmful to the Malanis and their children. They did not allow Meena or Nirma to touch their children.  

But the ASHA workers had received special training on ways to interact with the villagers. It took almost a year for Nirma and Meena to win over the Malanis, and convince them that Meena was there to benefit Malana’s next generation. Nirma organised meetings of the senior women of the village and advocated the benefits of vaccines and immunisation on children’s health. Along with Meena, she met the village council several times, and urged the Malanis to have faith in the government’s vaccines, assuring them that no harm would befall the children after vaccination.

“And finally, two-three households allowed us to vaccinate their children. They became our supporters and informed everyone that the injections did not cause any pain or fevers. After that, many other mothers came forward to get their child vaccinated,” Meena recalls. Half the battle was won with growing acceptance.

A generation’s future secured

Along with Nirma, Meena has immunised all 170 mothers for antenatal care and subsequently immunised their children. Today, Meena is not an outsider, nor an untouchable for the Malanis.

“Now they themselves come to the anganwadi centre for vaccinations. They even inquire about my visits and are now like friends and family,” Meena says.

Often, after a full day’s work, the villagers arrange and offer food to Meena so that she can do her work well. They sometimes accompany her till she reaches the main road and gets a vehicle to return home.

Today, there are no unvaccinated children in Malana, and women and children are now safeguarded against 12 preventable diseases. All thanks to the tenacity of two women.