‘Drops take seconds but change a life for ever’: the women saving India’s remotest people from polio

Carrying Hope Up the Mountains: Women Vaccinators Protect Kashmir’s Nomadic Children

Wanderstayfinder.com – Before dawn breaks over the Kashmir valley, two women begin their daily pilgrimage. Shameema adjusts her worn rubber sandals and verifies the temperature of her insulated container—the ice packs must keep the precious vaccines between 2°C and 8°C throughout the journey. Tanzeela, her companion, secures the laces on her canvas shoes, which have seen better days but still grip the rocky terrain effectively. Together, they carry the future of hundreds of children on their shoulders.

These dedicated health workers traverse more than 12 miles of increasingly difficult terrain to reach Namblan, a high-altitude meadow where nearly 50 dhokas—traditional mud-and-stone dwellings of the Gujjar and Bakarwal nomadic families—dot the hillsides. The journey begins on asphalt roads that eventually give way to dirt tracks, then to barely visible footpaths winding through mountain pine forests. Even electricity lines terminate far below these remote settlements, leaving the communities largely disconnected from modern infrastructure.

The Human Machinery of Immunisation

Shameema, now 45 years old, has dedicated over a decade to vaccination work in the region. Tanzeela, at 28, joined the programme three years ago. Together they represent a fraction of India’s vast network of 2.5 million frontline health workers—the human backbone supporting what stands as the world’s largest immunisation campaign. Shameema alone has administered polio drops to more than 3,000 children throughout her career.

“I saw that child struggle to walk to school,” Shameema says during a pause near a stream. “His mother held him on her back until he grew too heavy. [People in] these mountains need protection too – the children here deserve the same health as those in the cities.”

That child, whose leg remained deformed from a polio infection before India achieved full eradication, continues to motivate Shameema’s work. The memory of his mother carrying him on her back—until the burden became too great—remains etched in her mind as she climbs these same mountains today.

The Science Behind the Drops

The oral polio vaccine, developed by Polish scientist Albert Sabin in the late 1950s, contains a live but weakened form of the virus. When two drops are placed on a child’s tongue, they stimulate antibody production in the intestinal lining. These antibodies destroy the virus before it can penetrate the bloodstream and attack the nervous system. This mechanism creates what experts call communal immunity—a biological shield that protects entire clusters of children who share courtyards and water sources.

The gut immunity generated by the vaccine also reduces viral shedding in infected children, effectively breaking the chain of transmission in communities where clean water flows from mountain streams and springs. This is particularly crucial in regions where hygiene infrastructure remains limited.

India’s Polio Triumph

India’s achievement in polio eradication stands as one of public health’s greatest successes. The country received polio-free certification in 2014, following the final confirmed case in January 2011 in West Bengal. This milestone resulted from an extensive surveillance network comprising 60,000 health workers monitoring 40,000 reporting sites for acute flaccid paralysis—the hallmark symptom of wild poliovirus infection.

The frontline vaccinators receive modest compensation of 125 rupees per day, approximately one British pound, from the state government. This payment covers two-day vaccination campaigns that occur four to six times annually during national immunisation drives targeting all children under five years of age.

“The payment is small and the paths are steep,” Tanzeela says. “I think about my own nephews when I climb. The drops take seconds, but they change a life for ever.”

Kashmir’s Unique Challenges

The disputed region of Indian-administered Kashmir presents particular challenges for health workers. Seventy-three percent of the region’s 14 million residents live in rural areas, with hundreds of thousands of children under six scattered across distant villages and mountain settlements. Summer temperatures in Pulwama district, where Shameema and Tanzeela reside, can reach 37°C, making the cold chain logistics even more critical.

The Gujjar and Bakarwal pastoral communities, numbering approximately 1.2 million people, follow seasonal migration routes that take them far from permanent clinics and hospitals during the warmer months. Reaching these families requires careful coordination between state health departments, local village councils, and the frontline workers who possess intimate knowledge of the mountain trails.

Tanzeela has administered polio drops to roughly 800 children since joining the programme. She wears the same shoes she uses for farm work, noting that their thin soles provide better traction on rocky paths than the sandals worn by some colleagues. One fellow worker occasionally walks barefoot for portions of the trail, demonstrating the dedication required for this demanding work.

As horses remain the primary transport for nomadic families spending summer months in the highlands, the vaccinators’ foot journey becomes even more arduous. Yet they persist, carrying heavy insulated cool boxes containing vaccine vials, ice packs, and thick paper registers documenting each day’s work. Their commitment ensures that children in India’s most remote corners receive the same protection as those in urban centres—proving that geography need not determine health outcomes.