Bus Number 11
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Bus Number 11 Fatima is a lady health worker in Kaifabad. Because she lives in an area of Pakistan where no new polio case has been seen for several years, she works on three to five door-to-door polio campaigns a year. In areas with ongoing transmission, lady health workers work on six to eight polio campaigns a year; in the winter, there may be a campaign every month. For each campaign, Fatima must take about five days away from her normal work and family life. Along with another worker, she goes door-to-door in Kaifabad with oral polio vaccine, asking if children under five are present and vaccinating them if they are. At each house, she records on the door with chalk when she visited, how many children under five live in the house, and how many she has vaccinated. The areas she visits have been carefully mapped out to ensure complete coverage of the city. When Fatima comes to houses when the young children are not home, perhaps at their grandmother’s house or in the bazaar, she records their names, ages, and the address and returns to the house, often multiple times, until she finds and vaccinates them. She does all of this, she notes, on “Bus Number 11,” her own two legs. As Fatima goes door-to-door, other teams of workers vaccinate children at “transit points” like bus stations and busy markets. As a lady health worker, Fatima helps her neighbors with a wide variety of health issues, from birth control information to oral rehydration in cases of diarrhea to assistance with tuberculosis treatment. Her salary for this work is Rs. 1,900 (around $30 a month). During the weeks of polio campaigns, however, she focuses solely on polio and receives a supplement of Rs. 600 (about $10) for five days of work. Fatima is plump and talkative, with a sparkle in her eye. On campaign days, she gets up at dawn for morning prayers and then cooks breakfast for her husband and three children. She irons her two older children’s school uniforms, makes sure their books are in their backpacks, and delivers her young daughter to the neighbor who will watch her for the day. Depending on the area where she is working, Fatima may or may not have a proper lunch—if she knows people there, she may have lunch at a friend’s house, but in areas where she is less familiar, she may not eat much. When Fatima gets home, she picks up her young daughter, goes over the day’s homework with her older children, and cooks dinner for the family. She does the dishes. If the electricity is working in the evening, she irons her and her husband’s clothing for the next day. She gets to bed late. She describes a day of work to me: I start at eight in the morning and may not be done until four or five in the evening. We have to finish polio. We also have to mark the houses, and give the day’s report to our supervisor. . . . When we’re tired from the day’s work we have to go back to the hospital to hand in our report. Then we have to go [to the hospital] early in the morning the next day to get vaccine, and then back to start working [vaccinating children]. After the day of work we go back again to hand in our reports. . . . It’s really quite far. . . . It’s all walking, walking. It’s true that we do get lots of exercise—but that whole week I feel sick [bukhār nhīṇ utarta]. Then, of course, we have to go back over those same areas to find the children who weren’t there the first time. It’s so tiring—I’m sure you know. And then everyone [the lady health workers] has to find someone to watch their children. . . . And the pay! You know about the pay. ...


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