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'The doctor got 90 per cent of the 4.2 million children vaccinated. In 48 hours!'

May 18, 2007
You write in detail about Dr Pankaj Bhatnagar, who you came to know during your Indian sojourn. He certainly fits into the scheme of positive deviants. [One of the chapters in the book is on positive deviants]

That is part of the reason I talk about him. One of the key abilities of people on top of the curve is that they understand how to be diligent, how to pay attention to detail. I couldn't really understand what that meant until I travelled with Dr Bhatnagar who is a WHO [World Health Organisation] physician.

He was responsible for responding to a single outbreak of polio in a region in Karnataka. One boy developed polio. In response, he needed to organise 4.2 million children to be vaccinated in 48 hours in a 50,000 square mile area in a place where the health system has broken down. He had to help to lead a process that took what little infrastructure there was there and make it work.

It was remarkable to see how someone was trying to bring all the vaccines here and the major ways the operation can break down. He zeroed in on where he felt the biggest problems would be and then set about solving them.

In solving this problem, sometimes he would run into a doctor in that village responsible for organising the vaccines who would not be very competent. So what would he do? He would either find ways to challenge that doctor, for he could see in them that they could become something better than they seemed or, he would go around them. He was a fabulous tactician.

For example, if he recognised a village where the electricity breaks down all the time, he would order an ice factory to send the ice to keep the vaccines cold. He would go town by town, tackling problem by problem. He never complained and he went around with an unbelievable optimism. This vaccine procurement effort could not succeed unless he got 90 per cent or more of the children vaccinated. And, he did it in 48 hours!

Image: A tribal woman holds her daughter as a volunteer gives an oral polio vaccine during an immunisation programme on the outskirts of Hyderabad.
Photograph: NOAH SEELAM/AFP/Getty Images

Also see: 'India represents the world much better than the US'
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