Shifting polio eradication strategies may have generated fear and “resistance” to the eradication program in Aligarh, India during the summer of 2009. Participant observation and formal interviews with 107 people from May to August 2009 indicated that the intensified frequency of vaccination was correlated with patients' doubt in the efficacy of the vaccine. This doubt was exacerbated in a few cases as families were uninformed of the use of monovalent mOPV1, while P3 cases continued to occur. Many families had also come to believe that their children had been adversely affected by OPV after being told the vaccine carried no risk. Though polio is now largely eradicated in India, with only a single case in 2011, greater transparency about changes with vaccination policy may need to be considered to build trust with the public in future eradication programs.

BackgroundSignificant disparities in the incidence of polio existed during its eradication campaign in India. In 2006, Muslims, who comprise 16% of the population in affected states, comprised 70% of paralytic polio cases. This disparity was initially blamed on the Muslims and a rumor that the vaccination program was a plot to sterilize their children. Using the framework of structural violence, this paper describes how the socio-political and historical context of Muslim populations in India shaped the polio disparity.Methods and FindingsA qualitative study utilizing methods of rapid ethnography was conducted from May-August 2009 in Aligarh, Uttar Pradesh, India. Field methods included participant observation of vaccination teams, historical document research, and 107 interviews with both Global Polio Eradication Initiative (GPEI) stakeholders and families with vaccine-eligible children. Almost all respondents agreed that Aligarh was a highly segregated city, mostly due to riots after Partition and during the 1990s. Since the formation of segregated neighborhoods, most respondents described that "Muslim areas" had been underdeveloped compared to "Hindu areas," facilitating the physical transmission of poliovirus. Distrust of the government and resistance to vaccination were linked to this disparate development and fears of sterilization influenced by the "Family Planning Program" from 1976-1977.ConclusionsEthnic violence and social marginalization since the Partition and during the rise of Hindu nationalism led to distrust of the government, the formation of segregated slums, and has made Muslims victims of structural violence. This led to the creation of disease-spreading physical environments, lowered vaccine efficacy, and disproportionately higher levels of resistance to vaccination. The causes of the polio disparity found in this study elucidate the nature of possible other health disparities affecting minorities in India.LimitationsThis study is limited by the manual coding of the transcribed data, size, and some dialectal difficulties in translation.

The importance of Louis Dumont's work-both for specialists in Indian studies and for general social science theory-is by now obvious. Yet, since the publication of the initial volumes of Contributions to Indian Sociology (old series, coedited with D. Pocock), Dumont's work has been subjected to intensive criticisms that do not simply suggest he is wrong about a particular ethnographic fact, but rather that his approach is wrongheaded, that his starting points are idealist, biased (in favor of upper castes), or irretrievably tied to "French intellectual currents."The issue that fundamentally divides Dumont from his critics is his stress on analyzing ideology in terms of encompassing/encompassed aspects; for Dumont, Indian caste is hierarchical holism encompassing egalitarian individualism. His critics question this construction of a system of meaning, thereby raising the general issue of the understanding of meaning in symbolic form in social science and history. It is to this concern that we address ourselves: Dumont's approach to Indian caste ideology and his critics' (we select representatives of distinct types of criticism) alternate understandings of how to perceive (or, in extreme cases, to deny the existence of) that ideology.Within contemporary social science (especially cultural anthropology), the study of meaning as culture or ideology creates an immediate and profound impasse-posed as the problem of self-reflexivity: Do the forms through which one understands another culture reflect aspects of the analyst's culture? Put another way: Can we develop methods for analyzing culture that are founded on "rational" (verificationist, falsificationist, operational, etc.) procedures-procedures that by definition are not simply products of an historical epoch but that can stand independently of history as epistemological first principles? Such "rational" attempts to comprehend systems of meaning vastly different from the analyst's own often include claims that the analyst can "get inside the informant's head"-that the analyst can reproduce (as a kind of cognitive map) the meanings of symbols as given to the informant, or that the analyst has an overall typological classification that can include as an element of the typology any indigenous culture (the indigenous culture becoming "an instance of. . . ").Against this totalizing rationality (itself a relatively recent development in Western ideology, and thus subject to critical review), Dumont admits the limits of inquiry as historical placement and offers that limitation as the ground of a particularly anthropological form of understanding: We can understand something of ourselves by seeing ourselves in terms of other cultures; and we can understand something of others in terms of ourselves. Since social science is analytical (and analysis implies critical distance rather than simple acceptance) and since there is no generally accepted standard of rational