The Final Inch

The state of Uttar Pradesh, India is home to some 187 million people. At the start of The Final Inch, it is also identified as home to the world’s “greatest concentration of polio infection.” While the disease has been essentially eliminated in the “developed world,” even occasional infections pose threats to everyone, as it can spread quickly if given even a minimal foothold among an unvaccinated population. Already this year, some 14 infections have been reported in India, one of four countries where the disease exists (the others are Pakistan, Nigeria, and Afghanistan).

Nominated for a 2008 Academy Award, Irene Taylor Brodsky’s 38-minute documentary offers a look at India not included in Best Picture winner Slumdog Millionaire. Sometimes repetitive, always insistent, The Final Inch makes its case earnestly. At its center, UNICEF community mobilizer Munzareen Fatima points out that her work remains crucial, visiting houses each day, convincing families to vaccinate their young children (she looks some 446 homes, she says, returning each month to “make sure no child is missed.” Munzareen is unswerving in her mission. “Until your child is five years old,” she says, “He is vulnerable to the effects of polio.” Those effects are devastating. At one home, Munzareen meets with a woman with a baby in her arms, as well as her teenaged son, his legs bent. “We are giving the vaccine for free,” Munzareen points out, blaming the mother for her older son’s lifelong predicament. The mother nods sadly, noting that his crippled legs make him unmarriageable: “It was very difficult for us,” she says, “We are sorry it happened.”

“The virus is extremely opportunistic,” says one doctor, “It’s an animal, it’s looking for someplace to hide.” It may reside inside “one child’s gut,” and then, when that child moves with his family — to another country or across an ocean, for instance — the virus might find new places to thrive, and spread quickly into a new environment, including a developed nation like the U.S. Volunteers walk the streets at night, using flashlights to peer into children’s mouths and deliver the vaccine: with just “Two drops,” a classroom chant goes, “Polio disappears.”

Because it has disappeared in developed areas, the film contends, its threat has been forgotten. And so The Final Inch offers various images of polio’s devastation, including Mikail Davenport, afflicted “right after Christmas” in 1951, now riding his handcycle across Texas to “raise awareness,” as well as a 70-year-old Martha Mason, living in an iron lung in North Carolina since 1948. As she describes her older brother’s infection and death, the film shows photos of the children, healthy and stern-faced. When she contracted the disease, she says, she went to the hospital and within days, she was inside the machine that has kept her breathing for some six decades. “This is where I live,” she says grimly.

Munzareen is determined to keep even one more person from suffering such a fate. A member of what The Final Inch calls the “largest army in history,” Munzareen faces obstacles that are alternately material, philosophical, and emotional. While poverty and lack of education surely affect the families she visits, people are also suspicious of the government’s offers of help. Even if community leaders accept the premise that the virus is a function of poor sanitation, they blame authorities — local and national — for not attending to such basic living conditions. “The government has been running this program for so long,” says one man, visibly upset, “And yet we still have cases in our state.”

At the same time, Munzareen works within the expectations of her mostly Muslim environment. Though she says she’d rather not wear a burqa, she does when she goes house to house. “The burqa has many advantages,” she says. Still, some men — who have “the final word” in their homes — also resist medicine affiliated with Western powers, in particular the United States. “We worry that America made this medicine,” says one community leader. “We are against America.” When Munzareen asks why his government would make the vaccine mandatory if it was in any way harmful, he looks at her like she’s naïve. “They are all America’s pawns,” he scoffs, “Whatever America orders, everybody follows.”

Despite such suspicions, which emerge and persist for all kinds of good reasons, Munzareen refuses to give up her self-appointed mission. As Dr. Hamid Jafari of India’s National Polio Surveillance Project puts it, “If we take our foot off the accelerator, polio’s going to come back.”