Reaching vaccines to a forgotten village

Hidden deep in the hills of West Kameng district, the small tribal settlement of Tippi Nalla is home to just 36 households and 186 people. Surrounded by dense forest and steep terrain, it is a two-hour trek from the nearest road-accessible village. Because of this isolation, it had missed being included in routine immunization plans.

That changed in late 2024, when a micro-plan review flagged the village as missing. A rapid assessment soon revealed a stark reality: most children under five had never received a single vaccine. Geographic isolation, combined with a lack of outreach services, had created significant barriers to health-care access for the community, who work as migrant forest workers.

A WHO field team addressing a community meeting supported by village headman Mr Kachi Puroik to promote immunization and healthy behaviours (Photo: © WHO India/ Pakke)

Recognizing the urgency, WHO-National Public Health Support Network accompanied the district health department to reach out—not just with vaccines, but with dialogue. They sat with the village headman and a local religious leader, listening to concerns and building trust. Their support proved crucial in overcoming hesitation. Through open discussions, the team identified barriers ranging from lack of awareness to concerns and hesitancy around vaccines. Building trust became the first and most critical step.

The findings were promptly shared with block and district health authorities, triggering swift and coordinated action. Under the leadership of the district commissioner, a multi-sectoral health camp was organized in Tippi Nalla. For the first time, a team of vaccinators, mobilisers, and health workers made the arduous journey on foot to deliver services directly to the community.

Guided by trusted community figures, families came forward. Seventeen children received their first-ever vaccine doses during the initial outreach, marking a significant breakthrough. Although three families were temporarily absent due to seasonal migration, follow-up efforts ensured they would not be left behind.

WHO field teams and village headman Mr Kachi Puroik (Left, in blue) address the concerns of vaccine-hesitant families in Tippi Nalla (Photo: © WHO India/ Pakke)

Tippi Nalla has been formally incorporated into the Routine Immunization micro-plan, with quarterly outreach sessions scheduled. Ms Sara Khonjuju, an ASHA worker from a neighbouring village, has been assigned to support continuous service delivery. To date, five immunization sessions have been conducted, and all children under five have now received their due vaccines.

The impact has extended beyond immunization. Recognizing the broader needs of the community, the district administration has initiated steps to improve road connectivity and ensure access to safe drinking water—critical determinants of long-term health and well-being. “Our children are protected now. Health teams provide doorstep health services. We are thankful to you,” said village headman Mr Kachi Puroik, reflecting the quiet but powerful transformation.

Tippi Nalla is a powerful reminder that the most vulnerable populations are often the hardest to see—but not impossible to reach. With careful micro-planning, strong community engagement, and committed leadership, even the most remote communities can be brought into the fold—ensuring that no child is left behind in the journey toward universal immunization.