Better by Atul Gawande: Chapter 2

It has been over 2 months since my chapter 1 recap of Atul Gawande's Better. I've delivered very little after chapter 1 and Gawande's bio discusssion a while back. Despite my lack of activity, I have been progressing and feel the book is important enough to continue discussing.

Chapter 2 is titled "Mop-Up" and covers the World Health Organization's efforts to minimize the spread of a polio outbreak in India a few years ago.




The herculean task of distributing polio vaccines to millions of people, many in rural areas, was pretty amazing. The WHO had a team of only hundreds and taught the necessary vaccination procedures to thousands of volunteers and local representatives, who went door to door in all of these areas. Their target penetration for the vaccine was 90%.

What stood out most to me in this process was the diligence necessary to maintain standard procedures throughout this huge taskforce and to keep supplies at a sufficient level for everyone. For example, the vaccine needs to stay on ice to be effective. Gawande traveled with a supervisor who made rounds checking on the progress of the volunteers and making corrections as necessary.

Above all, the supervisor's attention to detail in terms of recording each and every case he came into contact with was astounding. It is diligence in reporting which gives the WHO the necessary information to learn from this mop-up and act on its lessons in the future. If those on the ground did not keep up with reporting, or if they kept sloppy records, or if they had incorrect information, then any future effort such as this would be risk being ineffective. In other words, the commitment to accumulating meaningful data and the commitment to studying and learning from that data is just as important as the actual process of vaccination itself.