Mumbai | How the transgender community is spreading awareness of routine immunisation of children in a Thane slum

Transgender community in Mumbra, Thane, Maharashtra, aids in improving routine immunisation among children, transforming lives and saving futures.

At 11 a.m., the sun is beating down in the densely populated urban slum tenements of Mumbra in Thane, Maharashtra. But Amrien Khan is unfazed by the heat. She walks purposefully down the narrow alleys, nodding her head as she is greeted by her neighbours. She rechecks the name displayed on the tablet in her hand and turns towards a partially constructed building.

After walking up two floors, she stops in front of a room and calls out: “Salam Alaikum! The last time I came, it was to bless your newborn. I sang and performed for donations from you. Now, I have come to remind you that your baby is due for her next dose of immunisation.” Immediately, the door opens and Khan is welcomed inside.

It is not just this door that the 30-year-old has helped to open. In a unique initiative, the transgender community has been engaged to improve routine immunisation among the children of Mumbra-Kausa. With a population of 3.68 lakh, the neighbourhood of Mumbra-Kausa, comprising predominantly migrant minority communities, is the biggest contributor to zero-dose (children who have not received a first dose of diphtheria-tetanus pertussis, or DPT1, vaccine) and under-immunised children under the purview of the Thane Municipal Corporation (TMC).

Now this is changing, thanks to Sakhee, the two-year pilot project designed and implemented by ZMQ Development, a not-for-profit, with support from GAVI, the Vaccine Alliance. Transgender persons employed and trained by ZMQ have facilitated the immunisation of 733 children identified as zero-dose or missed dose since the project began in April 2023.

Just as this achievement has been life-saving for children, it has also been transformative for the transgender community. Being a part of Sakhee has boosted their confidence and provided them with a livelihood of dignity. Learning to use a mobile-based application to map and track children who have fallen off the immunisation radar has given them a new purpose in life.

For Simran, it is a chance to begin anew. Losing a leg in an accident had led to depression, an uncertain future, and financial anxiety. Although she managed to source a prosthetic limb, it was Sakhee that helped her regain confidence in her abilities. “I never got this kind of platform before to do something for the community. I’m saving lives by raising awareness through behaviour change stories on the app on each of the nine vaccines critical for children. The badge I wear around my neck has given me a new identity and respect,” she says.

For decades, the transgender community has been an integral part of the lives of the families living in Mumbra-Kausa, celebrating births, marriages and other milestones with them. ZMQ saw them as natural allies in their initiative to save lives and channelised the strength of their informant network. “As they already have access to these families, we knew they could be the bridge between them and the government health system. Since ZMQ uses technology and storytelling to share information and address hesitancy and myths about vaccines, transgender persons, with their talents in communication and performing arts, were the perfect choice for the intervention,” says Hilmi Quraishi, co-founder and chief mentor, ZMQ.