Big steps in vaccination campaign

MATELILE – ON a wintry early April morning in Matelitsana, a village about 70km south-east of Maseru, villagers huddle in little groups, in their colourful blankets, as they engage in small talk.

Then the village councillor, a fairly young man in his early 40s, rises to officially open the pitso, a community meeting, to discuss the villagers’ concerns about the Covid-19 pandemic and the vaccination issue.

The women, who were in the majority, immediately break into a soulful hymn. The hymn is a plea to God for “divine intervention” and his mercies.

Since March 2020 when the then Lesotho Prime Minister Thomas Thabane declared a state of emergency following the outbreak of Covid-19, life has never been the same for this community, and many others in Lesotho.

They have seen their loved ones fall sick and die of Covid-19. They have buried loved ones. They have lived in fear of a tiny virus that has wreaked havoc on a global scale.

So it is not a surprise that in moments of such deep national anguish, Basotho, who are a deeply religious people, often go down on their knees in prayer, in a collective show of piety.

And how much they have needed that “divine intervention” as the Covid-19 pandemic swept through Lesotho, taking away loved ones and dear friends since the first case was recorded in May 2020!

It was clear that these villagers were in desperate need of practical wisdom as to how they can cope with a pandemic that has so far killed 697 people while infecting over 33 000 others, according to the National Covid-19 Secretariat (NACOSEC), an organisation that was formed to fight Covid-19.

World Health Organisation, in collaboration with the World Vision Lesotho and the Ministry of Health and the people of Matelitsana, have found able and willing partners.

When Covid-19 broke out two years ago sending the world into a state of panic, some Basotho could not comprehend that they were facing an existential threat.

There were individuals who even denied the very existence of the virus itself. They claimed Covid-19 was no worse than ordinary flu and that it would simply pass if one got infected.

But much more potently were individuals who pushed certain myths around the issues of vaccination.

It was these pockets of resistance that provided a formidable challenge to organisations such as WHO and World Vision when they began engaging rural communities.

It took a lot of hard work from both organisations to dismantle these myths brick-by-brick.

’Mampeoane Kholumo, who is the Health, HIV and Nutrition Technical Programme Manager at World Vision, says thanks to  WHO’s Access to Covid-19 Tools Accelerator Project (ACT-A), they were able to respond “to allow communities to access relevant and correct information on Covid-19”.

The ACT-A project, funded by the government of Canada is to support the development and equitable distribution of diagnostics, treatments, vaccines and protective personal equipment to reduce mortality and severe disease, restoring full societal and economic activity globally.   WHO has engaged a number of Non-State Actors such as World Vision Lesotho in order to reach hard-to-reach communities in the districts. Kholumo says the biggest challenge they faced was how to dismantle myths around Covid-19 and vaccination and convince villagers on the urgent need to take the jab.

What compounded matters was that when the ACT-A project was implemented, “many communities were still not convinced about the importance of vaccination”.

Anybody who came talking about vaccination was never taken seriously.

“They had this impression that it’s a team of people who have been bribed in an attempt to force them to go for vaccination,” she says.

“It took a lot of talking to convince them that we were being supported by the World Health Organisation as their health centre.”

“We told them that we had been capacitated on this issue because we are in a pandemic, that this is a global problem and that we want to save their lives,” she says.

“So if you can allow us, and listen to what we are saying, you will actually get the key message we are bringing to you to ensure that you survive the pandemic.”

Kholumo says convincing people to vaccinate was a very tough assignment.

Others would argue that those who had been vaccinated “were actually getting flu more frequently”.

“We were able to visit these villages until people got convinced about the services the project was supporting,” she says.

At the centre of the communities’ push-back against vaccines was their reading of certain passages of the Bible which they claimed prophesied about the “times of the end”.

“It was mostly a faith-based thing,” Kholumo says.

“They were saying it was written in the Bible that in the end of times, people will be denied services because of the 666 sign. They were trying to link vaccination with that sign saying since they were now being denied services, that this was no longer about vaccination but the 666 sign.”

“Fortunately, we have faith leaders within the health committee members which made it easier for us to address different congregations about this fear,” she says.

Kholumo says they also encountered myths among adolescents who feared that they would become infertile once they were vaccinated.

“We had to give them literature that supports the fact that all that is not possible, that it is just a myth,” she says.

“The issue of infertility was a big issue among the girls; they were the ones who were bringing this up often. They were saying they will be infertile and that their ovaries would be affected by the vaccines. Those concerns were addressed by the Wash Club teachers.”

Kholumo says the main objective of the project was “to contribute to improved community access to relevant Covid-19 response interventions”.

The idea, she says, was to help “communities see the importance of vaccination and also where they could access the vaccinations”.

“We also needed to see if there were any barriers to vaccination and address such challenges,” she says.

As they moved in rural communities, they faced a major push-back from communities that felt under siege from a government that was seeking to impose its will in its drive to vaccinate Basotho.

“When the health centre committees told the people that they were coming to sensitise them on issues of Covid, they were a bit challenged,” she says.

“At that time people felt that they were now being forced to vaccinate, for example, people were being told that the government was going to restrict their access to certain services.”

They felt that they “were also now being forced to vaccinate (by the health committees); they could not understand the importance of vaccination”.

Having recognised these “barriers” and working closely with risk communication groups in different districts, the health committees were able to address the barriers.

“We realised that most people after the education and counselling that was provided by the health centre committees, showing them examples of people who had been vaccinated, that encouraged most people to access vaccination,” she says.

Kholumo says the health committees also managed to encourage communities to continue using face masks even after they were vaccinated.

“People had an impression that once you are vaccinated, you could just go along and that you would not be infected. But they were able to provide facts around such myths to say, yes we are vaccinated but one is still at risk of being infected . . . but you won’t be affected negatively like someone who is not vaccinated,” she says.

“They managed to convince people to continue taking care of themselves.”

The health centre committees worked closely with the Risk Communication and Community Engagement (RCCE) from the Ministry of Health to address people’s concerns about vaccination.

She says that group comprises “people who are very knowledgeable about issues, they have the necessary experience. We have nurses and traditional healers in that group. They worked with such teams from the districts and that made it very easy to deal with some of these myths.”

“They needed scientific information to convince some of the people especially children,” she says.

Kholumo thanked the WHO and the government of Canada for the initiative which provided the capacity to “ensure they had the relevant information they needed on Covid-19 and the skills to mobilise for the vaccination at the community level”.

“This project strengthened the collaboration between the health centre committees and the RCCE which is the key team that is addressing all issues on Covid-19 at the district level”.

Voices from the village:

‘I was afraid of vaccination’

Although Tsietsi Mothae understood the need to vaccinate after speaking to nurses and officers from World Vision who came to his village of Ramosoeu, he was still reluctant to take the jab.

“I was a bit afraid,” he says. “People were saying a lot of things especially on local radio stations. Although I understood what the nurses taught us, I still had my reservations and didn’t vaccinate that day.”

For Mothae, it was a wait and see game. In fact, he says he wanted to wait a bit and see if those who had taken the vaccine “would survive the ordeal”.

“When I saw that they were fine, I then went to vaccinate at the health centre. But I now had to travel a (longer distance), which is the price of cowardice that I had to pay,” he says.

Thankfully, Mothae says he did not have any major side-effects.

“I would encourage everyone to vaccinate, for their own good. Some who did not initially want to vaccinate have had a change of heart,” he says.

‘There was a lot of misinformation’

Molise Mohai is the local councillor for Matelitsana which is made up of nine little villages. A councillor, which is a political office, is the first port of call in Lesotho and is often tasked with addressing villagers’ concerns around issues of governance and social harmony in rural villages.

He says he arranged community meetings for World Vision to engage the community and teach them about how they could protect themselves against Covid-19.

“We arranged gatherings for them where they would educate people and vaccinate those who wished to be vaccinated. In some villages, they went from house-to-house,” he says.

He says there were others though who were reluctant to get vaccinated.

“They were saying they had heard that some people had died after being vaccinated while others said they had heard that they would be (genetically) controlled by whites after being vaccinated,” he says.

“There was a lot of misinformation (during that campaign) but that has since gone down.”

He says what really helped was that some nurses fully “explained how the vaccine works even telling us about the side-effects and how to deal with them”.

Although there he was only aware of a single death that could be directly connected to his community, there were scores of individuals who were retrenched from their jobs as a direct result of the Covid-19 pandemic.

Mohai thanked the WHO and the Ministry of Health for the initiative saying without their help, they could not have been vaccinated.

“We could have died due to ignorance,” he says.

“Even villagers who couldn’t attend the gatherings for one reason or the other when the nurses were disseminating the information, travelled all the way to the health centre to be vaccinated. I wish the campaign was longer so that even those posted at cattle posts are vaccinated.”

‘Huge steps taken to vaccinate people’

’Matsie Letsie, who is the village chief of Matelitsana, says she was contacted by the council office informing her about the vaccination campaign being spearheaded by World Vision and the Ministry of Health.

She then arranged gatherings where villagers were to be taught about Covid-19 and for those who wanted to be vaccinated to do so.

“Although some people were initially reluctant to vaccinate, the people from World Vision and the nurses educated us and many thereafter agreed to be vaccinated,” she says.

While huge steps have been taken to encourage people to vaccinate, there are still “a few, mostly young people, who are still resisting”.

“They are being misled by what they read on social media. They are saying all sorts of baseless things, such as that vaccines kill, and that it will make them infertile and that they want to put a tracker in their bloodstream.”

Letsie is however quick to quote the Bible in providing an explanation for this current state of affairs.

“As the Bible says, my people will perish because of a lack of knowledge. As you can see, we are far from the health centre which is a source of accurate knowledge when it comes to issues of health,” she says.

“Who knows, perhaps we could have died from this pandemic if it wasn’t for this campaign by the WHO.”

She says others could also not have vaccinated since they are old and frail and cannot walk long distances to the health centre.

‘They said vaccine will kill us’

’Mathato Tlhakanelo is from a small village called Ha-’Mutsi, which is part of Matelitsana. She says when she was told that they were to vaccinate, she was simply gripped with fear.

“A lot was being said about the vaccines and that it was going to kill us,” she says.

And so when officers from World Vision and nurses from the health centre came to address the village, she was reluctant to attend.

“The nurses taught us about this Covid-19 pandemic and the vaccine. It was all new information, something we had not heard before. But what I appreciated more was that they did not withhold any information from us. They even told us about the side-effects and how to deal with them,” she says.

“I suffer from high blood pressure and the nurses told me that they were going to first assess my situation and determine if it was safe to vaccinate.”

My hand was numb for about two days and I was a bit dizzy, but I drank a lot of water and had a good night’s sleep as had been recommended, she says.

But even after vaccinating, she says some of her neighbours remain fiercely opposed to vaccination.

“I always tell them and say, look at me; here I am, I didn’t die. It has now been months since I vaccinated. But at the end of the day, we all realise it is a decision everyone must make for themselves.”

Due to the long distances, she says many people struggle to walk to the health centre.

“If the vaccine was not brought to us, many could not have vaccinated. There are many other people who default on their HIV, sugar diabetes medication due to the long distance.”

‘A wait and see game’

’Manthabeleng Ranki is a Village Health Worker in the villages of Motšohlong and Ha-Makhe. She says most people were just too afraid to vaccinate when the programme began and only relented when they saw that those who had been vaccinated had not suffered any adverse side-effects.

“I still have people who vaccinated who are still complaining that their vaccinated arms are still numb,” she says.

Educating the community

Mareitumetse Maliehe is a Village Health Worker in the village of Ha-Ramosoeu. She says her role was to speak to the community about the Covid-19 pandemic and encourage them to vaccinate against the pandemic.

“Our main role under the project was to encourage the community to vaccinate and ensure the safety of the community,” she says.

“We came across a number of challenges in trying to convince people to take up the vaccine. Some felt that the vaccine would kill them but we told them that the vaccine was risk-free and it would help them carry on with their lives. But there are still people even today who are still resisting the vaccine,” she says.

Staff Reporter