Taking vaccines to initiation schools

Mohale’s Hoek – For centuries, initiation has been viewed as an important rite of passage and a cherished tradition among Basotho men.

Young men, some in their early teens, still go into the mountains for months where they are taught how to be real men and the responsibilities that come with that.

When the Covid-19 pandemic broke out in Lesotho in March 2020 that presented a challenge. How would the government reach out to these thousands of young men and their teachers, some who were isolated in initiation schools in the mountains, and get them vaccinated?

Martin Semanama, an officer in the District Administrator’s office dealing with chieftaincy affairs in Mohale’s Hoek, says when Covid-19 struck there was initially no clarity as to how they would tackle the disease.

“The men who lead the traditional affairs are generally old men and did not know the best way of dealing with the disease and how people could avoid infecting one another,” he says.

“It is important that the Ministry of Health (and UNICEF) came and educated these men so that they would be able to deal with these issues appropriately.”

Semanama says the Ministry of Health approached the DA’s office in Mohale’s Hoek and asked them to invite “these men running initiation schools” to speak to them.

“We are grateful to the Ministry of Health and those associated with them (for the endevour),” he says.

He says when the government lifted the hard-lockdown in 2020, they sent letters to all chiefs in Mohale’s Hoek informing them that initiation schools were now free to operate.

But there was one condition: that every person attending initiation should produce a vaccination card. The result, Semanama says, was a surge in vaccinations in Mohale’s Hoek.

Although there were minor hiccups here and there, Semanama says “the vaccination roll-out process went very well in Mohale’s Hoek”.

Kimanzi Muthengi, UNICEF’s Deputy Representative to Lesotho, says the Covid-19 pandemic has taught them critical lessons that will help the world react to future global disasters.

“The pandemic has taught us to be well prepared. It taught us to always have a stockpile,” Muthengi says.

“We are looking at a situation where there will be emergency funding to the donor community so that we can quickly respond to pandemics in terms of resource mobilisation.”

“The other lesson is the quick adjustment of programmes and the way we respond on the part of the UN and our partners.”

Muthengi says the ability for governments to work differently to mobilise human and technical resources to respond has been a great lesson”.

He says for UNICEF’s programming “having reliable partners, the Ministry of Health, the non-governmental organisations, the community and also young people have proved to be very critical in coming up with an effective response to the pandemic”.

Muthengi, who is also the Acting Country Representative, was speaking as UNICEF is in the final stages of the implementation of the Covid-19 response project funded by the European Union Civil Protection and Humanitarian Aid (ECHO).

The project seeks to help ensure that countries are supported and vaccines reach the whole population, including the most vulnerable.

Support has been through training for health workers, shoring up logistics and building confidence in vaccine take-up.

The ECHO project is a contribution to the overall Covid-19 response that UNICEF, the Ministry of Health and other partners have been involved in since the pandemic broke out in 2020.

In Lesotho ECHO helped in the procurement of the cold chain equipment and building the capacity of community health workers.

It has also assisted with the operational cost of distributing, supporting activities at the community level and social behavioural change campaigns.

UNICEF has been at the forefront of several preparatory logistical support and capacity development support to help Lesotho respond to the pandemic through the distribution of vaccination.

One of the main components of the ECHO project is the initiative to increase vaccination uptake among males.

Muthengi says this was a critical intervention because research has shown that vaccination among males is lower compared to that of women.

The national vaccination coverage for males is about 53 percent compared to that of women which is 70 percent.

This mismatch, he says, may be due to many socio-cultural reasons and myths around vaccination.

“Specifically, you may have heard that there were perceptions that vaccination will reduce male libido and such unfounded myths around vaccines,” Muthengi says.

UNICEF, the Ministry of Health, District Health Management Teams, community health workers and Red Cross Lesotho have been engaging targeted male groups to increase the uptake of Covid-19 vaccines.

The project specifically targets community leaders such as chiefs and those involved in initiation schools.

Muthengi says UNICEF is grateful for the support from the “Lesotho government which had given full support to Covid-19 interventions through the Prime Minister, the Minister of Health and directors.

“The ministry’s staff has been in the forefront of receiving, storing and distributing and eventually having the vaccination reach their last mile. While this grant was supporting the pipeline we also had many stakeholders who contributed to providing the vaccines,” Muthengi says.

“Let me give appreciation to private sector members who were able to mobilise resources to provide funds for the African Union facility for the vaccines which in turn was able to ensure that Lesotho has a lot of access to the vaccines,” he said.

He said the general support from ECHO has enabled UNICEF to reach the last mile through the provision of cold chain equipment, mobilisation of the vaccine and socio-behaviour change campaign.

“This has been very central to the success of the programme.”

Chief Moopisa Makhosane

As a village chief, one of Moopisa Makhosane’s roles is to ensure that those running initiation schools comply with the set regulations.

The idea, Chief Makhosane says, is to ensure the safety of the young men who get enrolled in the schools.

“We inspect to see if those running the schools have met all the requirements, if they have been vaccinated and if there is enough food,” he says.

“We also check if the traditional doctors have the right qualifications and the age of the teachers. That is our job. We need to inspect these to ensure they are fit for the job.”

But even after UNICEF and the Ministry of Health officials explained the advantages of vaccination, some men running initiation schools were initially reluctant to do so.

“The men were initially afraid to get vaccinated because they had heard rumours that people would be able to trace their every move,” he says.

“But after noticing the benefits of vaccination, men have been very much willing to vaccinate.”

Makhosane says he would summon his people for a gathering when nurses visited his village. It was during these community gatherings where the people would be taught the benefits of vaccination.

He says it remains very important for any young man intending to go for initiation to first get vaccinated.

“Covid-19 remains a very dangerous disease,” he says.

“I would therefore encourage all those intending to go to initiation school to first go to the clinic to get their Covid-19 vaccination because this is a fatal disease. It can take a father, a child or the mother. It does not discriminate.”

Moherane Tsolo

Moherane Tsolo, 73, runs an initiation school in Thaba Tšoeu in Mohale’s Hoek.

He says a wake-up call for him came when Covid-19 began affecting some of the children under his care.

“Many children were hurt when they did not get the vaccine. That’s when we realised that the vaccine is important,” Tsolo says.

While others were in panic mode and were hesitant to take up the vaccine, Tsolo says he was calm and ready to vaccinate, thanks to “the guidance we received”.

“All our fears were removed,” he says.

He says it is important that men who are running initiation schools continue to “work together to protect children in our communities”.

Tsolo says he takes these children to the mountains for a period of six months.

Ralikonyana Ralikonyana

Any programme that seeks to change the behaviour of men would need the buy-in of key men at the centre of power in rural villages.

Once you get them on one’s side, half the battle for change would have been won.

That is the strategy that UNICEF has been using to get men in initiation schools get vaccinated.

At the centre of this strategy has been men like Ralikonyana Ralikonyana, 71, who has been engaged to be part of the discussions on traditional matters in his district of Mohale’s Hoek.

They deal with traditional issues such as initiation and how to handle challenges like the Covid-19 pandemic in relation to their culture as Basotho.

They are a key voice in influencing change.

“It is important that every child that goes to an initiation school be vaccinated so that they attend school with a healthy body,” he says.

“We are very happy with the training we have received today (from UNICEF) in Mohale’s Hoek. It is the light that we need. It will help in addressing areas we were not aware of.”

Ralikonyana was speaking after a half-day workshop on the Covid-19 pandemic held in Mohale’s Hoek recently. Traditional leaders, representatives from UNICEF and key men in rural villages attended the workshop.

Ralikonyana says the vaccination message was well received in Mohale’s Hoek.

“I am very impressed with the number of people who got vaccinated,” he says.

“All the groups have been vaccinated, that includes us as the people running initiation schools, students, parents. Most of them have received the Covid-19 vaccine.”

“I want to encourage the Majantja people (people from Mohale’s Hoek district) and those getting ready to go to initiation schools to get vaccinated. Once we all get the vaccine, we will all be strong.”

Staff Reporter