A long-awaited shot in the arm
As the COVID-19 vaccination campaign unfolds in remote reaches of the country, a reflection on the journey taken by the vaccines and what they mean to waiting communities
Darchula, Nepal, 4 August 2021: Less than an hour after walking to the Pipalchauri Health Post in Duhun from her house, Lalita Dhami has already breastfed and handed off her seven-month-old son to one of her colleagues to be looked after, and is all geared up to kickstart the day’s COVID-19 vaccinations. The auxiliary nurse midwife or ANM is one of two vaccinators working the drive this morning.
“I’ve been vaccinating people since the start of the campaign, but it’s exciting because this is the first time we’re giving this new vaccine,” she says.
Lalita is referring to the fact that the health facility – resting in a remote corner of Darchula District, itself located on the very edge of the country’s far-western border with India – is administering the single-shot Johnson & Johnson COVID-19 vaccines for the first time. The vaccines were part of over 1.5 million doses that were donated by the US Government to Nepal through the COVAX Facility.
As with other COVID-19 vaccine arrivals, the US-donated vaccines have undergone quite a journey since landing at the Tribhuvan International Airport in Kathmandu on 12 July 2021. Shortly after being moved to the Central Vaccine Store, as per provincial allocations, batches were sent out to different provinces via road, to be kept at the province-level vaccine stores. From here, allocated doses were delivered to various district vaccine stores, before being collected and carried – often on foot – by representatives of health facilities like Pipalchauri to their respective localities.
Given this long route that vaccines take to reach communities, UNICEF has been working closely with the government and key partners such as Gavi for decades now to assess, expand and strengthen the country’s cold chain capacity, so as to keep vaccines safe throughout.
This has included installation of cold rooms, refrigerators and freezers in vaccine storage facilities at the central, provincial, district and local levels, refrigerated containers for transportation, as well as supply of cold boxes and carriers. UNICEF also provides technical and logistical support at federal, provincial/district and local levels for effective vaccine and cold chain management.
According to Madan Chand, cold chain consultant for UNICEF Nepal, the cold chain has long played a crucial role in ensuring the quality and effectiveness of vaccines that were being distributed around the country, primarily for routine immunization programmes targeted at children.
But, he says, “the importance of that role has become all the more evident during the current COVID-19 pandemic, in a context where more and more vaccines are coming in.”
There is certainly no dearth of interest from Duhun locals in these arrivals. According to Parbati Mahara, another ANM at Pipalchauri, while people had initially been skeptical of vaccines when the drive was first launched earlier this year, hesitancy has since waned considerably, particularly in the wake of the second wave of the pandemic and the devastation it wrought across the country.
On its part, the health post has also been working to raise awareness and interest in the vaccines, through miking, counselling and the reach of female community health volunteers, among other efforts.
“All these combined have helped to increase vaccine confidence in the community,” Parbati says.
Among the first to arrive at Pipalchauri today is 45-year-old Dhaula Devi Mahara. The Duhun local says she had been told about the vaccine by a female community health volunteer and had quickly made up her mind to come. “The decision wasn’t hard, especially when I learned that it would be over in a single dose so we don’t have to come back,” she says, grinning.
It was a similarly obvious choice for Bir Singh Kunwar, 55, another local come to get the shot. Although most of the elderly people in his family have now been vaccinated against COVID-19, he hopes the vaccine drive will be expanded to younger groups soon, so his sons and daughters can get it too.
“Everyone should be given a chance to protect themselves,” he says.